Objective To observe the correlation of estrogen,fasting insulin(FINS),fasting plasma glucose (FPG),glycosylated hemoglobin(HbA1c),blood lipids and carotid arteries -membrane thickening(IMT)in the postmenopausal women with type 2 diabetes.Methods 63 postmenopausal women with type 2 diabetes were divided into normal IMT group(group A),IMT thickening group(group B),plaque group(group C)according to the vascular ultrasound carotid artery intima thickness,at the same time 15 cases of healthy physical examination as control group (group D).All of the groups were detected the plasma total cholesterol(TC),high-density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol(LDL-C),fasting insulin(FINS),fasting plasma glucose(FPG),gly-cosylated hemoglobin(HbA1c),follicle-stimulating hormone(FSH),estradiol(E2).Results Compared with group A,the levels of FINS,IR,HbA1c,TC,LDL-C in group C was higher(t=16.83,14.44,2.50,2.38,2.42,all P<0.01 or P<0.05),however,the results of E2,HDL-C was decreased(t=7.32,5.51,all P<0.01).The levels of FINS,HbA1c,TC,LDL-C,FSH,IR in group D was lower than those of group C(t=19.74,36.44,8.64,7.95, 27.13,6.71,all P<0.01),On the contrast,the levels of HDL-C,E2 were elevated(t=11.34,8.72,all P<0.01). The Pearson's correlation analysis showed that E2 had negative correlation with FINS,IR,TC,LDL-C (P<0.01 or P<0.05).E2 had positive correlation with HDL-C(P<0.05).Logistic regression analysis showed that IMT and FINS,IR,HbA1c,LDL-C were positively correlated(OR=2.94,72.63,27.30,98.18,all P<0.01),while nega-tively correlated with E2 levels(OR=2.94,P<0.01).Conclusion The increased level of estrogen was a protective factor of carotid artery atherosclerosis in postmenopausal women with type 2 diabetes.

Objective To explore the clinical value of 3.0T nuclear magnetic resonance susceptibility weighted imaging in diagnosis of neonatal hypoxic ischemic encephalopathy,thus to provide guidance for the clinical.Methods From December 10,2015 to December 10,2017,100 cases of neonatal hypoxic ischemic encephalopathy (observation group) and 100 cases of normal newborns in Lishui People's Hospital during the same period accepted health examination (control group) were selected in the research.All the cases received 3.0T magnetic resonance susceptibility weighted imaging,the diagnostic value of 3.0T MR susceptibility weighted imaging was observed.Results The ADC value of the observation group[(0.00 1 13 ± 0.000 01)mm2/s] was significantly lower than that in the control group[(0.001 98 ±0.000 02)mm2/s] (P ＜0.05).The neonatal ADC value of the mild group[(0.001 21 ± 0.000 01)mm2/s] was significantly higher than that in the moderate group[(0.001 12 ± 0.000 02)mm2/s] and the severe group[(0.001 02 ± 0.000 03)mm2/s] (P ＜ 0.05).ADC value was positively correlated with neonatal hypoxic ischemic encephalopathy,namely,the lower the ADC value,the more serious the neonatal hypoxic ischemic encephalopathy.The fractional anisotropy value and relative anisotropy value of newborn babies in the observation group were significantly higher than those in the control group (all P ＜ 0.05).Conclusion For neonatal hypoxic ischemic encephalopathy patients,3.0T nuclear magnetic resonance susceptibility weighted imaging in the diagnosis is feasible,it can help the clinician to analyze the disease,and has positive significance to carry out the treatment.

Objective To investigate the clinical efficacy of posterior short-segment pedicle screw fixation combined with vertebroplasty or injured vertebral transpedicular fixation in the treatment of osteoporotic thoracolumbar Magerl type A3 fractures.Methods A retrospective case control study was conducted on 39 patients with acute traumatic osteoporotic thoracolumbar burst fractures admitted from May 2007 to May 2016.There were 17 males and 22 females,aged 52-85 years (mean 61.3 years).All patients had single segment thoracolumbar fracture(T11-L2),with bone mineral density T value ＜-2.5 SD and the Frankel grade D or E.According to operation method,the patients were divided into Group A (n =22) which adopted short segment pedicle screw fixation combined with vertebroplasty and Group B (n =17) which adopted pedicle screw fixation combined with injured vertebra transpedicular fixation.The operation time and blood loss were compared between the two groups.VAS and Frankel grade were used to evaluate the patients' pain and the recovery of neurological function.The height recovery and Cobb angle of fracture vertebra were measured according to X-ray.Complications at follow ups were observed.Results All patients underwent the operations successfully with good healing.The mean follow-up time was 23.5 months (range,12-40 months).The operation time was (61.7 ± 6.7)minutes in Group A and (48.1 ± 7.5) minutes in Group B (P ＜ 0.05).The blood loss was (347.7 ± 44.9) ml in Group A and (288.3 ±41.6)ml in Group B (P ＜ 0.05).Postoperative VAS score and VAS at the final follow-up in both groups were significantly improved compared with those before operation (P ＜ 0.05),with no significant difference between the two groups.Four cases in Group A and two cases in Group B with Frankel grade D were classified as grade E.After operation,the recovery rate of injured vertebral Cobb angle and anterior height were significantly improved in both groups (P ＜ 0.05).The recovery rate of Cobb angle and anterior height at the last follow up was lower than that after surgery,but with no statistical difference (P ＞ 0.05),and no significant differences were found between the two groups either (P ＞ 0.05).The screws were removed from four patients in Group A and two patients in Group B.No complications or failure of internal fixation was found during follow-up.Conclusion Posterior shortsegment pedicle screw fixation combined with vertebroplasty or injured vertebra transpedicular fixation are both helpful to the height recovery of vertebral osteoporotic fractures and reduce kyphosis with similar efficacy,while the former has the advantages of shorter operation time and less bleeding.

Objective:To construct a bowel preparation nursing guidance based on key point control theory and mind mapping in full abdominal enhanced CT examination to provide a basis for improving the intestinal preparation and image quality of intestinal patients.Methods:This was a randomized controlled trial, 104 patients were selected as the research subjects who underwent full abdominal enhanced CT examination in the Second Hospital of Shanxi Medical University from January to August 2022, and randomly divided into the control group and the intervention group by table of random numbers, 52 cases in each group. The control group was given routine nursing guidance, while the intervention group was given nursing guidance based on key-point control theory and mind mapping. Compare the differences in intestinal cleanliness, intestinal fullness and CT image quality between the two groups.Results:The proportion of patients with good intestinal cleanliness was 65.4% (34/52) in the intervention group, which was higher than 25.0% (13/52) in the control group ( χ2 = 22.32, P<0.01). The proportion of patients in the intervention group with grade I intestinal filling was 71.2% (37/52), which was higher than the 23.1% (12/52) in the control group ( χ2 = 27.76, P<0.01). The proportion of patients in the intervention group with excellent image quality was 80.8% (42/52), higher than 30.8% (16/52) in the control group ( χ2 = 28.56, P<0.01). The score of State Anxiety Inventory score of patients in the intervention group was (41.21 ± 5.08), lower than that of the control group (48.69 ± 6.40) ( t = 6.60, P<0.01). The satisfaction score of patients in the intervention group was 43.50(39.00, 46.00), which was higher than that of the control group 39.00(36.25, 43.00) ( Z = - 3.45, P<0.01). Conclusions:The bowel preparation nursing guidance based on key-point control theory and mind mapping can effectively improve bowel preparation of patients and the image quality of full abdominal enhanced CT examination.

Objective:To observe the safety and efficacy of 0.01% atropine eye drops in the prevention of myopia onset in schoolchildren.Methods:A randomized double-blind controlled study was conducted.Sixty Chinese Han children (60 eyes) with binocular spherical equivalent (SE) between + 0.50 D and -0.75 D (pre-myopia) by cycloplegic autorefraction treated in The First Affiliated Hospital of Zhengzhou University were enrolled from July to October 2020.Aged 6-12 years old, the children were divided into 0.01% atropine group and control group according to a random number table, with 30 cases (30 eyes) in each group.The children were given one drop of 0.01% atropine or placebo eye drops in both eyes once a night.The SE, axial length (AL), accommodative amplitude and pupil diameter were compared before and after 3-month, 6-month of treatment between the two groups.Discomforts were recorded.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of The First Affiliated Hospital of Zhengzhou University (No.2020-KY-286). Written informed consent was obtained from guardian of each subject.Results:After treatment, 26 and 25 subjects completed the 6-month follow-up in 0.01% atropine group and control group, respectively, among which 3 subjects in 0.01% atropine group accounting for 11.5% and 9 in control group accounting for 36.0% developed myopia, showing a statistically significant difference ( χ2=4.238, P=0.040). There were significant differences in the overall comparison of SE and AL at different time points between before and after treatment ( Ftime=10.981, 81.854; both at P<0.001). At 3 and 6 months after treatment, there were significant increases in the SE and AL of control group and AL of 0.01% atropine group compared with respective baseline values (all at P<0.05). There was no significant difference in SE at 3 and 6 months after treatment compared with baseline SE in 0.01% atropine group (both at P>0.05). At 6 months after treatment, the change in SE in 0.01% atropine group was (-0.15±0.26)D, which was significantly less than (-0.34±0.35)D in control group, and the change in AL in 0.01% atropine group was (0.17±0.11)mm, Which was significantly shorter than (0.28±0.14)mm in control group, with significant differences between them ( t=2.207, P=0.032; t=3.127, P=0.003). There were significant differences in pupil diameter at different time points between before and after treatment ( Ftime=2.263, P=0.032). At 3 and 6 months after treatment, the pupil diameter was increased in comparison with baseline in 0.01% atropine group (both at P<0.05). There were significant differences in accommodative amplitude at different time points between before and after treatment in the two groups ( Fgroup=0.882, P=0.042; Ftime=0.337, P=0.033). The accommodative amplitude at 3 and 6 months after treatment were decreased in comparison with baseline in 0.01% atropine group and control group at corresponding time points (all at P<0.05). Within a month after treatment, photophobia in bright sunlight occurred in 5 cases in 0.01% atropine group, accounting for 16.7%(5/30), and 2 cases in control group, accounting for 6.7%(2/30), showing no significant difference ( χ2=0.647, P=0.421). No near-vision blur and other uncomfortable symptoms was found in the two groups. Conclusions:After 6-month application of 0.01% atropine eye drops, the prevalence of myopia in pre-myopia schoolchildren decreases and the changing rate of SE and AL slows down.The accommodative amplitude is slightly reduced and pupil diameter is slightly increased, with no obvious effects on study and life.

Objective:To investigate the clinical efficacy of arthroscopic modified anatomic glenoid reconstruction with Enden-Hybinette procedure combined with loop plate fixation in the treatment of recurrent anterior dislocation of shoulder combined with severe glenoid bone loss.Methods:A retrospective case series study was conducted to analyze 36 patients with recurrent anterior dislocation of the shoulder combined with severe glenoid bone loss who were admitted to 901st Hospital of the Joint Logistics Support Force of PLA from January 2019 to January 2021, including 28 males and 8 females, aged 18-33 years [(29.5±3.0)years]. All the patients had injury history. The dislocation frequency range was 2-40 times [(20.5±6.5)times]. Beighton scale scores were 3-9 points [(4.0±0.8)points]. All the patients underwent anatomic reconstruction of the glenoid bone with arthroscopic modified Enden-Hybinette procedure using iliac autograft and loop plate elastic fixation. Posterior glenoid version angle, the breadth of the glenoid cavity and the A-P glenoid cavity depth were measured and osseous anatomy of the reconstructed glenoid bone was evaluated. Union of the Iliac bone block and glenoid bone loss was observed and the absorption rate of the bone block was evaluated at 6 months after surgery. The shoulder stability score, functional activity score, joint range of motion score and total Rowe score of shoulder function were used to evaluate the shoulder stability, functional activity and movement before surgery, at 3, 6 months after surgery and at the last follow-up. The incidence of complications was observed.Results:All the patients were followed up for 12-24 months [(18.8±3.5)months]. At 1, 3, 6 months after surgery and at the last follow-up, posterior glenoid version angle was (11.3±1.7)°, (10.6±1.2)°, (9.1±2.0)° and (9.2±1.9)° respectively; the breadth of the glenoid cavity was (34.2±1.3)mm, (33.2±1.0)mm, (32.2±1.0)mm and (31.3±1.1)mm respectively; the A-P glenoid cavity depth was (2.6±0.1)mm, (2.4±0.1)mm, (2.3±0.2)mm and (2.2±0.2)mm respectively, which were all significantly improved compared with those before surgery [(-5.9±1.0)°, (24.3±1.2)mm and (0.6±0.1)mm respectively] ( P<0.01), with no significant differences among those at different postoperative time points ( P>0.05). Bony union was observed in the iliac bone block and glenoid bone loss after bone grafting in all the patients at 6 months after surgery and the iliac bone block resorption rate was (20.5±4.1)%. At 3, 6 months after surgery and at the last follow-up, the shoulder stability score was (41.5±6.1)points, (43.9±6.3)points and (44.7±5.0)points respectively; the functional activity score was (26.9±2.5)points, (27.1±2.5)points and (28.6±2.3)points respectively; the joint range of motion score was (13.9±1.0)points, (14.9±1.2)points and (15.8±1.5)points respectively; the total Rowe score of shoulder function was (81.4±11.5)points, (85.8±12.3)points and (86.4±9.8)points respectively, which were significantly improved compared with those before surgery [(6.1±1.5)points, (11.9±1.5)points, (8.5±1.4)points and (27.4±7.5)points respectively] ( P<0.01), with no significant differences among those at different postoperative time points ( P>0.05). At the follow-up, no complications such as incision infection, neurological injuries, implant failure of displacement, recurrent re-dislocation of the shoulder or osteoarthritis were observed. Conclusion:Arthroscopic modified anatomic glenoid reconstruction with Enden-Hybinette procedure combined with loop plate fixation in the treatment of recurrent anterior dislocation of shoulder combined with severe glenoid bone loss has the advantages of better osseous anatomy of the reconstructed glenoid bone, better bony union, satisfactory shoulder stability, functional restoration, etc.