Objective To evaluate the clinical outcomes of pedicle screw fixation in the treatment of Hangmans fracture. Methods The 15 patients who had been treated for acute Hangmans fracture in our department after 1999 were retrospectively analyzed. 4 of them were type I, and 11 type II. All the patients presented symptoms of nerve system at different degrees. They were treated with AO pure titanium cortex screw through isthmus after skull traction replacement. Results All the patients were followed up for 12 to 60 months. According to Frankle classification, 6 cases of Grade D and 5 cases of Grade C recovered up to Grade E, 2 cases of Grade C recovered to Grade D, 1 case of Grade B recovered to Grade C and 1 case of Grade B recovered to Grade D. X ray showed all the fractures healed up without vertebra artery injury or other complications. Conclusion The outcomes of pedicle screw fixation and reduction in treatment of acute Hangmans fracture are satisfactory, for the clinic technique promotes functional recovery of spinal cord, decreases the rate of infection and scarcely affects the function of upper cervical spine.

Objective To study the molecular characteristics of the Staphylococcus aureus isolated from the intensive care units (ICUs) of children's hospital.Methods From January 2016 to December 2016,a total of 39 S.aureus strains were collected and identified from various clinical specimens that were obtained from patients who were confined in the neonatal and pediatric ICUs of Beijing Childreng Hospital.Methicillin-resistant S.aureus (MRSA) and methicillin-susceptible S.aureus (MSSA) were identified using the cefoxitin disc method and the detection of the mecA gene.Multilocus sequence typing (MLST) and spa typing were analyzed using the PCR,and the staphylococcal chromosomal cassette mec (SCCmec) type was analyzed for the MRSA isolates.Twenty-one superantigen genes and the Panton-Valentine leukocidin (pvl) gene were also detected by PCR.Their susceptibility to 12 antibiotics was evaluated using the E-test method.The differences in prevalence of virulence genes and antimicrobial resistance were compared between the MRSA and MSSA isolates by Fisherg exact test.Results All the S.aureus strains were isolated from secretion inside the airway of pneumonia (including severe pneumonia),the blood of patients with bacteremia,and exudate of skin and soft tissue infections.ST59-SCCmecⅣa-t437 (55.6％) and ST398-t571 (28.6％) were the most predominant clones of MRSA and MSSA,respectively.Of the 39 isolates,26 strains (66.7％) had at least one superantigen gene,and seb (38.5％),sek (30.8％),and seq (20.5％) were the most common genes;seb-sek-seq (18.0％) was the main virulence genotype.The pvl geneg positive rate was 25.6％,and no significant difference between MRSA and MSSA was observed (P ＞ 0.05).Notably,79.9％ of the S.aureus isolates were multidrug resistant,and 94.9％,53.8％,and 51.3％ of the isolates were resistant to erythromycin,clindamycin,and chloramphenicol,respectively.The tested isolates were susceptible to trimethoprim/sulfamethoxazole,rifampicin,and vancomycin.Conclusions The S.aureus strains from the ICUs of childreng hospital were isolated from the secretion inside the airway of pneumonia (including severe pneumonia),the blood of patients with bacteremia,and exudate of skin and soft tissue infections.ST59-SCCmecⅣa-t437 (55.6％) and ST398-t571 (28.6％) were the common clones of MRSA and MSSA,respectively.The prevalence of superantigen genes and the multidrug resistant rate were relatively high.

As perimenopausal syndrome is a particularly disturbing condition to the patient, it is practical and necessary to establish a program of comprehensive traditional Chinese medicine therapy for women with perimenopausal syndrome.

Objective To explore the effectiveness of different multiple comparisons correction methods by comparing the detection rate and false positive rate of brain activation analysis using functional magnetic resonance imaging ( fMRI) data. Methods On the basis of task-based fMRI dataset ( including low-intensity and high-intensity stimuli condition,n=20) and resting-state fMRI dataset( n=32),brain acti-vation results were corrected by multiple comparsion correction methods in SPM and SnPM13 software,and the activation detection rate and false positive rate were compared with different correction methods. Results Voxel-or peak-based correction methods had relatively low false positive rate. When P<0. 05 after correction,the proportion of the subjects with false-positive were 0. 19 and 0. 16,and the number of false-pos-itive voxels were 404 and 2 448,respectively. But the two methods had low detection rate,which were more suitable for detecting strong activation. While cluster-based correction methods had relative high detection rate and high false positive rate. When P<0. 05 after correction,the proportion of the subjects with false-posi-tive were 0. 34 and 0. 38,and the number of false-positive voxels were 7 870 and 8 320,respectively. And thus they were more suitable for detecting weak activation. Group-level analysis could effectively reduce false positive rate. Conclusion In practice,researchers should choose a suitable correction method based on their specific research objectives and data to achieve a balance between the detection rate and false positive rate.

Objective To detect the positive rates of antibodies against avian influenza virus (AIV) subtypes H5, H6, H7 and H9 among people in poultry occupations in Guangdong province and to analyze the transmission of various subtypes of AIV from poultry to human contacts for the prevention and control of novel AIV infection in human beings.Methods Serum specimens were collected from 1066 peo-ple in poultry occupations ( occupational group) and 205 people not in poultry occupations ( non-occupational group) in 10 cities of Guangdong province.The inactivated AIV strains, isolated from poultry or environment of Guangdong province, were used as antigens to detect antibodies against AIV subtypes H5, H6, H7 and H9 by using the hemagglutination inhibition ( HI) assay.Results The positive rates of antibodies against AIV subtypes H5, H6, H7 and H9 carried by people from the occupational group were respectively 0.44%, 0%, 0.30%and 0.30%in 2013 and 1.08%, 0.0%, 0.0%and 0.27%in 2014.Only the anti-H9 anti-bodies were detected in serum samples collected form people in the non-occupational group in 2013 with a positive rate of 0.95%.No significant differences with the positive rates of anti-AIV antibodies were found between the occupational group and the non-occupational group.However, the geometric mean titer ( GMT) of anti-AVI antibodies in people from the occupational group was higher than that of the non-occupational group.Conclusion Although a grand spread of AIV from avian to human is not likely to happen yet, con-tacting with poultry is the risk factor for AIV infection in Guangdong population.A long-term surveillance of anti-AIV antibodies in serum should be strengthened among people in poultry occupations for the timely pre-vention and control of novel AIV outbreak.

Objective:To investigate whether anxiety state and anxiety trait modulate specifically pain-induced brain responses by comparing the brain activations induced by painful stimulation and those by tactile stimulation in college students with different levels of anxiety state or anxiety trait.Methods:From April 2017 to September 2017, sixty-two college students were tested in Tianjin Medical University General Hospital.Each subject’s anxiety trait and anxiety state were assessed by the state-trait anxiety inventory (STAI) prior to the fMRI experiment.During the fMRI experiment, each subject received painful and tactile stimuli.Their brain responses to each stimulus were collected by the MRI scanner, and the perceived intensity rating of each stimulus was collected using the visual analogue scale (VAS). The pain and tactile brain activation values of subjects with different state anxiety levels and different trait anxiety levels were compared.The fMRI brain activation was detected using general linear model.For each type of anxiety (state or trait), two-way ANOVA was performed to detect the interaction between anxiety level and stimulus modality on brain responses and two-sample t-tests were performed to analyze the specific form of interaction in each brain region. Results:There were interactions between state anxiety and stimulation modality on the activation intensity of bilateral posterior parietal lobe, dorsolateral prefrontal lobe and other brain regions( P<0.05, cluster-level FWE corrected) .The brain responses to tactile stimuli (5.66±0.65) in these areas were significantly stronger than those to painful stimuli (1.24±0.55) in the group of middle-level anxiety state ( P<0.001), but no significant difference was found in the other two groups (both P>0.05). For anxiety trait, a few brain areas in bilateral occipital cortex showed significant interactions between anxiety level and stimulus modality.The brain responses to tactile stimuli (8.38±1.00) in these areas were significantly stronger than those to painful stimuli (3.19±1.12) in the group of high-level anxiety trait ( P=0.001), but no significant difference was found in the other two groups (both P>0.05). Conclusion:The modulatory effects of anxiety (both state and trait) on brain responses are different between painful and tactile conditions.It provides important evidence for unveiling the brain mechanisms of the specific modulation of anxiety on pain, and suggests that patients' anxiety trait and anxiety state should be considered during clinical treatment of pain.

Objective To investigate the molecular characteristics,virulence genes and antimicrobial susceptibility to Staphylococcus aureus strains isolated from children with skin and soft tissue infections (SSTIs) in Beijing.Methods A total of 52 Staphylococcus aureus isolates were collected from children with SSTIs in Beijing Children's Hospital,Capital Medical University,and the clinical data were collected and analyzed.Methicillin-resistant Staphylococcus aureus(MRSA) and methicillin-susceptible Staphylococcus aureus(MSSA) were identified by using the cefoxitin disc method and the detection of mecA gene.Multilocus sequence typing (MLST) and staphylococcal protein A (spa) typing were analyzed by the PCR method,and the staphylococcal chromosomal cassette mec (SCCmec) type was analyzed for the MRSA isolates.The pvl,eta,etb,tsst-1 and hlg genes were also detected by PCR.The susceptibility strains to 16 antibiotics were evaluated by using the agar dilution method.Results A total of 52 Staphylococcus aureus SSTIs patients,30 with MRSA infections and 22 with MSSA infections were included in the study.There were 23 patients (44.2％) less than 1 year old.The most frequent infections were the newborn omphalitis (12/52 strains,23.1％)and abscess(11/52 strains,21.2％).ST59-MRSA-SCCmecⅣa-t437 was the most predominant clones of MRSA isolates.Among the MSSA isolates(14/30 strains,46.7％),no significant epidemic clone was found.Ten sequence types (STs) and 14 spa types were identified in MSSA,and the most common types were ST22(6/22 strains,27.3％)and t309 (5/22 strains,22.7％),respectively.Notably,the multidrug resistant rates of MRSA and MSSA isolates were all ＞ 85％.The percentages of the Staphylococcus aureus SSTIs strains resistant to Erythromycin,Penicillin,Chloramphenicol and Clindamycin were 100.0％,94.2％,69.2％ and 63.5％,respectively.The tested isolates were susceptible to Trimethoprim/Sulfamethoxazole,Mupirocin,Fusidic acid,Tigecycline,Linezolid and Vancomycin.The pvl gene's positive rate was 40.4％,and no significant difference between MRSA and MSSA was observed (P ＞ 0.05).Eta and etb genes were detected in 2 patients with staphylococcal scalded skin syndrome.Conclusions The Staphylococcus aureus SSTIs strains are most frequently isolated from newborn omphalitis and abscess in Beijing.The multidrug resistant rate is relatively high,so the erythromycin and clindamycin should not be preferred in empiric treatment of children with Staphylococcus aureus SSTIs.The prevalence of pvl gene is 40.1％.ST59-MRSA-SCCmecⅣa-t437 is the common clone of MRSA,while the MSSA isolates have a more diverse genetic background.

Objective To explore the value of curvature value of liver surface nodularity(LSN)based on MRI in evaluating liver function in patients with liver cirrhosis.Methods A retrospective analysis was made on the patients who underwent upper abdomen MR examination at 3.0T.The normal liver function patients and cirrhosis patients were enrolled in the study and then the Child-Pugh score of the patients were calculated.The patients were divided into three groups:normal liver group,compensated cirrhosis group and decompensated cirrhosis group.The water phase imaging of 3D modified Dixon fast field echo(mDixon-FFE)sequence was copied in DICOM format.ITK software was used to manually draw the full-thickness liver edge by two observers.The curvature value of LSN was obtained by using matlab self compiled code for follow up analysis.Kruskal-Wallis H test was used to compare the curvature value between the groups.The receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was obtained.Spearman test was used for the correlation analysis.Results The curvature values of LSN among the normal liver,compensated cirrhosis and decompensated cirrhosis groups gradually increased(P<0.05).Comparing normal liver with compensated cirrhosis,the AUC of diagnosing compensated cirrhosis was 0.84,with the sensitivity of 72.7%and the specificity of 89.3%.Comparing compensated cirrhosis with decompensated cirrhosis,the AUC of diagnosing decompensated cirrhosis was 0.91,with the sensitivity of 80%and the specificity of 90.9%.There was a moderate positive correlation between the curvature value of LSN and liver function score in patients with cirrhosis(r=0.63,P=0.002).Conclusion The curvature value of LSN based on MRI can be used for preliminary evaluation of liver function of liver cirrhosis,with the AUC more than 0.80 and higher sensitivity and specificity.

Objective The aim of this study is to explore the mechanism of canonical Wnt signaling pathway in type 2 diabetes mice peripheral neuropathy. Methods Male C57BL6 mice were randomly assigned to three groups. One group treated with normal diet as control. And the rest were used to establish the diabetic model through the combination of 60 kcal% high fat diet and an administration of multipleand low dose of streptozotocin on 5 consecutive days. When the model of type 2 diabetes mice peripheral neuropathy was successfully established, one group was injected with the canonical Wnt signaling pathway inhibitor XAV 939 ( T2DM-XAV 939 group) and the other one was injected with phosphate buffer saline (PBS) as control (T2DM-PBS group). The 21stweek was the end point of the experiment, and fasting blood glucose, insulin level, homeostasis model assessment for insulin resistance (HOMA-IR), plantar test, and exercise tolerance were measured, realtime PCR were adopted to detect the related mRNA expression of the canonical Wnt signaling pathway. Results T2DM-XAV 939 group had higher total cholesterol, triglyceride, fasting blood glucose, and HOMA-IR than T2DM-PBS group, but showed no statistical difference. The enzymatic activity of glutamic oxaloacetic transaminase was lower level than that in T2DM-PBS group (P＜0.05); T2DM-XAV 939 group had significantly higher plantar test and poorer exercise tolerance than those in T2DM-PBS group (P＜0.05). The mRNA levels of genes in canonical Wnt signaling pathway such as β-catenin, c-myc, mitochondrial transcription factor A (TFAM) had slightly lower level than those in T2DM-PBS group, without statistical difference, and the protein expression of c-myc was lower than that of T2DM-PBS group (P＜0.05). The insulin receptor substeate 2 (IRS-2) mRNA expression was higher than that in T2DM-PBS group (P＜0.05). With the development of the experiment, we found that the survival rate of the T2DM-XAV 939 group was significantly reduced compared with the other groups. Conclusion Inhibition of the canonical Wnt signaling pathway may aggravate diabetic peripheral neuropathy.

The epidemic of corona virus disease 2019 (COVID-19) is still ongoing, and infections among health care workers are not uncommon. How to complete the diagnosis and treatment of orthopaedic diseases and prevent the spread of the epidemic is a great challenge for orthopaedic surgeons. On the basis of exposure history and medical conditions of orthopaedic patients, the hierarchical control is very important for reduction of the exposure for the medical staff and patients. In order to ensure medical safety and reduce the consumption of materials for the epidemic prevention, we classified the hospitalized orthopaedic patients into three classes and six levels, to provide effective references for all levels of hospitals in orthopaedic clinical work.