Objective To investigate the preliminary clinical effect of closed reduction and cannulated nail internal fixa-tion for femoral neck fracture assisted by robot navigation and positioning system.Methods From July 2019 to January 2020,16 cases of femoral neck fracture(navigation group)were treated with closed reduction and internal fixation guided by robot system,including 7 males and 9 females,aged 25 to 72 years old with an average of(53.61±5.45)years old;Garden classification of fracture:3 cases of type Ⅰ,3 cases of type Ⅱ,8 cases of type Ⅲ,2 cases of type Ⅳ.Non navigation group(control group):20 cases of femoral neck fracture were treated with closed reduction and hollow nail internal fixation,8 males and 12 females,aged 46 to 70 years old with an average of(55.23±4.64)years old;Garden type Ⅰ in 2 cases,type Ⅱ in 4 cases,type Ⅲ in 11 cases,type Ⅳ in 3 cases.The operation time,fluoroscopy times,guide needle drilling times,screw adjustment times,intraoperative bleeding volume and other indicators of two groups were evaluated.Results Both groups were followed up for 12 to 18 months with an average of(15.6±2.8)months.The fractures of both groups were healed without delayed union and nonunion.There was no significant difference in healing time between two groups(P=0.782).There was no significant differ-ence in Harris scores between two groups at the last follow-up(P=0.813).There was no significant difference in operation time between two groups(P＞0.05).There were significant differences between two groups in fluoroscopy times,guide needle drilling times,hollow screw replacement times,and intraoperative bleeding volume(P＜0.05).Conclusion Closed reduction and hollow screw internal fixation assisted by robot navigation system for femoral neck fracture has the advantages of minimally invasive operation,precise screw placement,and reduction of X-ray radiation damage during operation.

COVID-19 has been prevalent for three years. The virulence of SARS-CoV-2 is weaken as it mutates continuously. However, elderly patients, especially those with underlying diseases, are still at high risk of developing severe infections. With the continuous study of the molecular structure and pathogenic mechanism of SARS-CoV-2, antiviral drugs for COVID-19 have been successively marketed, and these anti-SARS-CoV-2 drugs can effectively reduce the severe rate and mortality of elderly patients. This article reviews the mechanism, clinical medication regimens, drug interactions and adverse reactions of five small molecule antiviral drugs currently approved for marketing in China, so as to provide advice for the clinical rational use of anti-SARS-CoV-2 in the elderly.

Objective:To explore the clinical effect of repairing fingertip defects with the great toe fibular flap.Methods:A retrospective analysis was conducted on the clinical data of patients admitted to the Department of Hand Surgery, Xuzhou Renci Hospital from March 2019 to June 2022 who underwent the repair of fingertip defects using the great toe fibular flap. Emergency debridement of the wound of digital defect, temporary cover with xenocortic, and flap repair after 4-7 d. According to the size of digital defect, the free flap (0.5 cm larger than the wound) on the fibular side of the toe was designed and harvested, and the nail bed and phalange could be carried when accompanied by nail bed and phalangeal defects. Remove excess fat under the flap under the microscope and cover it on the wound at the end of the finger, and the flap was anastomosed with the arteries, veins, and nerves of the finger. Fix the phalanges crosswise with two 0.8 mm Kirschner needles. The wound in the donor area was directly pulled and sutured, or the suture was reduced and then moistened and changed, and it was allowed to grow on its own, or the first plantar back full thick skin sheet was transplanted and repaired. Provide an appropriate description of the surgical method, including the management of the donor recipient area. Regularly follow up the patient’s injured finger and donor foot recovery after surgery, and investigate whether the patient was satisfied with the surgical effect. At the last follow-up, finger function was evaluated using the applicable standards for upper limb functional assessment of the Chinese Medical Association Society of Hand Surgery.Results:A total of 35 patients with fingertip defect and phalangeal bone exposure were enrolled, including 17 males and 18 females. Age range from 15 to 60 years old, with an average of 36 years old. There were 9 thumbs, 8 index fingers, 10 middle fingers, 5 ring fingers, and 3 little fingers. Defect area 1.0 cm × 1.5 cm-2.0 cm × 3.0 cm. Three patients underwent venous crisis after surgery and survived after bleeding at the edge of the flap. The remaining flaps survived smoothly. There was one case of poor wound healing after removing the suture in the donor area, which healed after changing the dressing for 3 weeks. The postoperative follow-up was 10-18 months, with an average of 13 months. The color, texture, and nail appearance of the repaired finger flap were similar to those of normal fingers, with clear skin lines and beautiful appearance. The two point resolution of the flap was 8-10 mm, and the sensation returned to S3 level. No significant impact on foot function and appearance. The patient expressed satisfaction with the surgical effect. Finger function evaluation results: 28 cases were excellent and 7 cases were good.Conclusion:After using the great toe fibular flap to repair the fingertip defect, the appearance and function of the finger are restored well, and the donor area of the flap is concealed, with little impact on the donor foot, which can achieve good repair results.

Objective:To explore the clinical effect of repairing fingertip defects with the great toe fibular flap.Methods:A retrospective analysis was conducted on the clinical data of patients admitted to the Department of Hand Surgery, Xuzhou Renci Hospital from March 2019 to June 2022 who underwent the repair of fingertip defects using the great toe fibular flap. Emergency debridement of the wound of digital defect, temporary cover with xenocortic, and flap repair after 4-7 d. According to the size of digital defect, the free flap (0.5 cm larger than the wound) on the fibular side of the toe was designed and harvested, and the nail bed and phalange could be carried when accompanied by nail bed and phalangeal defects. Remove excess fat under the flap under the microscope and cover it on the wound at the end of the finger, and the flap was anastomosed with the arteries, veins, and nerves of the finger. Fix the phalanges crosswise with two 0.8 mm Kirschner needles. The wound in the donor area was directly pulled and sutured, or the suture was reduced and then moistened and changed, and it was allowed to grow on its own, or the first plantar back full thick skin sheet was transplanted and repaired. Provide an appropriate description of the surgical method, including the management of the donor recipient area. Regularly follow up the patient’s injured finger and donor foot recovery after surgery, and investigate whether the patient was satisfied with the surgical effect. At the last follow-up, finger function was evaluated using the applicable standards for upper limb functional assessment of the Chinese Medical Association Society of Hand Surgery.Results:A total of 35 patients with fingertip defect and phalangeal bone exposure were enrolled, including 17 males and 18 females. Age range from 15 to 60 years old, with an average of 36 years old. There were 9 thumbs, 8 index fingers, 10 middle fingers, 5 ring fingers, and 3 little fingers. Defect area 1.0 cm × 1.5 cm-2.0 cm × 3.0 cm. Three patients underwent venous crisis after surgery and survived after bleeding at the edge of the flap. The remaining flaps survived smoothly. There was one case of poor wound healing after removing the suture in the donor area, which healed after changing the dressing for 3 weeks. The postoperative follow-up was 10-18 months, with an average of 13 months. The color, texture, and nail appearance of the repaired finger flap were similar to those of normal fingers, with clear skin lines and beautiful appearance. The two point resolution of the flap was 8-10 mm, and the sensation returned to S3 level. No significant impact on foot function and appearance. The patient expressed satisfaction with the surgical effect. Finger function evaluation results: 28 cases were excellent and 7 cases were good.Conclusion:After using the great toe fibular flap to repair the fingertip defect, the appearance and function of the finger are restored well, and the donor area of the flap is concealed, with little impact on the donor foot, which can achieve good repair results.

Objective: To analyze the incidence of leptospirosis in Fujian province from 2015 to 2020 and provide the scientific evidences for the risk assessment, prevention and control of leptospirosis. Methods: The incidence data of leptospirosis in Fujian during 2015-2020 were collected from China Information System for Disease Control and Prevention for a descriptive analysis, and software ArcGIS 10.3.1 was used for spatial autocorrelation analysis, and rats were captured in 17 surveillance areas during the same period, and the rat organs were collected for pathogen culture, the level of Leptospira antibody was detected in serum samples of rats, healthy population and the serum samples of patients sent by the hospitals. The infection status of Leptospira in human and rats were analyzed. Results: The incidence of leptospirosis in Fujian showed a downward trend from 2015 to 2020. A total of 176 cases of leptospirosis were reported. There were obvious seasonality and bimodal distribution. The majority of cases were farmers, accounting for 49.43% (87/176). Most cases were aged 30-69 years (85.80%, 151/176). The male to female ratio of the cases was 3.51∶1 (137∶39). Spatial autocorrelation analysis showed that leptospirosis had high or low clustering areas. From 2015 to 2020, the average capture rate of rats in 17 surveillance areas was 6.96% (1 519/21 838), Rattus losea, Rattus flavipectus and Niviventer fulvescens were the main species. The average positive rate of Leptospira antibody in rats was 28.64% (252/880). Java and Autumnalis were the predominant serogroups, accounting for 56.75% (143/252) and 17.46% (44/252), respectively. The average positive rate of Leptospira antibody in healthy population was 16.13% (254/1 575), and Autumnalis and Australis were the predominant serogroups, accounting for 71.65% (182/254). The confirmation rate of leptospirosis in patient serum samples sent by the hospitals was 2.23% (188/8 431), Autumnalis (56.38%, 106/188) and Hebdomadis (19.68%, 37/188) were the major serogroups. Conclusions: The incidence of leptospirosis in Fujian showed a downward trend from 2015 to 2020, there were obvious area clustering and seasonality. The high clustering areas were mainly distributed in northern, western and central Fujian. Java and Autumnalis were the predominant serogroups in rats. The infection rate in healthy population decreased year by year. Autumnalis and Hebdomadis were the main serogroups in population in Fujian.
Animals ; Antibodies, Bacterial ; Female ; Humans ; Incidence ; Leptospira ; Leptospirosis/epidemiology* ; Male ; Rats ; Serogroup

Aortoiliac occlusive disease (AIOD) refers to the stenosis and occlusion of the distal abdominal aorta and(or) bifurcation of the aortoiliac artery,which is mainly caused by atherosclerosis,leading to pelvic and lower limb ischemia.Open surgery has always been the main treatment for complex AIOD.However,in recent years,with the development of endovascular surgery technologies and medical instruments,its treatment concept has been greatly changed.More and more clinical evidence has proved that the long-term efficacy of endovascular therapy is not inferior to that of traditional open surgery,so minimally invasive endovascular therapy has become the preferred treatment for AIOD.
Aortic Diseases/surgery* ; Arterial Occlusive Diseases/surgery* ; Atherosclerosis ; Endovascular Procedures ; Humans ; Iliac Artery/surgery* ; Treatment Outcome ; Vascular Patency

This study aimed to further explore the relevant mechanism of action by network pharmacology integrated with animal experimental verification based on previous proven effective treatment of vertebral artery type of cervical spondylosis(CSA) by Panlongqi Tablets. Bionetwork analysis was performed to establish drug-disease interaction network, and it was found that the key candidate targets of Panlongqi Tablets were enriched in multiple signaling pathways related to CSA pathological links, among which phosphatidylinositol 3-kinase(PI3 K)/serine-threonine kinase(AKT/PKB) signaling pathway was the most significant. Further, mixed modeling method was used to build the CSA rat model, and the rats were divided into normal, model, Panlongqi Tablets low-, medium-and high-dose(0.16, 0.32, 0.64 g·kg~(-1)) and Jingfukang Granules(positive drug, 1.35 g·kg~(-1)) groups. After successful modeling, the rats were administered for 8 consecutive weeks. Pathological changes of rat cervical muscle tissues were detected by hematoxylin-eosin(HE) staining, and the content of interleukin-1β(IL-1β), tumor necrosis factor-α(TNF-α), vascular endothelial cell growth factor(VEGF) and chemokine(C-C motif) ligand 2(CCL2) in rat serum and/or cervical tissues was determined by enzyme-linked immunosorbent assay(ELISA). Western blot was employed to detect the protein expression levels of chemokine(C-C motif) receptor 2(CCR2), PI3 K, AKT, phosphorylated AKT(p-AKT), I-kappa-B-kinase beta(IKK-beta/IKKβ), nuclear factor kappa B(NF-κB P65) and phosphorylated nuclear factor kappa B(NF-κB p-P65) in rat cervical tissues, and positive expression of p-NF-κB P65 in rat cervical muscle tissues was detected by immunofluorescence. The results showed that Panlongqi Tablets at different doses improved the degree of muscle fibrosis and inflammation in cervical muscle tissues of CSA rats, and reduced the content of inflammatory factors IL-1β, TNF-α, VEGF, CCL2 and CCR2 in serum and/or cervical tissues. The protein expression levels of PI3 K, p-AKT, IKKβ and p-NF-κB P65 as well as the nuclear entry of p-NF-κB P65 in cervical tissues were down-regulated. These findings suggest that Panlongqi Tablets can significantly inhibit the inflammatory response of CSA rats, and the mechanism of action may be related to the down-regulation of the activation of PI3 K/AKT signaling pathway.
Animals ; Drugs, Chinese Herbal ; I-kappa B Kinase/pharmacology* ; NF-kappa B/metabolism* ; Network Pharmacology ; Phosphatidylinositol 3-Kinases/metabolism* ; Protein Serine-Threonine Kinases ; Proto-Oncogene Proteins c-akt/metabolism* ; Rats ; Signal Transduction ; Spondylosis/drug therapy* ; Tumor Necrosis Factor-alpha/metabolism* ; Vascular Endothelial Growth Factor A/genetics* ; Vertebral Artery/metabolism*

Objective:To observe the effect of Tongluo Shenggu capsule （TLSGC） on glucocorticoid-induced vascular endothelial cell functional damage， and to preliminally explore the mechanism of action through MEK-ERK signaling pathway. Method:The blood vessel of aorta rings of normal SD rats were induced in vitro intervention with methylprednisolone sodium succinate （MPS， 0.04 g·L^-1） and/or vascular endothelial growth factor （VEGF， 20 μg·L^-1）， and were treated with TLSGC（12.5， 25， 50 μg·L^-1） continuously for 5 days to observe the number， length and area of microvascular ring buds．In addition， human umbilical vein endothelial cells （HUVEC） induced by VEGF（20 μg·L^-1） were added into MPS（0.04 g·L^-1） and TLSGC （12.5， 25， 50 μg·L^-1） were added. Then， Transwell migration， Transwell invasion and lumen formation experiments were used to detect the migration， invasion and lumen formation ability of HUVEC， respectively. The content of nitric oxide（NO） in the cell supernatant was detected by nitrate reductase method， the content of endothelin 1（ET-1） in the cell supernatant was detected by dry powder method. Moreover， the protein contents of vascular endothelial growth factor receptor 2 （VEGFR2）， extracellular signal-regulated kinase （ERK）， phospho-extracellular signal-regulated kinase （p-ERK）， mitogen extracellular kinase1（MEK） and phosphorylated mitogen extracellular kinase1（p-MEK） in the cells were determined by Western blot. Result:Compared with the normal group， MPS could significantly inhibit the number， length and area of VEGF-induced rat thoracic aortic ring microvessels， HUVEC cell migration， invasion and lumen formation ability. It could reduce NO content and increase ET-1 content. MPS could also significantly reduce the protein content of VEGF-induced VEGFR2， p-MEK and p-ERK in HUVEC（P<0.05，P<0.01）. Compared with the model group， TLSGC could dose-dependently increase the number， length and area of MPS-induced abnormally reduced rat thoracic aortic ring microvessels， promote MPS-induced abnormally decreased HUVEC cell migration， invasion and lumen formation ability. It could increase the protein contents of NO， VEGFR2， p-MEK and p-ERK in HUVEC， and reduce abnormally increased ET-1 content（P<0.05，P<0.01）. Conclusion:TLSGC has a protective effect on the damage of angiogenesis and secretion of vascular endothelial cells induced by glucocorticoid， and the mechanism may be related to the activation of MEK/ERK signaling pathway.

Objective:To observe the stability of severe acute respiratory syrdrome coronavirus （SARS-CoV-2） in cell cultures at different temperatures so as to provide basic data and scientific basis for the research and control of COVID-19 epidemic. Methods:The Vero E6 cells inoculated with SARS-CoV-2. According to TCID₅₀， SARS-CoV-2 with different dilution （10^-1， 10^-3， 10^-5， 10^-6）were stored at 37 °C， 22.5 °C， and 4 °C for one to seven days， and then infectious titer was determined by micro cytopathogenic effect assay， observing cytopathic effect （CPE）， and real-time fluorescence quantitative testing. Results:SARS-CoV-2 was stable under 4 °C. The infectivity of high concentration （10^-1 dilution） under 22.5 °C for seven days gradually decreased， while lower concentration completely lost infectivity after one day. The virus lost infectivity when stored at 37 °C for more than one day. Conclusion:SARS-CoV-2 is highly stable at 4 °C， sensitive to heat， and related to virus concentration.