ObjectiveTo evaluate multi-slice CT (MSCT) in glenoid bone loss of patients with recurrent anterior shoulder dislocation.Methods MSCT findings of 108 patients with recurrent anterior shoulder dislocation and 12 with single anterior shoulder dislocation were retrospectively studied.The incidence,degrees and locations of glenoid bone losses were recorded.The incidence was analyzed with Fisher exact test.The maximum length,depth and proportion were compared with Wilcoxon rank sum test.ResultsGlenoid bone loss was detected in 91.7％ (99/108)patients with recurrent anterior shoulder dislocation.The proportion of glenoid bone loss was ( 16.0 ± 6.0)％,and the central locations of glenoid bone loss were from 2: 20 to 4: 25 ( mean 3: 20).Sixty-two percent (67/108) patients had bony Bankart lesions in which 58.2％ (39/67) bony fragments were free and 41.8％ (28/67) were adherent to the anterior border of the glenoid cavity.Seventy-five percent (9/12) patients with single shoulder dislocation had anterior glenoid bone loss,and the proportion of glenoid bone loss was ( 15.2 ± 7.1 ) ％.There were no statistical differences of the incidence (P =0.100) and proportion of glenoid bone loss ( P =0.453 ) between the recurrent and single anterior shoulder dislocation.ConclusionsAnterior glenoid bone loss is common in patients with recurrent anterior shoulder dislocation.

Objective To explore the instructive value of preoperative splenic artery CTA examination on Laparoscopic splenectomy (LS). Methods From January 2008 to February 2010,36 cases requiring Laparoscopic splenectomy (LS) were selected randomly and divided into two groups: CTA group and non-CTA group, 18 cases in each group. As for the CTA group,splenic artery CTA examination was performed before operation,to understand splenic artery and its branches anatomy type and track and then individualized surgical treatment was developed. As for the non-CTA group,a routine surgical procedure was performed. The indices before and during the operation were recorded and compared through χ2 test The operating time and the amount of bleeding in the two groups were compared using t-test Results There were no significant difference between the indices recorded by splenic artery CTA examination and those by laparoscopic splenectomy intraoperation ( P > 0. 05 ) . The operating time was (124. 32 ±21.43) mins in the CTA group, which was significantly shorter than that in the non-CTA group ((148.27 ±28. 36)mins) (P <0. 05). The amount of blood in the CTA group was significantly less than that in the non-CTA group( ( 80. 50 ± 16. 42) ml vs. (101. 35 ± 26.25 ) ml). Conclusions Splenic artery CTA can identify splenic artery and its branches anatomy type and track before LS,therefore guide the development of individualized surgical treatment It increases the safety of LS, reduces bleeding and shortens the operational time. It has an instrutive value to laparoscopic splenectomy.

Objective:To explore the role of hierarchical teaching based on the "competency-based" concept in the standardized training of respiratory nursing interns.Methods:A total of 70 nursing interns who came to the Department of Respiratory Medicine in Beijing Jishuitan Hospital for standardized training from September 2019 to August 2020 were selected as the study subjects. They were randomly divided into the study group and the control group by coin tossing method, 35 in each group. The study group used hierarchical teaching based on the "competency-based" concept, while the control group adopted conventional hierarchical teaching. The nursing ability and teaching quality of the two groups of nurses were compared. SPSS 23.0 was used for t-test and Chi-square test. Results:The theoretical knowledge scores of the nurses in the two groups after the standardized training [(95.29±3.13), (86.29±5.13)] were higher than those before the training [(78.22±4.48), (77.29±5.13)]. The scores of theoretical knowledges, operation skills, medical record reporting, and the comprehensive quality scores of the study group after the standardized training were higher than those of the control group, and the differences were statistically significant ( P<0.05). The satisfaction of teaching quality in study group was higher than that in control group, and the difference was statistically significant ( P<0.05). Conclusion:The hierarchical teaching based on the "competency-based" concept can significantly improve the teaching quality in the standardized training and the comprehensive quality of respiratory nursing interns, which is worthy of application.

Objective ToinvestigatethecorrelationbetweenCTimagingfindingsoflungadenocarcinomaandepidermalgrowth factorreceptor(EGFR)genemutation.Methods Theclinicaldataof150lungadenocarcinomapatientsinthehospitalfrom October 2015toOctober2017werecollectedretrospectively.AccordingtotheEGFRgenemutation,thepatientsweredividedintononeffectivemutation group (n=78)andeffective mutationgroup (n=72).Univariateanalysisand multivariate L o g istic regression modelwereperformed toexplorethepredictionsignsofeffectiveEGFRgenemutationinlungadenocarcinoma.Results Univariateanalysisshowedthatthe proportionsoffemalepatients,smokinghistory,CTfindingsofspiculesign,necroticsign,pleuralindentationandnonfibrosisin theeffectivemutationgroupweresignificantlyhigherthanthoseinnoneffectivemutationgroup(P<0.05).However,therewereno significantdifferencesbetweenthesetwogroupsinage,diameteroflesions,locationoflesions,densityoflesions,lobulatedsign, cavitation sign ,air bronchogram and pleuralthickening sign (P>0 .05 ).M ultivariate L o g istic regression analysis showed thatfemale (OR=2.612),spiculesign(OR=2.476),necroticsign(OR=2.846),pleuralindentation(OR=2.221)andnonfibrosis(OR=2.476)were independentpredictorsofeffectiveEGFRgenemutationinlungadenocarcinoma(P<0.05).Conclusion FemaleandlungadenocarcinomaCT findingsofspiculesign,necroticsign,pleuralindentationandnonfibrosisarerelatedtoEGFRgenemutation,whichisofgreatsignificanceto distinguishingwildtypefrom mutanttypeofEGFRgeneandguidingtheclinicaltreatment.

Objective:To explore the clinicalfactors related to allograft fibrosis after pediatric liver transplantation.Methods:The clinical data were respectively analyzed for 94 pediatric recipients from January 2013 to December 2016 at Tianjin First Central Hospital.The Patients were assigned into fibrotic and non-fibrotic groups based upon the results of protocol liver biopsies. Univariate and multivariate Logistic regression analyses were performed for examining the risk factors of fibrosis after pediatric livertransplantation. Then Logistic regression model was established to obtain the predicted value of combined predictive factors.Thereceiver operating characteristic curve (ROC) was conducted to evaluate the predictive value of combined predictive factors.Results:A total number of 54(57.5%) patients occurred fibrosis among the 94 patients. There weresignificant differences in cold ischemia time (Z=2.094), warm ischemia time (Z=2.421), biliary stricture( χ2=4.560), drug-induced liver injury ( χ2=7.389), hepatic artery thrombosis and rejection ( χ2=6.955)between two groups ( P<0.05). Logistic regression analysis showed that cold ischemia time (OR=1.003, 95%CI: 1.000~1.007, P=0.044), biliary stricture(OR=6.451, 95%CI: 1.205~33.295), rejection(OR=2.735, 95%CI: 1.057~7.077)and drug-induced liver injury (OR=4.977, 95%CI: 1.207~20.522, P=0.026) were independent risk factors for fibrosis 5 years after liver transplantation. The area under the ROC curve was 0.786(95%CI: 0.691~0.881), for predicting patient outcome.If using 0.311as a cutoff Value, the sensitivity was 90.70%, and the specificity was 60.00%. However, through the ROC curve comparison, there was statistical significance between combined predictive factors and the other independent risk factors ( P>0.05). Conclusions:The incidence of fibrosis 5 years after pediatricliver transplantation is 57.5%. Prolonged cold ischemia time, biliarystricture, rejectionand drug-induced liver injury after liver transplantation are independent risk factors for fibrosis 5 years after pediatric liver transplantation.And the combined predictive factors have a high predictive value forallograftfibrosis.

Amid ongoing reforms in the healthcare system and the pursuit of high-quality development in public hospi-tals,the significance of party building in leading the standardization of hospital party branches has become increasingly promi-nent.Taking a university's affiliated hospital as an example,this study comprehensively analyzes the current situation of Party building on the standardized construction of party branches within university-affiliated public hospitals using the SWOT method.Meanwhile,this paper proposes targeted strategies by assessing the strengths,weaknesses,opportunities,and challenges of party building leadership.These strategies are intended to refine the framework for the role of Party building in advancing the standard-ized construction of Party branches in university-affiliated public hospitals.

Objective:To preliminary evaluate the validity and reliability of the Comprehensive International Classification of Functioning,Disability and Health(ICF)Core Set for Knee Arthroplasty Perioperative Period.Methods:Patients diagnosed with knee osteoarthritis and undergoing knee arthroplasty(n=41)were recrui-ted for study of criterion validity,internal consistency,interclass reliability and intraclass reliability.The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),Mos 36-item Short Form Health Survey(SF-36),Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to test criterion validity.Results:The scores of body structure and function and activity and participation components were positive-ly correlated with the WOMAC pain,physical function and total scores(ICC=0.59-0.92),as well as scores of SF-36(ICC=0.46-0.89).The scores of b130,b134,b152,d230 and d240 categories were positively correlated with the SAS scores(ICC=0.41-0.73),and the score of b530 category was positively correlated with the SDS scores(ICC=0.47),Ps＜0.05.The Cronbach α of the body structure and function,activity and participation,and environmental factors components were 0.93,0.93 and 0.53 respectively.The ICCs of interclass reliability ranged from 0.44 to 0.99,the ICCs of intraclass reliability ranged from 0.66 to 0.97.Conclusion:The Comprehensive ICF Core Set for Knee Arthroplasty Perioperative Period has a relatively good validity and reliability.

Anemia, Aplastic ; diagnosis ; pathology ; Humans ; Severity of Illness Index

Objective:To investigate the clinical characteristics and management status of children with Turner syndrome (TS) in China.Methods:As a cross-sectional study, 1 089 TS patients were included in the database of the National Collaborative Alliance for the Diagnosis and Treatment of Turner Syndrome from August 2019 to November 2023. Clinical characteristics (growth development, sexual development, organ anomalies, etc.), karyotypes, auxiliary examinations, and treatments were collected and analyzed.Results:Among the 1 089 TS cases, 809 were recorded karyotypes. The karyotype distribution was as follows: 45, X in 317 cases (39.2%), X chromosome structural variants (including partial deletions of p or q arm, ring chromosome, and marker chromosome) in 89 cases (11.0%), 45, X/46, XX mosaicism in 158 cases (19.5%), mosaicism with X chromosome structural variants in 209 cases (25.8%), and presence of Y chromosome material in 36 cases (4.4%). Among the 824 TS cases, the age of diagnosis was 9.7(6.4, 12.2) years, with a height standard deviation score (HtSDS) of -3.1±1.2. Five hundred and fifty three cases underwent growth hormone (GH) stimulation test, and 352 cases (63.7%) had GH peak values <10 μg/L and 75.9% (577/760) had low IGF1 levels, with IGF1 SDS ≤-2 accounting for 38.2% (290 cases). Among 471 cases aged ≥8 years, 132 cases (28.0%) showed spontaneous sexual development (mean bone age (11.0±1.7) years), 10 cases had spontaneous menarche (mean bone age (12.0±2.2) years), and 2 cases had regular menstrual cycles. Common physical features included cubitus valgus (311 cases (28.5%)), neck webbing (188 cases (17.2%)), low posterior hairline (185 cases (17.0%)), shield chest (153 cases (14.0%)), high arched palate (127 cases (11.6%)), short fourth metacarpal (43 cases (3.9%)), and spinal abnormalities (38 cases (3.5%)). Congenital cardiovascular and urogenital anomalies occurred in 91 cases (19.4%) and 66 cases (12.0%)respectively. Abdominal ultrasound in 33 cases (7.2%) indicated fatty liver, hepatomegaly, intrahepatic bile duct stones, and splenomegaly. Among 23 cases undergoing oral glucose tolerance test (OGTT) test, 2 were diagnosed with diabetes mellitus and 4 with impaired glucose tolerance. Following diagnosis, 669 cases (80.7%) received rhGH treatment at a chronological age of (9±4) years and bone age of (8.3±3.2) years. Additionally, 112 cases (19.4%) received sex hormone replacement therapy starting at the age of (14±4) years and bone age of (12.6±1.2) years.Conclusions:The karyotypes of 45, X and mosaicism were most common in Chinese children with TS. The clinical manifestations were mainly short stature and gonadal dysplasia. However, a few TS children could be in the normal range of height, and some cases among those aged of ≥8 years old had spontaneous sexual development. Some exhibited physical features, congenital cardiovascular and urogenital anomalies, and dysfunction of the hypothalamic-pituitary-IGF1 axis. Moreover, a few of them developed impaired glucose tolerance and diabetes mellitus. Following diagnosis, most of the patients received rhGH treatment, and a few of them received sex hormone replacement therapy.

Alveolar echinococcosis, caused by Echinococcus multilocularis infection, is a highly deadly zoonotic parasitic disease. As a benzimidazole compound, albendazole has a strong and broad-spectrum anti-parasitic action. For alveolar echinococcosis patients that are unwilling to receive surgical treatment, lose the timing for surgery, or are intolerant to surgery due to poor physical status, administration of albendazole may delay disease progression. Recently, a large number of advances have been achieved in experimental studies on alveolar echinococcosis. In order to increase the understanding of the therapeutic efficacy of albendazole for alveolar echinococcosis, this review summarizes the advances in albendazole treatment for alveolar echinococcosis, so as to provide insights into the clinical treatment of alveolar echinococcosis with albendazole.