Objective To explore the clinical effect of percutaneous osteoplasty with SKy bone expander system in the treatment of calcaneal fracture.Methods 63 feet of 55 patients with calcaneal fractures were involved in this study.According to Sanders fracture classification including 38 feet of Sanders Ⅱ,18 feet of Sanders Ⅲ,7 feet of Sanders Ⅳ.There were 6 to 16 days interval between the injuries and the surgeries.The patients were treated by percutaneous osteoplasty with the SKy bone expander system.The standard of operation was the satisfaction of reduction and Bohler's and Gissane's angles under X-ray.Results All of 63 feet of 55 patients were followed up for average 22 months.According to the criterion of therapeutic effect,the results were as follows:excellent in 30 cases,good in 26 cases,fair in 7cases,and no poor case.The excellent and good rate was 88.9％.Conclusion Percutaneous osteoplasty with SKy bone expander system in the treatment of calcaneal fracture,especially in reduction and fixation of Sanders type Ⅱ and Sanders type Ⅲ,can recover Bohler's and Gissane's angles,significantly shorten the duration of illness,and has fast recovery and can possess satisfactory curative effect,and it is worth popularizing.

Objective To study the expression of tumor stem cell marker aldehyde dehydrogenase 1 (ALDH1)in invasive bladder cancer tissue and to clarify its relationship with the biological behavior of bladder cancer. Methods The ALDH1 expression in 109 cases of primary invasive carcinomas specimens (case group)and 20 cases of normal bladder tissue surrounding cancer (control group)was detected by immunohistochemistry. At the same time,the ALDH1 expression in 6 cases of metastatic pelvic lymph node tissue and 20 cases of non-metastatic pelvic lymph node tissue was detected. The relationship between the ALDH1 expression and the chinicopathological charateristics of invasive bladder cancer and its influence in the survival rate and disease-free survival were analyzed. Results The positive rates of ALDH1 expression in bladder cancer tissue and normal bladder tissue were 33.94%(37/109)and 5.00% (1/20),respectively,there was significant different between them (P<0.01);they were 19.05% (8/42)and 43.28% (29/67)in the cases with non muscle invasive and nmuscle invasive bladder cancer, respectively,there was significant difference (P<0.01);they were 13.04% (3/23)and 39.53% (34/86)in the cases of bladder cancer with low grade and high grade,respectively,there was significant difference (P<0.05);they were 50.00% (3/6)and 12.90% (4/31)in the tissue of bladder cancer with metastatic lymph nodes and non metastatic ones,respectively,there was significant difference (P<0.05);they were 50.00% (3/6)and 0.00%(0/20)in the metastatic lymph nodes and non metastatic ones,respectively,there was significant difference (P<0.01).The overall survival rate in the patients with positive ALDH1 expression was 64.9% while it was 84.7% in negative ones,there was significant difference (P<0.05);the disease-free Survival was 51.4% and 75% in the patients with positive and negative ALDH1 groups,respectively,there was significant difference (P<0.05). Conclusion The high expression of tumor stem cell marker ALDH1 is associated with staging, grading and prognosis of invasive bladder cancer.ALDH1 may play a role in the tumorigenesis,progression and metastasis of bladder cancer.

Objective To explore the changes of serum thyroid peroxidase antibody (TPOAb), thyroglobulin (Tg), and anti-thyroglobulin antibody (Tg-Ab) in patients with gestational thyroid dysfunction and their relationship with pregnancy outcomes. Methods The clinical data were collected from 98 patients with gestational thyroid dysfunction in Nanchong Mental and Physical Hospital between January 2020 and December 2022. According to disease types, patients were divided into hyperthyroidism group (n=50) and hypothyroidism group (n=48). A total of 100 pregnant women with normal thyroid function during the same period were enrolled as the healthy group. The levels of serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroid hormone (FT4), TPOAb, Tg and Tg-Ab, and maternal and neonatal outcomes were compared among the three groups. According to maternal and neonatal outcomes, patients with gestational thyroid dysfunction were divided into normal pregnancy group (n=68) and adverse pregnancy group (n=30), and levels of serum TPOAb, Tg and Tg-Ab were compared between the two groups. Results Compared with the healthy group, level of serum TSH was decreased in the hyperthyroidism group (P<0.05), while levels of serum FT3, FT4, Tg, Tg-Ab and TPOAb were increased (P<0.05). Compared with the healthy group, levels of serum FT3 and FT4 were decreased in the hypothyroidism group (P<0.05), while levels of serum TSH, TPOAb, Tg and Tg-Ab were increased (P<0.05). The level of serum TSH in the hyperthyroidism group was lower than that in the hypothyroidism group (P<0.05), while levels of serum FT3, FT4, Tg, Tg-Ab and TPOAb were higher than those in the hypothyroidism group (P<0.05). There was no significant difference in the overall incidence of adverse pregnancy outcomes between the hyperthyroidism group and the hypothyroidism group (34.00% vs 27.08%, P>0.05), but the overall adverse pregnancy outcome rate in the two groups was higher than that in the healthy group (9.00%, P<0.05). The levels of serum TSH, TPOAb and Tg-Ab in adverse pregnancy group were higher than those in normal pregnancy group (P<0.05). Conclusion The levels of serum TPOAb, Tg and Tg-Ab are abnormally increased in patients with gestational thyroid dysfunction, which are all related to adverse pregnancy outcomes. Clinical attention should be paid to and early intervention should be taken.