ObjectiveTo investigate the status of sleep insufficiency in children and adolescents with mental disorders and related influencing factors. MethodsA total of 131 children and adolescents who were admitted to the Third People's Hospital of Fuyang from February to June 2021 and met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） for schizophrenia， depression or childhood-onset mood disorders were selected as the research subjects. A self-compiled questionnaire was used to collect the general demographic information， sleep status， lifestyle habits， family and school status of the selected individuals. The demographic information was compared between sleep sufficiency group and sleep insufficiency group. Spearman rank correlation was used to screen the influencing factors. Results① Among 131 children and adolescents with mental disorders， 93 cases （71.0%） had sleep insufficiency. There were significant differences between sleep insufficiency group and sleep sufficiency group in terms of disease types （χ²=8.798， P=0.012）， experience of being beaten in recent 6 months （χ²=3.427， P=0.035）， being scolded in recent 6 months （χ²=4.145， P=0.031）， and cyberbullying over the past year （χ²=4.187， P=0.041）. ② Among patients with sleep insufficiency， 77 cases （82.8%） reported difficulty in falling asleep and 69 cases （74.2%） reported nocturnal awakenings. ③ Sleep insufficiency in children and adolescents with mental disorders was positively correlated with the experience of being scolded （r=0.210， P=0.037） or beaten （r=0.145， P=0.023） over the past 6 months and cyberbullying over the past year （r=0.179， P=0.041）. ConclusionChildren and adolescents with mental disorders suffer a high risk of sleep insufficiency， and is closely associated with depressive disorder， experience of being scolded or beaten over the past 6 months， and cyberbullying over the past year.

OBJECTIVE: To investigate the clinical efficacy of femoral neck system(FNS) and three cannulated compression screws(CCS) in the treatment of unstable femoral neck fractures in young adults. METHODS: The clinical data of 52 young and middle-aged patients with unstable femoral neck fractures admitted from August 2018 to August 2021 were reviewed and analyzed. All patients were divided into two groups according to the internal fixation method, 25 cases were treated with FNS fixation, 27 cases were treated with closed reduction and 3 CCS inverted triangular distribution. The operation time, incision length, intraoperative bleeding, hospitalization expenses and fracture reduction quality of two groups were recorded and compared;The patients were followed up regularly after operation. The fracture healing time, complete weight-bearing time and postoperative complications(nonunion, femoral neck shortening, femoral head necrosis) of two groups were compared. The Harris score was used to evaluate hip function 6 months after surgery. RESULTS: The operation was successfully completed in both groups. The patients in FNS group had more bleeding, longer incision length and higher hospitalization cost than CCS group(P<0.01). There ware no significant difference in operation time and Garden index between two groups(P>0.05). Patients in both groups were followed up for 6 to 32 months.The fracture healing time in FNS group was less than that in CCS group, the time of complete weight bearing after surgery was earlier than that in CCS group, and the hip Harris score was higher than that in CCS group (P<0.01). There were no internal fixation fracture complications in two groups during follow-up. In the FNS group, there were 4 cases of avascular necrosis of the femoral head and 2 cases of femoral neck shortening, of which 3 cases underwent total hip replacement due to avascular necrosis of the femoral head. In the CCS group, there were 2 cases of nonunion, 9 cases of avascular necrosis of the femoral head, and 11 cases of femoral neck shortening, among which 5 cases underwent total hip replacement due to nonunion and avascular necrosis of the femoral head. CONCLUSION With simple operation, rotational stability and angular stability, FNS enables patients to start functional exercise as early as possible and reduces the incidence of postoperative complications of unstable femoral neck fracture. It is a new choice for the treatment of unstable femoral neck fracture in young adults.

In recent years, with the steady development of the medicine and health industry in China, Chinese medicine has gradually been recognised and trusted by people around the world, its application amount has being increased in clinic and health care. The worth of its research is also becoming more and more prominent. However, the toxicity and side effects of Chinese materia medica (CMM) have aroused widespread attention, the increasing number of patients with liver function damage has occurred. Thereby, it is urgent to further analyse and study the mechanism of liver toxicity of CMM to ensure the clinical safety and efficacy of common CMM. Based on the latest literatures about hepatotoxicity of common CMM in recent years, the present study analyzed the major mechanism of hepatotoxicity of CMM from the perspective of metabolism and toxicology, in order to provide a novel approach for hepatotoxicity investigation of CMM, and offer the useful reference for the rational application of CMM in clinic.

OBJECTIVE: To analyze the correlation between bone cement cortical leakage and injury degree of osteoporotic vertebral compression fracture (OVCF) after percutaneous kyphoplasty (PKP), and to provide guidance for reducing clinical complications. METHODS: A clinical data of 125 patients with OVCF who received PKP between November 2019 and December 2021 and met the selection criteria was selected and analyzed. There were 20 males and 105 females. The median age was 72 years (range, 55-96 years). There were 108 single-segment fractures, 16 two-segment fractures, and 1 three-segment fracture. The disease duration ranged from 1 to 20 days (mean, 7.2 days). The amount of bone cement injected during operation was 2.5-8.0 mL, with an average of 6.04 mL. Based on the preoperative CT images, the standard S/H ratio of the injured vertebra was measured (S: the standard maximum rectangular area of the cross-section of the injured vertebral body, H: the standard minimum height of the sagittal position of the injured vertebral body). Based on postoperative X-ray films and CT images, the occurrence of bone cement leakage after operation and the cortical rupture at the cortical leakage site before operation were recorded. The correlation between the standard S/H ratio of the injured vertebra and the number of cortical leakage was analyzed. RESULTS: Vascular leakage occurred in 67 patients at 123 sites of injured vertebrae, and cortical leakage in 97 patients at 299 sites. Preoperative CT image analysis showed that there were 287 sites (95.99%, 287/299) of cortical leakage had cortical rupture before operation. Thirteen patients were excluded because of vertebral compression of adjacent vertebrae. The standard S/H ratio of 112 injured vertebrae was 1.12-3.17 (mean, 1.67), of which 87 cases (268 sites) had cortical leakage. The Spearman correlation analysis showed a positive correlation between the number of cortical leakage of injured vertebra and the standard S/H ratio of injured vertebra ( r=0.493, P<0.001). CONCLUSION The incidence of cortical leakage of bone cement after PKP in OVCF patients is high, and cortical rupture is the basis of cortical leakage. The more severe the vertebral injury, the greater the probability of cortical leakage.
Male ; Female ; Humans ; Aged ; Kyphoplasty/methods* ; Bone Cements ; Fractures, Compression/surgery* ; Spinal Fractures/surgery* ; Retrospective Studies ; Osteoporotic Fractures/etiology* ; Treatment Outcome ; Vertebroplasty/methods*

Objective: To investigate the clinical effects of en bloc resection and debridement combined with gluteus maximus muscle flap in the treatment of ischial tubercle pressure ulcer complicated with chronic osteomyelitis. Methods: A retrospective observational study was conducted. From May 2018 to February 2020, 8 patients with pressure ulcers on the ischial tuberosity combined with chronic osteomyelitis who met the inclusion criteria were admitted to Fuyang Minsheng Hospital, including 5 males and 3 females, aged 38-69 years, with unilateral lesions in 6 patients and bilateral lesions in 2 patients. According to the anatomical classification of Cierny-Mader osteomyelitis, there were 6 patients (7 sides) with focal type, and 2 patients (3 sides) with diffuse type. The wound areas were 3 cm×2 cm to 12 cm×9 cm on admission. The pressure ulcer and chronic osteomyelitis lesions were completely removed by en bloc resection and debridement. The chronic infectious lesions were transformed into sterile incisions like fresh wounds by one surgical procedure, and the gluteus maximus muscle flaps with areas of 10 cm×6 cm to 15 cm×9 cm were excised to transfer and fill the ineffective cavity. The wounds of 5 patients were sutured directly, and the wounds of 3 patients were closed by local flap transfer. The intraoperative blood loss volume and blood transfusion, and length of hospital stay of patients were recorded. The incision healing and flap survival of patients were observed after operation. The recurrence of pressure ulcer and osteomyelitis, the appearance of the affected area, and the secondary dysfunction and deformity of the muscle flap donor site of patients were observed during followed up. Results: The intraoperative blood loss volume of the 8 patients was 220 to 900 (430±150) mL; 5 patients received intraoperative blood transfusion, of which 2 patients received 3 U suspended red blood cells and 3 patients received 2 U suspended red blood cells. The length of hospital stay was 18 to 29 (23.5±2.0) d for the 8 patients. In this group of patients, the incisions of 7 patients healed, while in one case, the incision suture was torn off during turning over and healed after secondary suture. The flaps survived well in 3 patients who underwent local flap transfer. During the follow-up period of 6-20 months, no recurrence of pressure ulcer or osteomyelitis occurred in 8 patients, the affected part had skin with good texture, mild pigmentation, and no sinus tract formation, and no secondary dysfunction or deformity occurred in the donor site. Conclusions: The en bloc resection and debridement combined with gluteus maximus muscle flap has good clinical effects on ischial tubercle pressure ulcer complicated with chronic osteomyelitis. Neither pressure ulcer nor osteomyelitis recurs post operation. The skin texture and appearance of the affected area are good, and the donor site has no secondary dysfunction or deformity.
Blood Loss, Surgical ; Debridement ; Female ; Humans ; Male ; Muscles/surgery* ; Osteomyelitis/surgery* ; Perforator Flap ; Pressure Ulcer/surgery* ; Reconstructive Surgical Procedures ; Skin Transplantation ; Soft Tissue Injuries/surgery* ; Treatment Outcome

Objective: To introduce a self-designed adjustable operation frame and explore the feasibility and safety in the treatment of severe kyphosis secondary to ankylosing spondylitis with posterior osteotomy. Methods: Between March 2016 and May 2018, 7 cases of severe kyphosis secondary to ankylosing spondylitis were treated with posterior osteotomy using self-designed adjustable operation frame with prone position. There were 5 males and 2 females with an average age of 49.4 years (range, 40-55 years). The disease duration was 10-21 years (mean, 16.7 years). The apical vertebrae of kyphosis were located at T 11 in 2 cases, T 12 in 1 case, L 1 in 1 case, and L 2 in 3 cases. Among the 7 cases, 2 were classified as typeⅠ, 4 as type ⅡB, and 1 as type ⅢA according to 301 classification system. There was no neurological deficit of all cases; but 1 case suffered bilateral hip joints ankylosed in non-functional position. The parameters of chin-brow vertical angle (CBVA), global kyphosis (GK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL), sagittal vertical axis (SVA) were measured; and the operation time, the intraoperative blood loss, and the complications were also collected and analyzed. Results: All operations completed successfully. The operation time was 310-545 minutes (mean, 409.7 minutes) and the intraoperative blood loss was 1 500-2 500 mL (mean, 1 642.9 mL). There were 2 cases treated with one-level osteotomy of sagittal translation, 1 case of radiculopathy symptom of L 3, and 3 cases of tension of abdominal skin. All patients were followed up 20-35 months (mean, 27.9 months). There were significant differences in CBVA, GK, TLK, LL, and SVA between pre- and post-operation ( P<0.05); but no significant difference between 1 week after operation and last follow-up ( P>0.05). All the osteotomies and bone grafts fused well and no complications of loosening and breakage of internal fixator occurred during the follow-up. Conclusion: In the posterior osteotomy for correction of severe kyphosis secondary to ankylosing spondylitis, the self-designed adjustable operation frame is convenient for the patient to be placed in prone position. It is safe, feasible, and effective to perform osteotomy correction with the aid of the self-designed adjustable operation frame.

Objective : To explore the effect of LncRNA MEG3 in temozolomide (TMZ) resistance of glioma cells. Methods : TMZ⁃resistant glioma cells U87(U87/TMZ) were constructed,qRT⁃PCR was used to detect the LncRNA MEG3 expression level, and MTT was used to detect the cell proliferation ability. The LncRNA MEG3 in U87/TMZ was overexpressed by liposome method (pcDNA⁃MEG3 group), the empty vector was transfected as the empty vector group ( pcDNA group), and the conventionally cultured U87/TMZ was used as the blank group ( Control group),then treated with 10 μg/ml TMZ. The plasmid transfection effect was analyzed by qRT⁃PCR. The expression of LncRNA MEG3⁃related protein was confirmed by Western blot. The cell cloning experiment detects the effect of LncRNA MEG3 on cell proliferation. The effect of LncRNA MEG3 on cell invasion was tested by Transwell. The effect of LncRNA MEG3 on cell apoptosis was detected by flow cytometry. And mouse transplant tumoranimal model was constructed for in vivo experiments. Results : Compared with U87, the expression level of Ln cRNA MEG3 in U87/TMZ was lower (P < 0. 01), and the cell viability of U87/TMZ was higher than that of U87 (P < 0. 01) . After overexpression of MEG3 combined with TMZ, compared with the Control group and the pcDNA group, the pcDNA⁃MEG3 group up⁃regulated the expression of MEG3 mRNA and p53 protein, and down⁃regulated the expression of MDM2 protein, and the proliferation and invasion ability of the pcDNA⁃MEG3 group decreased while the apoptosis ability increased (P < 0. 01) . The construction of mouse transplant tumor animal model showed that the tumor volume and mass of the pcDNA⁃MEG3 group were reduced compared with the pcDNA group (P < 0. 01) . Conclusion Overexpression of LncRNA MEG3 can attenuate the drug resistance of TMZ⁃resistant glioma cells.

Objective: To discuss the clinical characteristics, mechanism, and treatment of odontoid fracture combined with lower cervical spinal cord injuries without fracture or dislocation.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Female ; Hip Fractures ; surgery ; Hip Prosthesis ; Humans ; Male

OBJECTIVE: To introduce a scout view scanning technique of back-forward bending CT (BFB-CT) in simulated surgical position for evaluating the remaining real angle and flexibility of thoracolumbar kyphosis secondary to old osteoporotic vertebral compression fracture. METHODS: A total of 28 patients with thoracolumbar kyphosis secondary to old osteoporotic vertebral compression fracture who met the selection criteria between June 2018 and December 2021 were included in the study. There were 6 males and 22 females with an average age of 69.5 years (range, 56-92 years). The injured vertebra were located at T ₁₀-L ₂, including 11 cases of single thoracic fracture, 11 cases of single lumbar fracture, and 6 cases of multiple thoracolumbar fractures. The disease duration ranged from 3 weeks to 36 months, with a median of 5 months. All patients received examinations of BFB-CT and standing lateral full-spine X-ray (SLFSX). The thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), local kyphosis of injured vertebra (LKIV), lumbar lordosis (LL), and the sagittal vertical axis (SVA) were measured. Referring to the calculation method of scoliosis flexibility, the kyphosis flexibility of thoracic, thoracolumbar, and injured vertebra were calculated respectively. The sagittal parameters measured by the two methods were compared, and the correlation of the parameters measured by the two methods was analyzed by Pearson correlation. RESULTS: Except LL ( P>0.05), TK, TLK, LKIV, and SVA measured by BFB-CT were significantly lower than those measured by SLFSX ( P<0.05). The flexibilities of thoracic, thoracolumbar, and injured vertebra were 34.1%±18.8%, 36.2%±13.8%, and 39.3%±18.6%, respectively. Correlation analysis showed that the sagittal parameters measured by the two methods were positively correlated ( P<0.001), and the correlation coefficients of TK, TLK, LKIV, and SVA were 0.900, 0.730, 0.700, and 0.680, respectively. CONCLUSION Thoracolumbar kyphosis secondary to old osteoporotic vertebral compression fracture shows an excellent flexibility and BFB-CT in simulated surgical position can obtain the remaining real angle which need to be corrected surgically.
Male ; Female ; Humans ; Aged ; Fractures, Compression/surgery* ; Spinal Fractures/diagnostic imaging* ; Lumbar Vertebrae/surgery* ; Thoracic Vertebrae/surgery* ; Kyphosis/surgery* ; Osteoporotic Fractures/surgery* ; Lordosis ; Tomography, X-Ray Computed ; Retrospective Studies