Objective:To compare the anterior long-segment fixation, posterior long-segment fixation, and combined anterior-posterior fixation in the treatment of ankylosing spondylitis with cervical fracture (ASCF).Methods:A retrospective study was conducted to analyze the 153 patients with ASCF who had been treated at Department of Orthopaedics, Peking University Third Hospital and Department of Orthopedics, Luoche Central Hospital between January 2014 and December 2023. The cohort included 86 males and 67 females, with an age of (41.6±11.5) years, a disease duration of (10.0±3.9) years, and an interval from injury to surgery of (3.3±1.4) d. By Frankel's classification for preoperative nerve injury, 57 cases were grade B, 51 grade C, and 45 grade D. Based on the surgical approaches, the patients were divided into 3 groups: an anterior group ( n=63) undergoing the anterior cervical long-segment fixation, a posterior group ( n=51) undergoing the posterior cervical long-segment fixation, and a combination group ( n=39) undergoing combined anterior-posterior cervical fixation. Surgical time, intraoperative blood loss, fracture healing, complications, and changes in Frankel grading for spinal cord injury were compared among the 3 groups. Results:There was no statistically significant difference in the preoperative general data among the 3 groups, indicating comparability ( P > 0.05). All patients were followed up for (33.5±12.0) months after surgery. In the anterior group, the surgical time [(103.0±16.8) min] was significantly shorter than that in the posterior group [(148.4±17.7) min] and that in the combination group [(228.5±23.9) min], the intraoperative blood loss [(92.8±27.8) mL] was significantly less than that in the posterior group [(477.5±109.5) mL] and that in the combination group [(769.5±136.9) mL], and the incidence of complications [9.5% (6/63)] was significantly lower than that in the posterior group [41.2% (21/51)] and that in the combination group [53.8% (21/39)] (all P<0.05). There was no statistically significant difference in the fracture healing time among the 3 groups ( P=0.111). At the last follow-up, X-ray and CT scans showed no loosening or breakage of internal fixation in all the 3 groups. The Frankel grading at the last follow-up: 12 cases of grade C, 15 cases of grade D, and 36 cases of grade E in the anterior group; 3 cases of grade B, 12 cases of grade C, 12 cases of grade D, and 24 cases of grade E in the posterior group; 6 cases of grade C, 12 cases of grade D, and 21 cases of grade E in the combination group. At the last follow-up, all patients showed a significant improvement compared to their Frankel grades before surgery ( P<0.001), but there was no statistically significant difference between the 3 groups ( H=2.238, P=0.327). Conclusions:In the treatment of ASCF, anterior long-segment fixation is advantageous over posterior long-segment fixation and combined anteri-or-posterior fixation due to its shorter surgical time, reduced intraoperative blood loss, and a lower complication incidence. All the 3 surgical approaches demonstrate comparable outcomes in terms of fracture healing time, radiographic stability, and final neurological recovery.

Objective:To compare the anterior long-segment fixation, posterior long-segment fixation, and combined anterior-posterior fixation in the treatment of ankylosing spondylitis with cervical fracture (ASCF).Methods:A retrospective study was conducted to analyze the 153 patients with ASCF who had been treated at Department of Orthopaedics, Peking University Third Hospital and Department of Orthopedics, Luoche Central Hospital between January 2014 and December 2023. The cohort included 86 males and 67 females, with an age of (41.6±11.5) years, a disease duration of (10.0±3.9) years, and an interval from injury to surgery of (3.3±1.4) d. By Frankel's classification for preoperative nerve injury, 57 cases were grade B, 51 grade C, and 45 grade D. Based on the surgical approaches, the patients were divided into 3 groups: an anterior group ( n=63) undergoing the anterior cervical long-segment fixation, a posterior group ( n=51) undergoing the posterior cervical long-segment fixation, and a combination group ( n=39) undergoing combined anterior-posterior cervical fixation. Surgical time, intraoperative blood loss, fracture healing, complications, and changes in Frankel grading for spinal cord injury were compared among the 3 groups. Results:There was no statistically significant difference in the preoperative general data among the 3 groups, indicating comparability ( P > 0.05). All patients were followed up for (33.5±12.0) months after surgery. In the anterior group, the surgical time [(103.0±16.8) min] was significantly shorter than that in the posterior group [(148.4±17.7) min] and that in the combination group [(228.5±23.9) min], the intraoperative blood loss [(92.8±27.8) mL] was significantly less than that in the posterior group [(477.5±109.5) mL] and that in the combination group [(769.5±136.9) mL], and the incidence of complications [9.5% (6/63)] was significantly lower than that in the posterior group [41.2% (21/51)] and that in the combination group [53.8% (21/39)] (all P<0.05). There was no statistically significant difference in the fracture healing time among the 3 groups ( P=0.111). At the last follow-up, X-ray and CT scans showed no loosening or breakage of internal fixation in all the 3 groups. The Frankel grading at the last follow-up: 12 cases of grade C, 15 cases of grade D, and 36 cases of grade E in the anterior group; 3 cases of grade B, 12 cases of grade C, 12 cases of grade D, and 24 cases of grade E in the posterior group; 6 cases of grade C, 12 cases of grade D, and 21 cases of grade E in the combination group. At the last follow-up, all patients showed a significant improvement compared to their Frankel grades before surgery ( P<0.001), but there was no statistically significant difference between the 3 groups ( H=2.238, P=0.327). Conclusions:In the treatment of ASCF, anterior long-segment fixation is advantageous over posterior long-segment fixation and combined anteri-or-posterior fixation due to its shorter surgical time, reduced intraoperative blood loss, and a lower complication incidence. All the 3 surgical approaches demonstrate comparable outcomes in terms of fracture healing time, radiographic stability, and final neurological recovery.

【Objective】 To demonstrate the real incidence and clinical features of acute transfusion reactions (ATRs) and analyze its association with transfusion effectiveness. 【Methods】 The blood transfusion process of patients in the Hematology Department in our hospital from March 16, 2018 to March 16, 2019 was observed and followed up. The vital signs and clinical features were recorded, the clinical data and relevant laboratory examination results were collected, and the correlation between ATRs, clinical features and transfusion effectiveness was statistically analyzed. 【Results】 A total of 2500 transfusions were observed in the Hematology Department, out of which 138 patients developed 242 ATRs. The overall incidence of ATRs was 9.68% (95% CI, 8.52%~10.94%) and the incidence of ATRs during platelets transfusion was the highest. The clinical features of most ATRs were mild and no fatal consequences occurred. No significant difference was found in the association between transfusion effectiveness with ATRs in platelets and red blood cells transfusion (P>0.05). 【Conclusion】 None of the ATRs observed in this study resulted in serious consequences or had effect on the transfusion effectiveness. The characteristics presented in these reactions may provide certain references for clinical practice.

Objective:To explore the clinical effect of multidisciplinary cooperative intervention in improving self-management and improving fluid retention in the elderly patients with chronic heart failure.Methods:Totally 130 cases of the elderly patients with chronic heart failure from January to December 2018 were enrolled and were divided into control group and observation group with 65 cases randomly. The control group received routine nursing instruction and telephone follow-up. The observation group was given multidisciplinary team guidance to patients self-management in addition to routine nursing instruction and telephone follow-up. After 3 months, the self-management and fluid retention of the two groups were compared.Results:After 3 months of intervention, the scores and total scores of the observation group in the four dimensions of drug management, diet management, psychological and social adaptation management, symptom management were 19.43±0.71,11.51±0.59,19.07±0.65,25.24±1.31, 72.65±7.16, the control group was 11.09±3.40, 6.05±1.71, 12.73±2.49, 15.72±4.18, 46.35±7.83. The scores and total scores of the observation group were better than those of the control group ( t value was 4.835-13.727, all P < 0.05).After intervention for 3 months, the proportion of severe edema, moderate edema and mild edema in the observation group was 4.61% (3/65), 13.85% (9/65), 81.54% (53/65), respectively, and the control group was 38.46% (25/65), 52.31% (34/65) and 9.23% (6/65) respectively. The degree of fluid retention in the observation group was better than that in the control group ( Z value was -2.373, all P < 0.05). Conclusion:Multidisciplinary cooperative intervention can improve self-management and improve fluid retention in elderly patients with chronic heart failure.

Objective To analyze the differences in social psychological characteristics of patients with different subtypes of functional dyspepsia (FD).Methods From August 2011 to July 2015,210 FD patients met Rome Ⅲ criteria were enrolled and divided into pure postprandial distress syndrome (PDS)group (69 cases),pure epigastric pain syndrome (EPS) group (74 cases) and PDS overlap EPS (PDS+ EPS) group (67 cases).Hamilton depression scale (HAMD),Hamilton anxiety scale (HAMA),life event scale (LES) and Eysenck's personality questionnaire (EPQ) were used for evaluation.Chi-square test and least-significant difference were performed for statistical analysis.Results Incidence rates of depression and anxiety of PDS+EPS group were both 100.0％ (67/67),which were higher than those of pure PDS group (84.1％,58/69 and 91.3％,63/69),and the differences were statistically significant (x2 =11.62 and 16.34,both P＜0.01);which were also higher than those of pure EPS group (78.4％,58/74 and 90.5％,67/74),and the differences were statistically significant (x2 =6.10 and 6.67,both P＜0.05).Somatic anxiety score and mental anxiety score of PDS+ EPS group were 16.34±3.70 and 14.18±2.99,respectively;which were higher than those of pure PDS group (11.26±3.42 and 10.70±2.94) and pure EPS group (12.30 ± 4.29 and 10.36 ± 2.63),and the differences were statistically significant (t=8.33,5.97,6.85 and 8.06;all P＜0.01).The top two life events in three groups were sleeping habits alteration (67.6％,142/210) and severe disease or trauma (26.7％,56/210).The incidence rate of sleeping habits alteration in pure PDS group was 53.6 ％ (37/69),which was lower than that in pure EPSgroup (77.0％,57/74) and PDS+EPS group (71.6％,48/67),and the differences were statistically significant (x2 =8.68 and 4.71,both P＜0.05).Most of P scale scores of pure PDS group,pure EPS group and PDS+EPS group were normal,most of E and L scale scores were low;most of N scale scores of pure PDS group were low,and these of pure EPS group and PDS+EPS group were normal.Conclusions The incidence of depression and anxiety of PDS+EPS group is the highest.Somatic anxiety is more obvious than mental anxiety in PDS+EPS group and pure EPS group,most with sleep events.Slow emotional response is common in pure PDS group.

Objective: To investigate the relationship among depression, anxiety, stress and addictive substance use behavior in secondary vocational students. Methods: Cluster sampling method and the Adolescent Health-related Behaviors Questionnaire were used to collect demographic characteristics, psychological symptoms, and addictive substance usage among 5 935 students in nine vocational schools in Chongqing, Zhaoqing, Ningbo, and Taiyuan. Multivariate logistic regression analysis was used to analyze the relationship between the addictive substance use behavior and psychological factors. Results: The detection rates of depression, anxiety and stress were 46.5% (n=2 762), 58.7% (n=3 483), and 29.8% (n= 1 770), respectively. The prevalence of addictive substances was 74.8% (n=4 440), traditional drugs was 0.8% (n=50), new drugs was 2.8% (n=166), other addictive drugs was 4.1% (n=241). Multivariate logistic regression analysis showed that compared with the normal psychological states of secondary vocational students, the OR value of mild depression tendency alcohol and tobacco use behavior of secondary vocational students was 1.45; the OR values of mild anxiety, moderate anxiety, severe anxiety and very serious anxiety were 1.46, 1.46, 1.71, and 1.83, respectively; the traditional drugs use behaviors were 5.51, and 2.61, respectively, for the severe anxiety and very serious anxiety. Compared with the normal psychological state of secondary vocational students, the OR values of the severe anxiety and very severe anxiety were 2.56, and 2.66, respectively, for severe anxiety and very serious anxiety. Compared with normal psychological status of secondary vocational students, the OR values of mild, moderate, severe, and very severe anxiety were 2.14, 2.47, 2.39, and 3.45, respectively; all P values <0.05. Conclusion Anxiety and mild depression were risk factors of tobacco and alcohol use in secondary vocational students; severe and above anxiety were the risk factors of drug use in secondary vocational students; anxiety was the risk factor for other addictive drug use in secondary vocational students.

Objective:To explore the relation of new-type drug using intention,self-efficacy,and perceived stress in secondary vocational school students.Methods:A total of 2692 secondary vocational school students in Zhaoqing,Guangdong Province were selected.The questionnaire of new-type drugs using intention,General Self-Efficacy Scale (GSES),and Perceived Stress Scale (PSS) were respectively used to assess the secondary vocational school students'new-type drugs using intention,self-efficacy,and perceived stress.Path analysis model was used to analyze the relationship of new-type drugs using intention,self-efficacy,and perceived stress among secondary vocational school students.Results:There were 13.6％ (295/2165) of the secondary vocational school students reported an intention to use new-type drugs.The total scores of GSES and PSS were (2.4 ±0.5) and (18.8 ±5.0),respectively.The results of path analysis showed that,after controlling for age,gender,and residence,the scores of GSES were negatively correlated with the scores of PSS (γ =-0.21,P ＜0.001),and the scores of PSS were positively correlated with the scores of questionnaire of new-type drugs using intention (γ =0.05,P ＜ 0.05).However,the scores of GSES showed no significant direct correlation with the scores of questionnaire of new-type drugs using intention (γ =0.04,P ＞ 0.05).Conclusion:The secondary vocational school students' level of perceived stress are positively correlated with their intention to use new-type drugs.Self-efficacy might moderate the individual's level of perceived stress,thus to show indirect correlation to the secondary vocational school students' intention.

This study examined the effects of combined administration of tyrosine, lecithin, L-glutamine and L-5-hydroxytryptophan (5-HTP) on heroin withdrawal syndromes and mental symptoms in detoxified heroin addicts. In the cluster-randomized placebo-controlled trial, 83 detoxified heroin addicts were recruited from a detoxification treatment center in Wuhan, China. Patients in the intervention group (n=41) were given the combined treatment with tyrosine, lecithin, L-glutamine and 5-HTP and those in the control group (n=42) were administered the placebo. The sleep status and the withdrawal symptoms were observed daily throughout the study, and the mood states were monitored pre- and post-intervention. The results showed that the insomnia and withdrawal scores were significantly improved over time in participants in the intervention group as compared with those in the control group. A greater reduction in tension-anxiety, depression-dejection, anger-hostility, fatigue-inertia and total mood disturbance, and a greater increase in their vigor-activity symptoms were found at day 6 in the intervention group than in the control group (all P<0.05). It was concluded that the neurotransmitter-precursor-supplement intervention is effective in alleviating the withdrawal and mood symptoms and it may become a supplementary method for patients' recovery from heroin addiction.
Administration, Oral ; Adult ; Dietary Supplements ; Drug Therapy, Combination ; methods ; Female ; Heroin Dependence ; diagnosis ; therapy ; Humans ; Male ; Neurotransmitter Agents ; administration & dosage ; Placebo Effect ; Single-Blind Method ; Substance Withdrawal Syndrome ; diagnosis ; drug therapy ; therapy ; Treatment Outcome

This study examined the effects of combined administration of tyrosine, lecithin, L-glutamine and L-5-hydroxytryptophan (5-HTP) on heroin withdrawal syndromes and mental symptoms in detoxified heroin addicts. In the cluster-randomized placebo-controlled trial, 83 detoxified heroin addicts were recruited from a detoxification treatment center in Wuhan, China. Patients in the intervention group (n=41) were given the combined treatment with tyrosine, lecithin, L-glutamine and 5-HTP and those in the control group (n=42) were administered the placebo. The sleep status and the withdrawal symptoms were observed daily throughout the study, and the mood states were monitored pre- and post-intervention. The results showed that the insomnia and withdrawal scores were significantly improved over time in participants in the intervention group as compared with those in the control group. A greater reduction in tension-anxiety, depression-dejection, anger-hostility, fatigue-inertia and total mood disturbance, and a greater increase in their vigor-activity symptoms were found at day 6 in the intervention group than in the control group (all P<0.05). It was concluded that the neurotransmitter-precursor-supplement intervention is effective in alleviating the withdrawal and mood symptoms and it may become a supplementary method for patients' recovery from heroin addiction.

Drug abuse continues to be a serious public health threat worldwide. Most drug abuse prevention research has been conducted with predominantly American or European adolescent populations. Little is known about approaches that work best to prevent the initiation of Chinese adolescent drug use. For targeting risk factors of drug initiation in Chinese adolescents, a school-based health intervention program named "Cognition-Motivation-Emotional Intelligence-Resistance Skills" (CMER) was developed to enhance cognition upon drug use, to decrease motivation of drug use and to improve emotional adjusting and drug resistance skills in this study. A total of 798 students from 3 senior high schools in Wuhan, a city in central China, were assigned randomly to intervention and control groups. The intervention group received the CMER program in which knowledge, development of positive attitude and motivation towards drugs and training of peer resistance skills were basic elements. The immediate impact was compared by measuring the above mentioned elements prior to and three-month after the training session. Students from both groups were asked to complete a self-administered questionnaire. The questionnaire included demographic items, self-reported drug use behavior, cognition, attitude, and motivation associated with the initiation of drug use and resistance skills. Three months after the intervention, significant effects were found on "illegal substance use at least once" (P<0.05) between the intervention and control groups. Immediate effects of the intervention were also found on knowledge, motivation and peer resistance skills (P<0.05), but there was no clear evidence for any effects on attitude towards substance use (P>0.05). It was concluded that the CMER program, which significantly increased the knowledge of drugs and peer resistance skills, was effective in the drug abuse prevention in a sample of school students in Wuhan, China.
Adolescent ; Adolescent Behavior ; psychology ; China ; epidemiology ; Cognition ; physiology ; Female ; Health Education ; methods ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Motivation ; School Health Services ; Students ; psychology ; Substance-Related Disorders ; epidemiology ; prevention & control ; Surveys and Questionnaires ; Young Adult