[Objective]To investigate the hallux valgus angle and pathogenesis of hallux valgus in general population.[Method]A total of 1 233 adult population in Shijiazhuang were selected for this study by random cluster sampling method,then a questionnaire survey was participated including gender,age,nation,culture degree,inhabitate time,symptome occurrence time,original symptome,aggravate factors,relieve factors,family medical history,living habit,life style,et al.Hallux valgus angle was measured by protracter.The angle exceed 15? was confirmed the hallux valgus.The data was analysised with logistic multiple regression analysis.[Result]The average hallux valgus angle was(8.31?4.93)? of male and(9.72?7.12)? of female.There were 98 hallux valgus patients in this study,and the morbidity rate was 7.95%.The morbidity rate was 1.29% of male and 11.00% of female.Ratio of male to female was 1∶8.53.The average age was 22 years old.The concentrated symptome occurrence time was 20 to 45 years old;the average age was 25 years old.78 hallux valgus patients had a family medical history(79.6%).The dangerous factors of hallux valgus were inheritance,gender,flatfoot.The effective factors in female related to inheritance,the age that start wearing high-heel shoes but not to the height of the heel and the full time who were high-heel shoes.The aggravate factors were as follow:wearing high-heel shoes,long time standing,long time walking.The relieving factors were as follow:wearing flat and low-hell shoes,a warm water bath for foot,massage.[Conclusion]Female has a high risk to have hallux valgus.The hallux valgus has a close relationship with inheritance,and the age who start wearing high-heel shoes influences the incidence in female.

Objective To evaluate the protective effect of adiponectin in early atherosclerosis and the diagnostic value of adiponectin in metabolic syndrome in obese children. Methods Total 176 obese children and 88 normal weight children aged 9-12 years were included in the present study. All participants underwent hematologic and biochemical tests including serum adiponectin, high sensitivity C-reactive protein (hsCRP),fasting blood glucose, insulin, and plasma lipids. Homeostasis model assessment of insulin resistance (HOMA-IR)was calculated. Noninvasive ultrasound measurement including intima-media thickness of the common carotid artery(IMT), brachial flow-mediated dilatation (FMD), carotid artery compliance (CAC), and the maximum fatthickness ahead of peritoneum (Pmax) were obtained to investigate arterial mechanical properties and endothelial function. Results (1) The level of adiponectin was negatively correlated with obese index, blood pressure,fasting insulin, hsCRP, HOMA-IR, and IMT(P<0.05 or P<0. 01 ); but not with triglyceride, fasting blood glucose, CAC, high-density lipoprotein-cholesterol (HDL-C), and FMD. (2) The risk of metabolic syndrome increased 3.43 times in children with adiponectin level <7. 060 mg/L compared with ＞7. 060 mg/L. (3)Receiver operating characteristic( ROC ) curve was used to choose the optimal cutpoint of adiponectin to identify obese children with the metabolic syndrome. The area under the curve (AUC) for adiponectin to discriminate the sensitivity of metabolic syndrome was 0. 769 (95% CI0. 714-0.816, P< 0. 0 1 ). (4) The obese children were divided into three groups according to the cut-off value for adiponectin (high, middle, low groups). There were significant differences in the prevalences of severe obesity, visceral fat accumulation, hypertension, insulinemia,low HDL-C, metabolic syndrome among three groups (P<0.05). Conclusions High levels of serum adiponectin could prevent early stage of atherosclerosis. The lower the adiponectin level, the higher the incidence of metabolic syndrome.

Primary congenital glaucoma (PCG) is one of the major diseases causing blindness in children, but its pathogenesis has remained unclear. Genetic factors play an important role in the pathogenesis of PCG. Molecular genetics of candidate genes such as CYP1B1, MYOC, LTBP2 and FOXC1 has so far been explored, but no disease-causing gene has been identified. Molecular genetic research on PCG including candidate gene screening and research strategies are reviewed here.
Animals ; DNA Mutational Analysis ; Genetic Testing ; Glaucoma ; genetics ; Humans

OBJECTIVE:To establish a method for the determination of related substances in Lovastatin tablet. METHODS:HPLC was performed on the column of Waters XTerra? MS C18 with mobile phase A of 0.01%Phosphoric acid solution and B of acetonitrile(gradient elution)at a flow rate 1.0 ml/min,column temperature was 40 ℃,the detection wavelength was 238 nm,and the injection volume was 10 μl. RESULTS:The impurity components were well separated in principal components;the linear range of lovastatin was 17.5-700 μg/ml(r=0.9999);RSDs of precision,stability and reproducibility tests were lower than 1%;recov-ery was 99.30%-100.67%(RSD=0.4%,n=9). CONCLUSIONS:The method is reproducible with good durability and high preci-sion,and can be used for the quality control of Lovastatin tablet.

Objective To investigate and analyze the influence of whole blood specimens storage time in blood routine examination parameters. Methods All 40 healthy cases were randomly selected, and all the whole blood specimens were stored at 4℃. 1,2,3,5 and 7 days after the blood sampling,the specimens were tested by Sysmex-XS1000 au-tomated hematology analyzer, and statistical analysis was conducted. Results The specimens were kept in refrigerator at 4℃,for 7 days, WBC, RBC, Hb, MCH, PLT, RDW-CV, N, L, M and E could still maintain stable. There was no significant difference(P>0.05)in comparing all the measurement data and the fresh sample measurement data. HCT,MCV,RDW-SD and B% gradually increased after 3 days, and MCHC gradually decreased. The difference was statis-tically significant (P<0.05). Conclusion Complete blood count specimens can store at 4℃ for 3 days. The results are relatively stable,and parts of main analysis indicators results can still remain stable for a week.

Objective To explore the value of clinical application of high intensity focused uitrasound (HIFU)supplementary treatment evaluated and instructed by immediate contrast-enhanced uitrasound for Drimary hepatic carcinoma.Methods Fifty-five cases(68 lesions)of hepatocellular carcinoma(HCC)were randomized into 2 groups,30 cases(38 lesions)in group A and 25 cases(30 lesions)in group B.Patients of group A were examined by contrast-enhanced ultrasound before and after therapy in 10 minutes.The lesions of incomplete deactivation were treated by HIFU in time.The treatment security and the therapeutic effects were observed by the clinical symptom,serum AFP and imaging appearance.The long-term therapeutic effects were judged by follow-up survival rate.Results Nineteen lesions in group A were found incomplete deactivation and run supplementary treatment in time.No serious complication was identified.The AFP descending rate was 86.7%(26/30)in group A,64.0%(16/25)in group B,respectively(P＜0.05),and the lesions complete necrosis rate was 97.3%(37/38),60.0%(1 8/30),respectively(P＜0.05).Half year survival rate was 100%in group A,90.0%ih grouD B(P＜0.05),and 1 year survival rate was 76.0%,68.0%,respectively(P＜0.05).Conclusions HIFU supplementary treatment evaluated and instructed by immediate contrast-enhanced ultrasound for primary hepatic carcinoma can help to destroy the lesions completely,alleviate the symptom,reduce recurrence,improve life quality,lengthen the lifcrime,and has the better clinical practice value.

Caries is a frequently occurring oral disease that is caused by chronic, progressive destruction of dental hard tissue. The enamel is the superficial layer of the tooth crown; enamel formation-related genes play an important role in the development of enamel, and enamel demineralization is a prerequisite for the occurrence of caries. Therefore, this paper reviewed the relationship between enamel-related gene polymorphisms and caries susceptibility and its possible mechanisms to provide new ideas for the prevention and treatment of caries. The results of a literature review showed that the gene polymorphisms related to enamel formation may increase or decrease susceptibility to caries by influencing the development and structure of enamel. For example, ENAM rs3796703 CT can increase the susceptibility to caries, and AMBN rs34538475 TT can reduce the susceptibility to caries. In the future, the detection and analysis of polymorphisms related to enamel formation that affect the structure or development of enamel may serve as a clinical method to evaluate the susceptibility of caries, which is of great significance for the early prevention and treatment of the disease.

Objective To investigate the indication of approach,type of fixation and the clinical outcome of minimally invasive internal fixation for treatment of pelvic anterior ring injury.Methods From January 2012 to August 2016,data of 32 patients with 44 pelvic anterior ring injuries who had been treated with minimally invasive internal fixation were retrospectively analyzed.There were 22 males and 10 females with an average age of 38.2 years old (range,20-65 years).14 patients were injured by traffic accident,12 patients by falling and 6 patients by crush injury.There were 4 cases of pubic symphysis diastasis,27 fractures of anterior ring which included 12 billatral fractures and 1 combined vertical displacement of pubic symphysis associated with pubic fracture.According to AO classification,there were 3 cases in A2.3,3 cases in B1.2,4 cases in B2.2,4 cases in B2.3,2cases in C1.1,1 case in C1.2,5 cases in C1.3,4 cases in C2,6 cases in C3.There were 25 patients associated with other injuries,including brain injury in 2,thoracic injury in 17,abdominal injury in 8,urogenital system injury in 5,lumbosacral nerve plexus injury in 4 and the extremity or lumbar fracture in 19.The average period from injury to operation was 9.2 d (range,5-32 d).4 patients who had the pubic symphysis diastasis,3 had pelvic anterior ring fracture medial obturator foramen and 1 combined vertical displacement of pubic symphysis associated with pubic fracture were reduced by modified Pfannenstiel incision and fixed with cannulated screws,while 36 patients with fractures of lateral obturator foramen were reduced by modified Pfannenstiel incision associated with small ilial crest incision and fixed with locking reconstruction plates,and 25 patients received the fixation of pelvic posterior ring injury simultaneously.Results The average time of operation was 44.5 min (range,30-65 min),and the average amount of blood loss intraoperative was 56.2 ml (range,20-150 ml).All patients were followed up successfully,with an average time of 28.2 months (range,16-42 months).All the fractures were healed with an average time of 4.5 months (range,3-9 months).According to Matta standard of reduction assessment,30 fractures' reduction were excellent,12 were good and 2 were fair,which the rate of satisfaction was 95.5％ (42/44).Neither reduction loss or fixation failure nor infection occurred,and the occurrence rate of complication was 9.1％ (4/44),including one patient with fatal liquefaction and was cured 3 weeks after wound dressing,one patient with lateral femoral cutaneous nerve injury who was cured within 3 months by oral drug and 2 patients who complained discomfort of inguinal area because of the fixation prominence and were lessened by physical therapy.Conclusion Minimally invasive internal fixation can be recommended for treatment of pelvic anterior ring injury because of the advantages of less damage,safer manipulation,less complications and good prognosis.

Objective To investigate the clinical results and summarize the advantages and surgical indications in the treatment of femoral head fractures (Pipkin type Ⅰ and Ⅱ) via medial hip approach.Methods From October 2014 to August 2015,sixteen patients of femoral head fracture (Pipkin type Ⅰ and Ⅱ) surgically treated via medial hip approach were retrospectively analyzed in our Hospital.There were 13 males and 3 females with an average age of 44.8 years (range,22-62 years old).According to Pipkin classification,12 femoral head fractures were classified as type Ⅰ and 4 type Ⅱ.Thirteen patients were injured by traffic accidents,two patients by falling down from height and one patient was injured by collapses of a heavy objective.All femoral head fractures were combined with posterior hip dislocation.The skeletal traction was performed in each patient after successful close reduction of the hip joint under general anesthesia.Computed Tomography scans of hip joints were performed routinely.All femoral head fractures were fixed with absorbable screws via medial hip approach.The mean time from injury to operation was 5.3 days (range,2-14 days).Results The average duration of the operations was 75 min (range,60-110 min).The average length of incisions was 7.1 cm (range,6-9 cm).The average blood loss was 160 ml (range,80-300 ml).All the patients were followed up for an average period of 26.3 months (range,24 to 30 months).Eight femoral head fractures with Pipkin Ⅰ and three with Pipkin Ⅱ were union and the healing time was 3-12 months,with an average time of 8.8 months.Three femoral head fractures with Pipkin Ⅰ were incomplete union at the latest follow-up of 24 months after surgery.One femoral head fracture with Pipkin Ⅰ and one with Pipkin Ⅱ didn't get union at the latest follow-up of 24 months after surgery.According to Thompson and Epstein function evaluation,the clinical outcomes were rated as excellent in 12 cases,good in 1,fair in 3.The excellent and good rate was 81.3％ (13/16).According to Merled'Aubigne-Postel evaluation criterion,there were 13 cases excellent,1 good and 2 fair.The excellent and good rate was 87.5％ (14/16).There were no intraoperative complications in all patients such as neurovascular injury injuries.No incision infection,fat liquefaction and other incision related complications occurred postoperatively.Avascular necrosis of the affected femoral head occurred in one case whose symptom didn't aggravate after appropriate conservation.Fractures were nonunion in 2 cases but the patients' functions were satisfactory in daily living.Traumatic arthritis of the affected hip occurred in 2 cases.The patients felt uncomfortable with long walking but could get better after taking NSAIDs.The fracture fragment absorption occurred in 3 cases but these patients had a good function and needed no further treatment.Conclusion Good exposure could be achieved for reduction and fixation in the treatment of femoral head fractures (Pipkin Ⅰ、Ⅱ) via hip medial approach.The operation is a minimally invasive procedure and the treatment outcome is satisfactory,but the indication should be strictly controlled.

Objective:To investigate the clinical outcomes of fragility fractures of the pelvis (FFP) treated with robot-assisted screws, minimally reduction according to the pelvic osseous pathways.Methods:A retrospective analysis was performed on the data of 50 elderly patients with FFP treated by the Department of Trauma and Pelvic Trauma of Tianjin Hospital from March 2016 to October 2021, and the 50 patients with FFP were divided into robotic-assisted screw fixation group (robot group) and open reduction steel plate fixation group (open group) according to the fixation method. There were 30 patients in the Robot group, 6 males and 24 females, average age 75.03±7.32 years (range, 60-90 years). According to Rommens and Hofmann FFP classification, there were 4 cases of IIc type, 8 cases of IIIa type, 1 case of IIIb type, 12 cases of IIIc type, 3 cases of IVa type, 2 cases of IVb type. There were 20 patients in the open group, 5 males and 15 females, average age 71.90±5.51 years (range, 62-85 years). According to Rommens and Hofmann FFP classification, there were 2 cases of IIc type, 6 cases of IIIa type, 9 cases of IIIc type, 3 cases of IVa type. The two groups were compared with age, pelvic fracture classification, operation time, intraoperative blood loss, fracture reduction quality, visual analogue scale (VAS), Majeed score, and wound healing or not.Results:All patients were followed up for 12.72 months (range, 6-24 months). In the robot group, the operation time was 50.17±19.32 min (range, 30-120 min), and intraoperative blood loss was 55.50±28.60 ml (range, 10-150 ml); in the open group, the operation time was 92.25±27.55 min (range, 60-180 min), and intraoperative blood loss was 217.50±67.20 ml (range, 150-400 ml), there were statistical differences ( t=6.36, P<0.001; t=11.72, P<0.001). According to Mears and Velyvis imaging evaluation criteria, in the robot group, anatomical reduction were achieved in 10 cases, satifactory reduction were achieved in 20 cases; in the open group, anatomical reduction were achieved in 14 cases, satifactory reduction were achieved in 6 cases, there were statistical differences (χ 2=6.46, P=0.011). In the robot group, VAS for pelvic pain was 7.33±1.32 points (range, 4-9 points) before operation, 4.13±1.07 points (range, 3-8 points) one week after surgery, and 2.30±0.84 points (range, 1-5 points) at the last follow-up; in the open group, VAS for pelvic pain was 7.45±1.23 points (range, 5-9 points) before operation, 5.25±1.25 points (range, 3-8 points) one week after surgery, and 2.80±1.24 points (range, 1-6 points) at the last follow-up, the difference between the two groups was statistically significant ( F=162.18, P<0.001; F=70.18, P<0.001), the difference between the two groups was statistically significant 1 week after surgery ( t=3.37, P=0.001), and there was no statistically significant difference between the two groups before surgery and the last follow-up ( P>0.05). The Majeed score was 82.10±4.80 (range, 65-95) in the robot group, 77.60±5.40 (range, 70-93) in the open group at the last follow-up, there were statistical differences ( t=3.09, P=0.003). There was no wound complication in the robot group, there were 4 cases with wound infection or rupture in the open group. One LC-II screw loosen in the robot group, which needed reoperation with cement, there was also 1 screw of plate loosening in the open group with no reoperation. Conclusion:Robot-assisted screws fixation with minimally reduction based pelvic osseous pathways shows satisfactory clinical outcomes, satisfactory reduction, effective pain relief, and fewer postoperative complications in treatment of elderly FFP.