BACKGROUND:Open reduction and internal fixation has been confirmed to treat posterior Pilon fracture,but choosing which fixation scheme is still under discussion.OBJECTIVE:To explore the biomechanical properties of posterior Pilon fracture after repaired by two different fixation methods,thus providing reference for selecting an appropriate fixation scheme.METHODS:Twenty right artificial femurs were randomized into two groups A and B,and the models of posterior Pilon fracture were established based on its characters and classification.The group A received with 5 holes distal tibial posterior locking plate fixation,and the group B underwent two 3.5 mm of cortical screws from back to front bicortical fixation,followed by placed in the InstronElectroPulsE3000 universal electronic static and dynamic materials testing systems,vertical speed loaded until internal fixation failure,the loading was recorded when different steps appeared.RESULTS AND CONCLUSION:(1) After loading,none of groups presented with screw bent or broken.(2) The axial load when appeared with 0.5,1.0,1.5,and 2.0 mm steps in the group A was higher than that in the group B,and the axial load significantly increased with fracture fragment displacement increasing (P ＜ 0.05).(3) The biomechanical test shows that the distal tibial posterior locking plate fixation is better than screws in the treatment of posterior Pilon fracture.

Objective To investigate the effects of the treatment of open injury and orthopedic postoperative wound infections with Vacuum Sealing Drainage.Methods Retrospective analysis of the clinical results of 32 patients with open injury or orthopedic postoperative wound infections in our hospital.Results Follow the indications and contraindications strictly and ensure right pressure,all the infection of wounds was controlled,and split skin graft survived.Without the package and pressurized fixation,the wounds healed better.Conclusion Vacuum Sealing Drainage can be considered one of the effective methods to treat the open injury or orthopedic postoperative wound infections and is worthy to be carried out as a routine.For patients with vascular rupture or defect,when there was still skin defects after vascular graft repair,as long as covered vascular anastomosis with the surrounding skin and soft tissue during the operation,there was still can use closed vacuum sealing drainage to cover the wound to prevent infection.

Objective:To establish a computer-aided design and 3D printing system for precise implantation of micro implant anchorage, and accurately calibrate the position and direction of micro implant implantation.Methods:A retrospective selection was conducted on 15 patients (30 in total) who underwent micro implant implantation surgery from the Department of Stomatology, the Affiliated Hospital of Jiangnan University from November 2019 to November 2021, including 6 males and 9 females, aged (17.1±6.3)years old. The preoperative patient was photographed with cone beam computed tomography (CBCT) and the collected DICOM data format was output. A 3D scan was performed on the patient′s preoperative analysis model to obtain the STL file of the model scan. The CBCT data and model data were fitted and matched using 3Shape Implant Studio software, and the thickness of the guide plate, the amount of undercut compensation, and the size of the key component collar were designed. The 3D printer was used for printing after resizing. Using the assist method to implant micro implants, CBCT was taken postoperatively to compare the preoperative design with the postoperative results.Results:After fitting the postoperative CBCT with the designed CBCT of the micro implant, it was found that the micro implant was consistent with the preoperative design, maintained a safe distance and parallel to the adjacent tooth root, and did not damage the maxillary sinus and other areas. No detachment of the micro implant anchorage was observed 1 or 3 months after surgery. The application of assisted micro implant anchorage 3D guide plate was reliable, with accurate implantation position and direction, and can be implanted in most parts of the oral cavity.Conclusions:The use of computer-aided design and 3D printing system to create an assistive micro implant anchorage 3D guide plate can accurately locate the position and direction of the micro implant, which is worthy of clinical promotion and application.

Premature ovarian insufficiency (POI) is characterized by amenorrhea before age 40 with raised FSH level and decreased E2 level. POI, as a main reason for infertility, poses great threat on patients. physical and psychological health.By reviewing clinical trials of acupuncture in treating premature ovarian insufficiency, this study focuses on the significance and feasibility of patient registry about acupuncture therapy for premature ovarian insufficiency. Patient registry can be used in collecting real-world evidence and exploring effective intervention to improve pregnancy rate

Objective: To analyze the trend change of the drowning mortality among children and adolescents in Chongqing, 2012-2021, and to provide suggestion for drowning prevention and control. Methods: Drowning death cases (ICD-10:W65.0-W74.9) among children and adolescents in Chongqing from 2012 to 2021 were derived from Chongqing death registration system. The difference of the drowning mortality between male and female, urban and rural area were compared by Chi square test. The trend change of the drowning mortality between 2012 and 2021 was analyzed by annual percent change( APC ). Results: The mortality and ASMR of drowning among children and adolescents decreased from 9.57/10 5, 9.42/10 5 in 2012 to 2.80/10 5, 2.83/10 5 in 2021 significantly( t=10.93, 10.52, P <0.01). And its APC were -13.15% and 13.06% respectively. The drowning mortality in male was higher than that in female( P <0.05). The drowning mortality in rural area was higher than that in urban area( P <0.05). The mortality of drowning among children aged between 0 and 4 years old, 5 and 9 years old, 10 and 14 years old decreased by 15.30 %,17.80% and 11.40%( APC =-15.30%, -17.80%, -11.40%, t=11.11, 9.22, 5.62, P <0.05). The proportion of drowning in natural water field among children and adolescents accounted for about 80%. Conclusion The mortality of drowning among children and adolescents in Chongqing decreases rapidly. Vulnerable population of drowning includes boys, rural children and adolescents, and children age of 0-14 years old. Comprehensive prevention for drowning should be carried out continuously.

The morbidity and mortality of lung cancer is the first in the world, immunotherapy has become a important treatment strategy in addition to chemotherapy, radiotherapy and targeted therapy. In recent years, the US Food and Drug Administration (FDA) has successively approved immunological checkpoint inhibitors as standard programs for non-small cell lung cancer (NSCLC) in second-line or first-line treatment. The National Comprehensive Cancer Network (NCCN) also recommends immunological checkpoint inhibitors as the standard treatment for small cell lung cancer (SCLC). Now, the treatment for lung cancer has entered the era of precision treatment, it is very important to select effective and reliable biomarker for the dominant populations of lung cancer to receive immunotherapy. A large number of researchs indicated that tumor mutation burden (TMB) may be an independent predicted biomarker for immunotherapy, but with limitations. This article reviewed the predictive value of TMB and its limitations in the field of immunotherapy for lung cancer.
Animals ; Biomarkers ; metabolism ; Humans ; Immunologic Factors ; administration & dosage ; Immunotherapy ; Lung Neoplasms ; drug therapy ; genetics ; metabolism ; Mutation ; Tumor Burden

Objective To analyze the trend of the mortality and disease burden of drowning in Chongqing and provide suggestions for drowning prevention and control. Methods The information data on drowning deaths in Chongqing (ICD-10 code: W65-W74) from 2012 to 2018 were collected. SPSS 25.0 software was used to calculate and analyze indicators such as mortality, age standardized mortality rate by Chinese population (ASMRC), years of life lost with premature death (YLL_s), years lived with disability (YLD_s), and disability adjusted life years (DALY_s). The differences of drowning mortality between male and female, urban and rural areas were tested by Chi-square test. The trend of drowning mortality and disease burden was calculated as annual percent change (APC) using curve-estimation model of logistic regression. The difference of APC was tested by t-test (α=0.05). Results The mortality and ASMRC of drowning decreased from 4.90/100 000 and 4.87/100 000 in 2012 to 3.85/100 000 and 3.59/100 000 in 2018, respectively. The APCs were -3.34% and -4.49%, respectively. There was no significant difference in the change trend (t value: 2.34 and 2.42, P>0.05). The mortality of drowning in the male was higher than that in the female (P<0.05). The mortality of drowning in rural area was higher than that in urban area (P<0.05). The mortality of drowning among children under 5 years old was the highest. The mortality of drowning among children under 5 years old decreased from 14.47/100 000 in 2012 to 4.28/100 000 in 2018, and the APC was -17.06%. The change trend was statistically significant (t=8.86, P<0.001). The drowning mortality rate in the 65-year-old and older group increased from 8.14/100 000 in 2012 to 9.77/100 000 in 2018, with an APC of 4.92%. There was no significant difference in the trend of change (t=2.56, P=0.051). The rates of DALYs and YLLs decreased from 2.73 thousand person-years and 2.70 thousand person-years in 2012 to 1.66 thousand person-years and 1.64 thousand person-years in 2018, respectively. The APCs were -7.41% and -7.41%, respectively. All of these were statistically significant (P<0.05). The rate of YLDs decreased from 0.03 thousand person-years in 2012 to 0.02 thousand person-years in 2018. There was no significant difference in the trend of change (P>0.05). Conclusion The mortality and disease burden of drowning in Chongqing showed a decreasing trend, which was lower than the national average level. Children, male and elderly people are the vulnerable population to prevent drowning, and rural areas are the key areas to prevent drowning.