Objective:To compare 2 modalities of Kirschner pin fixation for severely displaced (Campbell type Ⅱ) juxta-epiphyseal fracture of the proximal phalanx in children.Methods:A retrospective study was conducted to analyze the clinical data of 69 children with severely displaced (Campbell type Ⅱ) juxta-epiphyseal fracture of the proximal phalanx who had been treated at Department of Orthopaedics, Shenzhen Children's Hospital from January 2018 to December 2020. Clinical data: 41 boys and 28 girls; (7.6±3.2) years in age; 34 left hands and 35 right hands affected; 4 thumbs, 4 middle fingers, 5 ring fingers, and 56 little fingers injured. The patients were divided into 2 groups according to surgical modalities. Group A (35 fingers in 35 cases) was treated by closed reduction, longitudinal intramedullary fixation with a single Kirschner pin, and external plaster fixation while group B (34 fingers in 34 cases) by closed reduction, crossing fixation with 2 Kirschner pins, and external plaster fixation. The 2 groups were compared in terms of preoperative fracture angulation, operation time, postoperative fracture angulation, hospitalization days, and postoperative functional recovery.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). All fractures got united after 3 to 6 weeks. There was no statistically significant difference between the 2 groups in terms of preoperative fracture angulation, operation time, or postoperative fracture angulation ( P>0.05). The hospitalization days in group A were significantly shorter than that in group B ( P<0.05). Fifty children (24 cases in group A and 26 cases in group B) were followed up for (54.3±10.5) months. By the trial criteria for upper limb functional evaluation of the Hand Surgery Society, the hand function was evaluated at the last follow-up as excellent in 24 cases in group A, giving an excellent rate of 100% (24/24), and as excellent in 26 cases in group B, giving an excellent rate of 100% (26/26) too, showing no significant difference between the 2 groups ( P<0.05). No postoperative complications such as Kirschner wire breakage, needle tract infection, significant angular deformity, rotational deformity, or bone bridge formation occurred in any of the patients. Conclusion:For children with severely displaced (Campbell type Ⅱ) juxta-epiphyseal fracture of the proximal phalanx, longitudinal intramedullary fixation with a single Kirschner pin and crossing fixation with 2 Kirschner pins may achieve comparable efficacy in terms of fracture stability and function, but the former may result in shorter hospitalization days.

The vagus nerve, as an important "guardian" of the body, is involved in the steady-state regulation of cardiovascular, respiratory, gastrointestinal digestion and endocrine systems. Recent studies have shown that the vagus nerve plays an important regulatory role in inflammatory response via the inflammatory reflex, which is closely related to the fact that the afferent and efferent fibers of the vagus nerve can sense and regulate inflammation, respectively. The pathophysiological mechanism of sepsis is based on the dysregulation of immune response, and it is often initiated by the excessive inflammatory response of the innate immune system. In recent years, in order to expand intervention strategies for the immune dysregulation of sepsis, researchers have made many efforts on regulating the inflammatory response of the vagus nerve in sepsis. This article focuses on the mechanism of vagus nerve-mediated inflammatory reflex and the regulatory role of vagus nerve in inflammatory response of sepsis, in order to reveal new therapeutic strategies for the treatment of sepsis.

Objective To analysis the change of hip joint in healthy infants by ultrasound,and establish the normal reference value of the developmental dysplasia of the hip(DDH). Methods A total of 8 000 healthy infants from 0 to 24 weeks were collected from the Multi-center study of 10 children′s medical centers. Among them,3 855 infants(2 065 females and 1 790 males) with complete data and follow-up were included in this study. All subjects were divided into 6 groups ( ＜4,4～7,8～11,12～15,16～19 and≥20 weeks group). α angle,femoral head length and width,femoral head coverage ratio by acetabulum ( FHC) were measured in the coronal view on the neutral position;distance from pubis to femoral head ( P-H) and distance from ischium to femoral head ( I-H ) were measured in the transverse view on neutral position;distance from femoral head topubis ( H-P) was measured in the posterolateraltransverse view on the flexion position. The results of each group changes with age were analysised. Results ① The α angle of healthy infants from 0 to 20 weeks were increased with age,the difference among the groups were statistically significant( P ＜0.05),but there was no significant difference between 16～19 and ≥20 weeks group( P ＞0.05). ②The femoral head length and width of all age groups were increased with age,the difference among all the groups was statistically significant( all P ＜0.05). ③ FHC from 0 to 20 weeks were increased with age,the difference among the groups were statistically significant( P ＜0.05) except between 16～19 and ≥20 weeks group( P ＞0.05). ④ The P-H and I-H in all age groups showed no statistically significant ( all P＞0.05). ⑤The H-P of all age groups were increased with age,the difference between the groups were statistically significant(all P ＜0.05).Conclusions The development of hip joints have the certain regular developmental pattern in healthy infants less than 5 months of birth and are relatively constant after birth more than 5 months. The ultrasound normal reference value of the hip joints can be used for the early diagnosis of the DDH.