Objective:To explore the different characteristics of early postoperative kinesiophobia in elderly patients with total hip arthroplasty (THA) and analyze the influencing factors, so as to provide reference for formulating targeted nursing strategies.Methods:This study was a cross-sectional study. Using the convenient sampling method, a total of 225 elderly THA patients admitted to the Second Affiliated Hospital of Air Force Medical University of PLA from May 2022 to June 2023 were selected as the research objects. The evaluation was conducted using the general information questionnaire, Tampa Scale for Kinesiophobia (TSK), Numeric Rating Scale, Pain Catastrophizing Scale and Groningen Orthopedic Social Support Scale.Results:A total of 225 questionnaires were distributed and 210 valid questionnaires were collected, with an effective response rate of 93.33%. The TSK score of 210 elderly THA patients was (38.76±8.52), among which 49.52% (104/210) of patients had kinesiophobia (TSK>37 points). The latent profile analysis results showed that early postoperative kinesiophobia in elderly THA patients could be divided into three potential categories, such as catastrophic cognition-high kinesiophobia group (48.57%, 102/210), uncertain cognition-moderate kinesiophobia group (20.48%, 43/210) and positive cognition-low kinesiophobia group (30.95%, 65/210). The results of Logistic regression analysis showed that age greater than or equal to 76 years old, education level of primary school or below, high comorbidity, moderate to severe pain and positive catastrophic pain were the influencing factors for patients in the catastrophic cognition-high kinesiophobia group ( P<0.05), while education level of primary school or below and low social support were the influencing factors for patients in the uncertain cognition-moderate kinesiophobia group ( P<0.05) . Conclusions:There is significant heterogeneity in early postoperative kinesiophobia among elderly patients with total hip arthroplasty, with the main influencing factors being advanced age, physical pain, social support and educational level. It is suggested that medical staff should carry out psychological counseling according to the characteristics of early kinesiophobia of different categories of patients, strengthen social support to correct wrong cognition of patients, reduce their kinesiophobia and improve early rehabilitation training behavior.

Objective:To investigate the value of CT findings of childhood hepatoblastoma (HB) in predicting preoperative tumor risk stratification.Methods:Totally 46 children with HB confirmed by surgery and pathology were retrospectively enrolled from October 2010 to October 2019 in Shenzhen Children′s Hospital and Xuzhou Children′s Hospital. The preoperative abdominal plain CT and three-phasic contrast-enhanced CT with complete clinical files were evaluated. According to the clinical risk stratification established by the multidisciplinary diagnosis and treatment consensus for children with HB, the HB children were divided into high-risk group and non-high-risk group with 16 and 30 cases respectively. The maximum diameter of tumor, relative tumor volume index, cystic change or necrosis, bleeding, calcification, fibrous septations, tumor rupture, liver capsule retraction and subcapsular effusion were evaluated. Enhancement percentage and enhancement index on arterial, venous and delayed phases of each tumor were measured and calculated. Pearson′s χ 2 test or Fisher′s exact test were used to compare the differences in gender and lesion morphological characteristics between the high-risk group and the non-high-risk group. Two independent sample t test or Mann-Whitney U test were used to compare the differences in age, gestational age, birth weight, α-fetoprotein, platelets, maximum diameter of tumor, relative tumor volume index and CT parameters of the lesion between the two groups. Statistically significant features were included in the binary logistic regression analysis and independent predictors related to high-risk group were obtained. The ROC curve was used to determine the critical value of the high-risk group. Results:There were statistically significant differences in age, maximum diameter of tumor, relative tumor volume index and tumor rupture between the high-risk group and the non-high-risk group (all P<0.05). The logistic regression analysis showed that the maximum diameter of tumor (OR=1.906, P=0.004) and tumor rupture (OR=16.558, P=0.005) were risk factors of the high-risk group. Based on ROC curve, the optimum cut-off point of maximum diameter of tumor to predict high-risk group was 10.5 cm. Tumor rupture, maximum diameter of tumor and maximum diameter of tumor combined with tumor rupture for predicting the incidence of high-risk group resulted in the area under the curve of 0.744, 0.807 and 0.879, respectively. The sensitivity and specificity of maximum diameter of tumor combined with tumor rupture were 75.0% and 96.7%, respectively. Conclusion:The age of onset in high-risk group is relatively older. The maximum diameter of tumor greater than 10.5 cm accompanied by tumor rupture can be regarded as a high-risk sign.

OBJECTIVETo explore pathogenic mutation in a family affected with 2-hydroxyglutaric aciduria.

METHODSExons of 3 candidate genes, including L2HGDH, D2HGDH and SLC25A1, were amplified with polymerase chain reaction and subjected to direct sequencing.

RESULTSDNA sequencing has found that the proband and his affected younger brother have both carried a heterozygous mutation c.845G>A (p.R282Q) in the exon 7 of the L2HGDH gene. The same mutation was not detected in the his sister who was healthy. Pedigree analysis has confirmed that the above mutation was inherited from the mother. No mutation was detected in exons and flanking sequences of the D2HGDH and SLC25A1 genes.

CONCLUSIONMutation of the L2HGDH gene probably underlies the 2-hydroxyglutaric aciduria in this family.

Alcohol Oxidoreductases ; genetics ; Base Sequence ; Brain ; diagnostic imaging ; Brain Diseases, Metabolic, Inborn ; diagnostic imaging ; enzymology ; genetics ; Child ; Female ; Humans ; Male ; Molecular Sequence Data ; Mutation ; Pedigree ; Radiography ; Young Adult