Objective To investigate the relationship of carotid artery stenosis and early postoperative cerebrovascular accident in patients undergoing off-pump coronary artery bypass grafting.Methods One hundred patients with carotid artery stenosis were divided into two groups by random digits table method:off and on-pump coronary artery bypass grafting group.The incidence of early cerebral vascular accident after operation in two groups (48 h after operation) was compared and analyzed.Results The rate of early postoperative cerebral vascular accident in on-pump coronary artery bypass grafting group was 18.2％ (8/44),1 patient occurred cerebral infarction,7 patients occurred transient ischemic attack,none occurred cerebral hemorrhage.The rate of early postoperative cerebral vascular accident in off-pump coronary artery bypass grafting group was 5.4％(3/56).The rate of early postoperative cerebral vascular accident between two groups had significant difference (x2 =4.141,P =0.042).Conclusion The patients with carotid artery stenosis with off-pump coronary artery bypass grafting can reduce early postoperative cerebral vascular accident.

Objective The kinds and activities of proteolytic enzymes of tongue,esophagus,craw,muscular stomach,glandular stomach,duodenum,large intestine,pancreas,liver in digestive system of Buteo buteo were studied to provide basic information for taxonomy and evolvement study of wild birds. Methods The experiment was carried out at 4℃ by using gelatine polyacrylamide gel electrophoresis(G-PAGE) ameliorated by Xu Cunshuan. Results 1.At least 26 kinds of proteolytic enzymes were found in digestive system of Buteo buteo.2.The kinds and activities of proteolytic enzymes in the digestive system of Buteo buteo were affected by pH.The activities of proteolytic enzymes was the weakest in the acid environment and the strongest in the alkaline environment,showing that the activity of the alkaline proteolytic enzymes were stronger than that of the neutral proteolytic enzymes,and that of the acid proteolytic enzymes were weakest.3.Duodenum and pancreas had more kinds and stronger activities of proteolytic enzymes than those in tongue,esophagus and craw in any pH value condition.4.The proteolytic enzymes with 75 and 70?kD molecular weight existed in every organ of digestive system except pancreas and liver in any pH condition.Conclusion The similarity of the kinds and the activities of proteolytic enzymes exist in the organs with similar structure and similar functions. The proteolytic enzyme of 75 and 70?kD molecular weight,whose pH-dependent activity is not obvious,exists widely in digestive system of Buteo buteo.The activity of proteolytic enzyme with 198?kD molecular weight is found in every organ of digestive system under pH 8.5 condition.

Objective The kinds and activities of proteolytic enzymes of organs in the digestive system of Grus grus were studied to provide basic information for the taxonomy and evolvement study of wild birds. Methods The experiment was carried out at 4℃ by using gelatine polyacrylamide gel electrophoresis(G-PAGE) ameliorat. Results 1.Altogether 26 kinds of proteolytic enzymes were found in the digestive system of Grus grus in all pH value conditions.2.The kinds and activities of proteolytic enzymes in the digestive system of Grus grus were affected by pH.The activities of proteolytic enzymes were weakest in the acid environment and strongest in the neutral environment,which shows that the activities of the neutral proteolytic enzymes were stronger than those of the alkaline proteolytic enzymes,and those of the acid proteolytic enzymes were weakest.3.The kinds and activities of proteolytic enzymes of the same organ varied tremendously in different pH value conditions.The proteolytic enzymes of different organs had different optimal pH values.4.Proteolytic enzymes with 19?kD molecular weight existed in every organ of the digestive system except glandular stomach in all pH conditions.Proteolytic enzyme with 66 and 22?kD molecular weight was found in every organ of the digestive system in the neutral environment.Conclusion The optimal pH value of proteolytic enzymes in the digestive system of Grus grus is 7.0.The distribution,activity and pH-dependency of proteolytic enzymes of 66?kD,22?kD,19?kD molecular weight are the important characteristic of proteolytic enzymes in the digestive system of Grus grus.

Objective To discuss the therapy for acetabular comminuted fractur e combined with compressive defects. Methods From July 1997 to February 2005, 43 cases of comminuted acetabular fracture combined with compressive defect were t reated. 25 cases were obsolete, 16 fresh, and 2 malformed (90 days after injury) . 34 cases were complicated fractures with defects, and 9 simple fractures with defects. The defect volumes ranged from 3 to 9 cm3, averaging 4.5 cm3. They were treated with ATMFS (acetabular tridimensional memory fixation system) to fixate the comminuted bone fragments tridimensionally. The modified acetabular approac h, reduction of acetabular comminuted articular face, anatomical reconstruction of posterior wall of acetabulum with autogenous ilium, autogenous and artificial bone implantation and bone wax isolation were used. The follow-ups lasted from 5 to 86 months, averaging 15.7 months. Results 31 cases achieved anatomical red uction by filling up the compressive defects. 12 cases were treated by anatomica l reconstruction of posterior wall. On average, 5.3 months after operation, the injured hip joint was as good as the healthy one in 40 cases. Ischemia necrosis of femoral head occurred in 1 case, and 2 cases experienced heterotopic ossifica tion with ischemia necrosis of femoral head which led to osseous fusion of hip j oint. Conclusion The new methods for treatment of acetabular fractures with comp ressive defects elevate the reduction rate of acetabulum and femoral head, and a re effective for the functional recovery of hip joint.

Objective:To master the iodine nutrition status of children and pregnant women after adjustment of salt iodization content in Shaanxi Province, and provide scientific basis for preventing and treating iodine deficiency disorders.Methods:In 2018, 107 counties (cities, districts) in Shaanxi Province were divided into three districts in Guanzhong, northern Shaanxi and southern Shaanxi for studying iodine nutrition based on terrain distribution. Among them, each monitoring county (city, district) was further divided into 5 sampling areas according to east, west, south, north, and middle locations. One township (street) was selected in each location, and forty-two 8 - 10 years old non-boarding children (age and sex balanced) and 21 pregnant women were selected in each township (street), edible salt samples and random urine samples were collected for salt iodine, urinary iodine testing, and goiter of children was examined.Results:A total of 34 264 edible salt samples from 8 - 10 years old children and pregnant women were collected, the median salt iodine was 23.80 mg/kg, and the qualified iodized salt consumption rate was 96.98% (33 229/34 264). The median salt iodine and the qualified iodized salt consumption rate were statistically significantly different among the three regions in Guanzhong, northern Shaanxi, and southern Shaanxi ( H = 26.471, χ 2 = 32.371, P < 0.05). A total of 22 895 urine samples were collected from children, with a median urinary iodine of 218.00 μg/L, which was at an ultra-suitable level of iodine nutrition; and 11 369 urine samples from pregnant women were collected, with a median urinary iodine of 181.03 μg/L, which was at an appropriate level of iodine nutrition. The median urinary iodine of pregnant women in Guanzhong, northern Shaanxi, and southern Shaanxi was 186.39, 177.52, and 176.00 μg/L, respectively. A total of 22 895 children aged 8 to 10 years old were examined, the goiter rate was 1.35% (309/22 895), and there was no significant difference between different regions (χ 2 = 3.395, P > 0.05). Conclusions:Shaanxi Province has reached the standard for elimination of persistent iodine deficiency, children's iodine nutrition is at a ultra-suitable level, and pregnant women is at an appropriate level.

Objective:This study aims to provide scientific evidence for prevention and treatment of iodine deficiency disorders through monitoring the iodine nutrition status of children and pregnant women in Shaanxi Province.Methods:Totally 110 counties (cities, districts) in Shaanxi Province in 2019 were surveyed. Each of the counties (cities, districts) was further divided into five sampled regions along five different geographic directions: east, west, south, north and middle. From each region, one town was selected and then one primary school was selected from each town. Finally, there were a total of 42 non-boarding students aged 8 - 10 years old (age and gender balanced) selected from each school, who would be tested household salt iodine's level and urinary iodine's level. Also, we did the same test for 21 pregnant women who were selected from each town randomly. Additionally, we examined the children's thyroid by B-scan ultrasonograph in 39 counties (cities, districts).Results:A total of 23 101 salt and urine samples were collected from children aged 8 - 10 years old, the average of salt iodine content of the children' family was (24.07 ± 3.71) mg/kg; the consumption rate of qualified iodized salt was 97.55% (22 536/23 101); the median urinary iodine was 211.68 μg/L; and the thyroid goiter rate (TGR) was 1.50% (123/8 191). A total of 11 555 salt and urine samples from pregnant women were collected, the salt iodine content was (24.05 ± 3.66) mg/kg; and the consumption rate of qualified iodized salt was 97.57% (11 274/11 555); the median urinary iodine was 182.74 μg/L.Conclusions:In 2019, the iodine nutrition of children in Shaanxi Province is in the super appropriate level, and the iodine nutrition of pregnant women is appropriate. The iodine content of edible salt can be adjusted. It is suggested that pregnant women should be supplied special iodized salt.

Objective:To learn about the iodine nutrition level of school-age children aged 8 - 10 in Shaanxi Province.Methods:From 2017 to 2020, in counties (cities, districts) under the jurisdiction of Shaanxi Province, one township (street) was selected from five directions: East, West, South, North and Middle, one primary school was selected from each township (street), and 42 non-boarding school-age children aged 8 - 10 (age balanced, half male and half female) were selected from each primary school. Random urine samples of children were collected once, and urinary iodine was detected by arsenic-cerium catalytic spectrophotometry.Results:A total of 91 766 children's urine samples were tested from 2017 to 2020, and the median urinary iodine was 221.7 μg/L. Urinary iodine < 100 μg/L accounted for 10.4% (9 554/91 766), 100 - < 200 μg/L accounted for 32.3% (29 602/91 766), 200 - < 300 μg/L accounted for 30.6% (28 065/91 766), and ≥300 μg/L accounted for 26.7% (24 545/91 766). The median of children's urinary iodine in each year was 228.5, 218.0, 211.7, and 230.1 μg/L, respectively, the difference between years was statistically significant ( H = 278.66, P < 0.001). Conclusion:From 2017 to 2020, the iodine nutrition of school-age children aged 8 - 10 in Shaanxi Province is generally in an ultra-suitable state.

Objective:To observe the effect of mirror visual feedback training on upper limb function and muscle tension in children with spastic hemiplegia resulting from cerebral palsy (SHCP).Methods:Seventy-six children aged 2-5 with SHCP were randomly divided into a control group of 33 and a treatment group 34. All were given routine occupational therapy, physical therapy, massage and physical agents. Each therapy session lasted 30 minutes daily, 5 times a week over 3 weeks as a course of treatment. There was a one week interval after each of 6 courses, so the total treatment lasted 6 months. The treatment group was additionally trained with mirror visual feedback with the same schedule. Before, as well as after 3 and 6 months of treatment, each patient′s upper limb motor function, fine motor function and muscle tone were evaluated using the Fugl-Meyer motor function assessment scale (FMA), the Peabody fine motor development scales (PDMS-FM), the modified Ashworth scale (MAS) and integrated electromyograms (iEMGs).Results:There were no significant differences between the two groups before treatment. After both 3 and 6 months significant improvement was observed in both groups′ average FMA score, PDMS-FM total score, grip, and visual motor integration. At both points the treatment group′s averages were significantly better than those of the control group. The average MAS and iEMG results, however, were not significantly different at either time point.Conclusions:For children with spastic hemiplegia caused by cerebral palsy, mirror visual feedback training can effectively improve upper limb functioning, but it cannot reduce their muscle tone.

Osteoporotic proximal humeral fracture (OPHF) is one of the common osteoporotic fractures in the aged, with an incidence only lower than vertebral compression fracture, hip fracture, and distal radius fracture. OPHF, secondary to osteoporosis and characterized by poor bone quality, comminuted fracture pattern, slow healing, and severely impaired shoulder joint function, poses a big challenge to the current clinical diagnosis and treatment. In the field of diagnosis, treatment, and rehabilitation of OPHF, traditional Chinese and Western medicine have accumulated rich experience and evidence from evidence-based medicine and achieved favorable outcomes. However, there is still a lack of guidance from a relevant consensus as to how to integrate the advantages of the two medical systems and achieve the integrated diagnosis and treatment. To promote the diagnosis and treatment of OPHF with integrated traditional Chinese and Western medicine, relevant experts from Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine have been organized to formulate Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine ( version 2024) by searching related literatures and based on the evidences from evidence-based medicine. This consensus consists of 13 recommendations about the diagnosis, treatment and rehabilitation of OPHF with integrated traditional Chinese medicine and Western medicine, aimed at standardizing, systematizing, and personalizing the diagnosis and treatment of OPHF with integrated traditional Chinse and Western medicine to improve the patients ′ function.