Objective To investigate the importance and method of early treatment of pelvic fracture combine with hemorrhagic shock.Methods Review the experience comes from emergent treatment of 74 cases of pelvic fracture combine with hemorrhagic shock in the department of emergent surgery.To study the characteristics,meaningful therapy and the affects to course of pelvic fracture.Results By effective early anti-shock treatment.Conclusion All 74 patients of pelvic fracture combine with hemorrhagic shock were safety recover from shock phase and get further treatment.

Objective To retrospectively analyze the treatments of nonvalvular atrial fibrillation (nvAF) in elderly patients aged 80 years and over,and to investigate the influencing factors for occurrence of stroke and transient ischemic attack(TIA)and relationships between antithrombotic therapy and stroke or TIA.Methods 101 elderly patients with nvAF were enrolled and grouped according to the occurrence of stroke/TIA and antithrombotic-correlated bleeding.The influencing factors were retrospectively analyzed and antithrombotic schemes were compared.Results Incidence rate of stroke/TIA was 28.7％ (29/101).Among all patients,70 cases were treated with antiplatelet therapy,19 cases were treated with anticoagulation therapy,while 12 cases received no antithrombotic (antiplatelet or anticoagulation) therapy before stroke.Both the nvAF time course and the antithrombotic strategy were significantly different between post-AF stroke/TIA group and non-postAF stroke/TIA group(both P＜0.05).The difference was reflected in ratios of antiplatelet therapy/anticoagulation therapy.The proportion of anticoagulation therapy was higher in non stroke/TIA group(x2 =5.778,P =0.016).Different antiplatelet therapy scheme significantly affected occurrence of stroke/TIA(P＜0.05).There was no significant effect of antithrombotic schemes on hemorrhagic events(x2=0.708,P =0.702).Multiple logistic regression analysis showed that hypertension,coronary heart disease,cancer,diabetes and previous stroke history,as well as nvAF duration were the independent risk factors for post-AF stroke/TIA(OR=1.351,95 ％CI:1.129-1.617).Conclusions Currently,the proportion using anticoagulation therapy is low,and single antiplatelet therapy is the main regimen in the elderly patients with nvAF.For elderly patients with nvAF,anticoagulation therapy has a protective effect against the occurrence of post-nvAF stroke/TIA,meanwhile there is no significantly increased risk of bleeding,which makes anticoagulation therapy advisable in the elderly.The nvAF time course is one of the risk factors,which is worth experts' attention in risk evaluation of thrombus in elderly patients.

Objective: To explore effects of perforator flaps combined with muscle flaps for repairing grade Ⅳ pressure ulcers in ischial tuberosity of elderly patients. Methods: Nine elderly patients with grade Ⅳ pressure ulcers in ischial tuberosity were hospitalized in our burn ward from April 2014 to April 2017. Size of wounds ranged from 5 cm×3 cm to 12 cm×7 cm, and depth of sinus ranged from 6 to 22 cm. After admission, emergency debridement or debridement in selective time was performed. After debridement, the wounds were treated with continuous vacuum assisted closure therapy. After the treatment for 1 to 2 weeks, tissue flaps repair operations were performed. Four patients were repaired with inferior gluteal artery perforator flaps combined with long head of biceps femoris muscle flaps. Three patients were repaired with inferior gluteal artery perforator flaps combined with semimembranous muscle flaps. One patient was repaired with inferior gluteal artery perforator flap combined with gracilis muscle flap. One patient was repaired with femoral profound artery perforator flap combined with gluteus maximus muscle flap, and the distal area of femoral profound artery perforator flap of the patient which showed intraoperative cyanosis of 6 cm×4 cm was thinned to medium thickness skin to cover the muscle flap. The other eight patients showed no abnormality during operation. Size of perforator flaps ranged from 7 cm×5 cm to 14 cm×12 cm, and size of muscle flaps ranged from 11 cm×4 cm to 24 cm×6 cm. The donor sites of flaps were all sutured directly. Results: The tissue flaps and skin graft of all patients survived well after operation. During follow-up of 8 to 35 weeks, operative area of all patients showed good shape and texture, with no local diabrosis or recurrence of pressure ulcers. Conclusions The combination of perforator flaps and muscle flaps is effective in repairing and reducing recurrence of grade Ⅳ pressure ulcers in ischial tuberosity of elderly patients.

Objective: To investigate the general situation of scoliosis and influencing factors among middle school students in Guangzhou, so as to provide evidence for behavioral intervention measures. Methods: By stratified cluster random sampling method, 2 121 students from 8 middle schools of Guangzhou were selected to conduct questionnaire survey and physical examination. Results: The detection rate of scoliosis among middle school students in Guangzhou was 8.20%, girls (9.50%)＞boys (7.00%), urban area (10.45%)＞suburb area (4.77%), senior high school (10.08%)＞junior school (6.39%) ( P ＜0.05). Among the most of the 174 positive students were found to have large thoracic curve, right lateral bending, being girls with medium scoliosis. Multivariate Logistic regression analysis showed that students in urban area ( OR=2.56, 95%CI =1.71-3.82), with mobile electronic devices usage time≥3 h/d( OR=1.59, 95%CI =1.12-2.27), prolonged near vision work ≥1 h ( OR=1.40, 95%CI =1.00-1.95), outdoor activity time＜2 h/d( OR=1.82, 95%CI =1.24-2.67) had a higher detection rate of scoliosis ( P <0.05). Conclusion The detection rate of scoliosis among middle school students in Guangzhou is much higher, which might be related to district, mobile electronic devices usage, prolonged near vision work and insufficient outdoor activity. Health education regarding spinal knowledge should be strengthened.

Objective: To describe the prevalence and relationship between moderate to vigorous physical activity(MVPA), screen time (ST) and depressive symptoms among middle school students in Guangzhou, and to provide a reference for adolescent depression prevention and control. Methods: Using stratified cluster random sampling method, a total of 2 140 students were selected from one urban area and one suburban country for MVPA, ST and depressive symptoms investigation. Logistic regression was used to analyze relations among MVPA, ST and their combined patterns for depressive symptoms. Results: A total of 89.72% students failed to meet the MVPA recommendations, girls (95.52%) were higher than boys(84.38%). Totally 67.38% of the students failed to meet the ST recommendations, boys (69.75%) were higher than girls(64.81%). The prevalence of depressive symptoms was 27.01%, girls (31.58%) higher than boys(22.80%). MVPA, ST failure compliance rate and depression symptoms detection rate of vocational high school and ordinary high school were higher than junior high school ( χ 2=6.40,121.71,27.37, P ＜ 0.05 ). Logistic regression analysis showed that the OR for depressive symptoms was 1.19 ( P =0.35) in students whose MVPA time achieving 1 h<7 d in the last week, and was 1.93 ( P <0.01) in students with the ST>2 h/d independently, no significant interactions were observed. Students with both MVPA time 1 h<7 d in the last week and the ST>2 h/d were more likely to report depressive symptoms( OR=2.03, P <0.05). Conclusion Insufficient MVPA, prolonged ST and high prevalence of depressive symptoms are observed among middle school students in Guangzhou. Students with both insufficient MVPA and prolonged ST are more likely to suffer from depressive symptoms. Specific psychological care and health education regarding physical activity and screen behavior should be implemented to students with different characteristics, as well as their parents for depressive symptom prevention.

Objective: To analyse monitoring absenteeism due to respiratory symptoms/diseases among preschoolers in Guangzhou, and to provide reference for risk prevention and control of respiratory infectious diseases in kindergartens. Methods: Data of absenteeism due to symptoms and diseases in kindergartens were collected from "Guangzhou Student Health Monitoring System", and was analyzed by using R 4.1.3 software. Results: During 2018-2020 academic year, there were 1 965, 2 019, 2 236 kindergartens being monitored respectively. The absenteeism rate of kindergarten s children due to respiratory symptoms and diseases in Guangzhou were 3.08‰ and 2.02‰. The absenteeism rates due to respiratory symptoms were 3.75‰, 4.17‰, 2.97‰ and 2.09‰ in baby class, junior class, middle class and senior class, respectively. The absenteeism rates due to respiratory diseases were 2.34 ‰, 2.60‰, 1.94‰ and 1.50‰, respectively. The absenteeism rate in higher grade was lower than that in lower grade( χ 2= 65 197.95 ，27 929.44， P <0.01). The absenteeism rates of boys (3.11‰, 2.05‰) due to respiratory symptoms/diseases were significantly higher than those of girls (3.06‰, 1.97‰)( χ 2=57.71，229.45， P <0.01). The absenteeism of preschoolers due to respiratory symptoms/diseases showed two peaks in December of the this year and May of the following year. At the beginning of the second semester of 2019 academic year (after the outbreak of Coronavirus disease 2019), the absenteeism rate due to respiratory symptoms/diseases were lower than those of the same period in previous years. Conclusions The absences due to respiratory symptoms or diseases not only accounted for half of the total absences due to illness, but also had seasonal characteristics. Children in the youngerage group and most boys are treated as a focus group for absence due to respiratory symptoms/illnesses. It s necessary to give full use of timely warning function of health monitoring system.