0.05). No loosening, distortion and breaking of fusion apparatus were found. Conclusion STT arthrodesis simulated in new fusion apparatus does not show displaced even though forced the utmost movement in range of motion of extension 35?/flexion 50?, radial deviation 10?/ulnar deviation 30?. STT arthrodesis can get excellent stability using new fusion apparatus.

0.05).②blood test and gastrointestinal reaction of the two groups one month after operation:The leukocytopenia(

Objective To analyze the injury characteristics in 2004-2009 road traffic accidents (RTAS) of 0-25 years old adolescents treated in Beijing 120 Emergency Center so as to provide scientific basis for making effective measures in prevention and control of RTAs. Methods The data of all the adolescents with traffic injuries treated in Beijing 120 Medical Emergency Center were collected for a retrospective analysis on sex,age,traffic injury time,wound regions,injury characteristics and death condition of the injured adolescents. Results( 1 ) There were 17 232 injuries and 259 deaths according to the traffic reports from 2004 to 2009. Among the total injury cases,there were 4 229 cases of 0-25 years old adolescents (24.5％),at (20.13 ± 4.43 ) years of age.The injury number showed a significant rising trend with the increase of age and the injury number of 20 years old group were obvious more than that of other age groups.(2) There were 2 252 males and 1 677 females,with ratio of males to females for 1.5:1 ( P ＜ 0.05 ).( 3 ) Total number of patients was decreased yearly.The high incidence of adolescent RTAs could be seen in September,October and May in one year; Friday,Saturday and Sunday in one week; and between 8:00 am and 11:00 pm in one day.The low incidence of adolescent RTAs could be seen in Tuesday in one week,and 3:00-6:00 am in one day (P ＜0.05).(4) Cases of limb and arthrosis wounds (53.4％) were more than those of head and neck wounds (35％).Most of the cases were pedestrians (49.1％ ).(5) There were 38 deaths,including 28 males and 10 females,at ageof (19.29 ± 5.30) years.The death were mainly resulted from craniocerebral injuries (87％),which mainly concentrated in July ( 13.2％ ) and August ( 15.8％ ). Conclusions The present condition ofadolescent traffic injuries is not good enough.We should strengthen traffic security education,increase executive powers in the traffic rush and promote cooperation and communication in pre-hospital emergency,as may be beneficial for decreasing adolescent RTA.

Objective To investigate the rehabilitation prognoses of children with traumatic brain injury (TBI).MethodsA retrospective analysis was made in 64 children who had been admitted for rehabilitation.Their clinical information,rehabilitation protocols,recovery of consciousness and ability in the activities of daily living (ADL) were analyzed. ResultsThe children's injuries were severe-42.19％ had consciousness disorders,but 80％ of them recovered consciousness after rehabilitation.Their limb motor dysfunction was dominated by hemiplegia (51.67％).For 65.63％ of the patients rehabilitation was initiated within one month after injury.The average length of stay in rehabilitation was 33.09 ± 25.96 days.Those with consciousness disorders stayed significantly longer than those without.The main treatments were hyperbaric oxygen therapy,exercise and neurotrophic drugs (the ratios were 95.31％,89.06％ and 82.81％ respectively).After the first course of inpatient rehabilitation,the conscious ness recovery rate was 81.48％ and ADL ability improved significantly.The total effectiveness rate was 90.63％.Univariate and multivariate analyses showed that the factors most strongly correlated with effective rehabilitation were age at injury and the rehabilitation intervention time.ConclusionThe results suggest that a general hospital should focus on early (acute and subacute phase) rehabilitation.So developing the rehabilitation network system is necessary and urgent.Rehabilitative therapy is very helpful in TBI cases.Being older at the time of injury and earlier rehabilitation intervention predict better short term outcomes.It is necessary to build and improve on a more standardized and systemic rehabilitation and assessment system for pediatric TBI.

Objective This study used multivariate regression analysis to study the prevalence of malnutrition and the impact of malnutrition on independence in activities of daily living,health outcomes,chronic disease and healthcare cost among older Chinese adults.Methods This study was based on data from the 2013 China Health and Retirement Longitudinal Survey(CHARLS).The CHARLS data covers information on demographics,family,health status and functional limitations,health insurance,employment and earnings among mid-aged and older community-dwelling Chinese.This research focused on older Chinese adults aged 60 years and over.As a result,over 5,900 subjects were included.This study defined malnutrition based on body mass index,weight loss and reduced handgrip strength.Functional status was assessed via adapted versions of the Katz index of independence in basic activities of daily living (ADL)and the Lawton-Brody index of independence in instrumental activities of daily living (IADL).Health outcomes included self reported health status.Then multivariate regression analysis was used to investigate the relationship between malnutrition and various health outcomes.Results Thirty percent of older Chinese adults were malnourished.Malnutrition was associated with significantly lower IADL (OR =0.868,P ＜ 0.05),poorer health status(OR =0.675,P＜0.001),as well as higher probability of having stroke(OR =1.399,P＜0.05)and chronic stomach disease(OR =1.241,P＜0.001).As a significant contributor of poorer self-reported health status,malnutrition,in turn,increased hospital cost by ￥214 (14％increase,P＜0.01)per person per year.Conclusions Malnutrition leads to functional limitations and worse health outcomes among community-dwelling older Chinese adults.These results imply that nutrition interventions such as nutrition screening and assessment,making scientific and personal nutrition support plans,and providing timely adequate nutrition support therapy can improve the health status and lower the healthcare cost of older adults living in the community.

OBJECTIVE:To study the lifespan effect of ethyl acetate extract from Polygonum multiflora(EPM)on caenorhab-ditis elegans,and to investigate its anti-aging effect. METHODS:EPM low-concentration,medium-concentration and high- concen-tration groups(25,37.5,50 mg/L,calculated by crude drug)and blank group(0 mg/L)were established to investigate the effects of EPM on the lifespan of caenorhabditis elegans. EPM group(37.5 mg/L)and blank group(0 mg/L)were established to perform re-productive test,acute heat stress test and acute oxidative stress test of caenorhabditis elegans. The effects of EPM on reproductive capacity and pressure stress of caenorhabditis elegans were investigated. RESULTS:The lifespan test,average lifespan of cae-norhabditis elegans in EPM low-concentration,medium-concentration and high-concentration groups were prolonged significantly, compared to blank group(P<0.05 or P<0.01),especially in EPM medium-concentration group. In reproductive test,the number of offspring of caenorhabditis elegans in EPM group on the second and third day were increased significantly,compared to blank group (P<0.05). In acute heat stress test and acute oxidative stress test,average survival time of caenorhabditis elegans in EPM group was prolonged significantly(P<0.05). CONCLUSIONS:37.5 mg/L EPM can retard the aging process of caenorhabditis ele-gans and doesn’t damage the reproductive capacity.

ObjectiveTo investigate the epidemiological features and risk factors of road traffic injury in Beijing.MethodsData of road traffic injuries of Beijing Changping Hospital in 2010 was collected for statistical analysis of the epidemiological features. ResultsA total of 990 cases of road traffic injuries were treated in Beijing Changping Hospital in 2010,with a male/female ratio of 2.57:1 and at average age of 45 yeats.There were 21 cases aged ＜ 18 years,703 cases aged 18-55 years and 266 cases aged ≥56 years.Self-employed individuals and fanning production staffs were the risky population that were easily subjected to road traffic injuries.Summer and autumn were the accident-prone seasons.The most common injury site was the lower limbs,next with the neck and head.The hospital stay was mainly in a range of 5-10 days (12.8 days on average).ConclusionsMale self-employed individuals and agricultural producers are the high-risk groups of road traffie accidents in the area,where shows a high occurrence of road traffic accidents in the summer and autumn.Thereby,traffic safety education and prevention-control measures based on these characteristics should be carried out to effectively reduce the number and severity of the local traffic injuries.

OBJECTIVEThe aim of this study was to establish a standard protocol for detection of EGFR mutations in cytologic specimens.

METHODS287 cytologic samples were collected from the patients who were suspected of having lung cancer at six hospitals in Beijing. A detection protocol for EGFR mutations was designed. Two comparative experiments were carried out for the coincidence in EGFR mutation rates between direct sequencing (Seq) and amplification refractory mutation system (ARMS) methods, and between 40 matched cytologic samples with formaldehyde-fixed paraffin embedded (FFPE) cytologic blocks and cytospin slides.

RESULTSTumor cells were found in 236 out of 287 cases (82.2%, 236/287) . Among them, there were 31 cases (13.1%, 31/236) of low tumor cell content samples and 205 cases (86.9%, 205/236) of high tumor cell content samples. 180 cases in the high tumor cell content samples (87.8%, 180/205) were diagnosed to be consistent with NSCLC. 25 out of 194 cases were ruled out or indefinite to be diagnosed as NSCLC by immunohistochemistry. By direct sequencing, the mutation rate of EGFR was 27.8% (50/180) in NSCLC samples and 28.2% (50/177) in adenocarcinoma samples (high tumor content samples) . By ARMS, the mutation rate of EGFR was 45.6% (82/180) in NSCLC samples and 46.3% (82/177) in adenocarcinoma samples (high tumor content samples). The EGFR mutation rate in low tumor content samples was 38.7% (12/31) , there was no significant difference in EGFR mutation rates between the groups of low tumor cell content samples and high tumor cell content samples (P = 0.12). The concordance rate of EGFR mutation rates was 100% between scraping tumor cells from slides samples and from FFEP blocks in the 40 matched samples. Forty-eight out of 180 definitive NSCLC patients received Gefitinib therapy. The FPS was 12 months in the gefitinib-treated ARMS⁺ group and 2 months in the ARMS⁻ group (P < 0.001), and the OS was 19 months in the gefitinib-treated ARMS⁺ group and 7 months in the ARMS⁻ group (P = 0.003), but no significant differences were found in the efficacy (PFS and OS) of Gefitinib between Seq⁺ and Seq⁻ groups (P = 0.227, P = 0.510, respectively), and Seq⁺/ARMS⁺ and Seq⁻/ARMS⁺ groups (P = 0.354, P = 0.334, respectively).

CONCLUSIONSThe detection protocol for EGFR mutations in cytological specimens introduced in this study is tested to be reliable and feasible. Pathological evaluation and immunohistochemistry are important in the detection procedure of EGFR mutations in cytologic specimens. High sensitivity methods should be selected for detection of EGFR mutations in cytologic samples.

Adenocarcinoma ; metabolism ; Carcinoma, Non-Small-Cell Lung ; metabolism ; Humans ; Lung Neoplasms ; diagnosis ; epidemiology ; metabolism ; Mutation ; Mutation Rate ; Polymerase Chain Reaction ; Receptor, Epidermal Growth Factor ; genetics ; metabolism

Objective:To explore the surgical technique and the clinical efficacy of the lateral-rectus approach with traction reduction by the modified Starr pelvic reduction frame for Tile C pelvic nonunions and malunions.Methods:Data of 7 patients with Tile C pelvic nonunions and malunions from June 2017 to June 2018 who were treated via the lateral-rectus approach combined with traction reduction by the modified Starr pelvic reduction frame were retrospectively analyzed. There were 5 males and 2 females, aged from 22 to 53 (mean, 40 years). The injury mechanism included 3 cases of car accident injury, 3 of falling injury and 1 of crushing injury. The reasons for retreatment were pain in 7 cases, inability to walk and sit in 3, unequal length of lower limbs and lameness in 3. According to Tile classification, there were 4 cases of C1 type, 2 of C2 type and 1 of C3 type. A complete pelvic model with equal size as the patient’s pelvis was 3D-printed out according to three-dimensional reconstruction CT. The osteotomy or release site was designed, and the preoperative plan was detailed. Expose and release via the lateral rectus approach combined with traction reduction was conducted using the modified Starr pelvic reduction frame. Operative time, intraoperative blood loss and postoperative complications were collected. Visual analogue scale (VAS) at 6 months after surgery were recorded. Majeed score was used to evaluate the clinical efficacy. The quality of fracture reduction was evaluated by the Mears-Velyvis radiological evaluation criterion at the latest follow-up.Results:The operation time was 140-280 min, with an average of 190 min. The intraoperative blood loss was 700-2,800 ml, with an average of 1,250 ml. In 6 cases, the final fixation was performed at one time, while 1 case of Tile C3 type was performed in two stages. All patients were followed up for 10-22 months, and all the fractures healed. The mean time of bony union was 8 weeks (range, 6-12 weeks). The VAS of the 7 patients was improved from an average of 6.4 points to an average of 0.7 points during 6 months postoperative follow-up. The Majeed clinical efficacy score of the latest follow-up was improved from the average 60 points preoperative to 85 points postoperative. According to the Mears-Velyvis radiological evaluation criterion, the satisfaction rate reached 85.7%(6/7). After operation, 1 case occurred obturator nerve injury who recovered within 3 months, and 1 case remained limb shortening deformity of 1 cm. There was no fixation failure.Conclusion:The anterior osteotomy via the lateral-rectus approach can fully cut off nonunions and malunions of the pelvis, effectively release the soft tissues around the osteotomy site, with minimal surgical trauma and low risks of neurovascular injuries. Combined the modified Starr pelvic reduction frame, it can effectively correct pelvic deformities, lower limb rotation and unequal length deformities to achieve the expected effect of surgery.

Objective:To investigate the clinical efficacy of integrated acetabular wing-plate in the management of both column fractures with posterior wall involvement via the lateral-rectus approach.Methods:A retrospective case series analysis was performed on 43 patients with both column fractures involved with posterior wall admitted to Third Affiliated Hospital of Southern Medical University from March 2016 to June 2020. There were 35 males and 8 females, aged 19-78 years [(47.3±13.3)years]. The single lateral-rectus approach was used to expose, reduce and fix the fracture using the integrated acetabular wing-plate. Operation time, incision length, intraoperative blood loss and bone healing time were recorded. Quality of fracture reduction was assessed according to the Matta reduction criteria at postoperative 2 days, and hip function by the modified Merle d′Aubigné-Postel score at postoperative 3 months and 12 months. Postoperative complications were observed.Results:All patients were followed up for 12-48 months [(28.1±13.1)months]. Operation duration was 35-150 minutes [(84.6±26.3)minutes], with incision length of 8-12 cm [(9.4±1.0)cm] and intraoperative blood loss of 100-1 200 ml [(200(300, 500) ml]. Bone healing time was 3-6 months [(3.9±0.9)months]. According to Matta reduction criteria,the results were excellent in 32 patients, good in 7 and poor in 4 at postoperative 2 days, with the excellent and good rate of 91%. The modified Merle d′Aubigné-Postel score was 12-18 points [(16.1±1.5)points] at postoperative 3 months, and 13-18 points [(17.3±1.2)points] at postoperative 12 months ( P<0.01). According to modified Merle d′Aubigné-Postel score, the results were excellent in 3 patients, good in 34 and fair in 6 at postoperative 3 months, with the excellent and good rate of 86%; and the results were excellent in 32 patients, good in 9 and fair in 2 at postoperative 12 months, with the excellent and good rate of 95% ( P<0.01). Postoperative complications were incision fat liquefaction and infection in 1 patient, weakness of hip adduction in 5 and screw loosening with traumatic arthritis in 1. There was no sciatic nerve injury or heterotopic ossification. Conclusion:For both column fractures with posterior wall involvement, single lateral-rectus approach combined with integrated acetabular wing-plate has advantages of short operation time, minor trauma, low rate of bleeding and complications, and good hip function recovery, indicating satisfactory clinical effect.