OBJECTIVE: To investigate the clinical efficacy and safety of ultrasound-guided closed reduction and internal fixation using Kirschner wire for the treatment of olecranon fractures of the ulna in children. METHODS: Between January 2019 and January 2021, 13 children with olecranon fracture were treated with ultrasound-guided closed reduction and percutaneous Kirschner wire internal fixation, including 10 males and 3 females. The age ranged from 3 to 14 years old. Children with ulnar olecranon fractures were evaluated using the Gicquel scoring system. The clinical evaluation encompassed postoperative pain, functional status, and range of motion, with a maximum score of 15 points. The radiological assessment contributed an additional 4 points. A cumulative score of more than 18 scores was classified as excellent, more than 17 scores as good, more than16 scores as fair, and less than 16 scores as poor. Clinical assessment:A score of 14 indicates excellent performance, a score of 13 reflects good performance, a score of 12 denotes fair performance, and a score of less than 11 signifies poor performance. RESULTS: A total of 13 patients were followed up, with a duration ranging from 6 to 12 months. According to the Gicquel scoring criteria, the comprehensive evaluation of clinical and radiographic findings yielded 10 excellent and 3 good outcomes. Evaluation based solely on clinical findings resulted in 13 excellent outcomes. CONCLUSION Ultrasound-guided percutaneous cross Kirschner wire fixation for children's olecranon fracture has the advantages of less trauma, rapid recovery, less fluoroscopy, and good recovery of elbow function. The clinical effect is satisfactory.
Humans ; Child ; Male ; Female ; Fracture Fixation, Internal/instrumentation* ; Ulna Fractures/physiopathology* ; Bone Wires ; Child, Preschool ; Adolescent ; Olecranon Process/surgery* ; Ultrasonography ; Closed Fracture Reduction/methods* ; Olecranon Fracture

AIM: To evaluate the application of optical coherence tomography angiography(OCTA)in diabetic patients without retinopathy(NDR)by Meta-analysis.METHODS: CNKI, WanFang Data, VIP, CBM, PubMed, and Embase databases were searched for relevant studies. The retrieval time was from the establishment of the database to October 2021. Two investigators independently screened the literature, extracted data and evaluated the quality of the included studies using the NOS scale. Meta-analysis and publication bias evaluation was performed using RevMan 5.3 and STATA, and sensitivity analysis was performed for results with large heterogeneity to ensure the accuracy of the results.RESULTS: A total of 44 studies, including 2 053 patients(2 600 eyes)with NDR and 1 775 healthy control patients(2 117 eyes), were included. The Meta-analysis was performed on 17 indexes including the area and perimeters of the foveal avascular zone(FAZ), the vascular density(VD)of FAZ-300um(FD300), acircularity index(AI), VD of macular area, ganglion cell complex(GCC)thickness and retinal nerve fiber layer(RNFL)thickness. Meta-analysis results showed that the area and perimeter of FAZ in superficial capillary plexus(SCP)and deep capillary plexus(DCP)in the NDR group were higher than those of healthy control patients, and FD300, VD of macular area and RNFL thickness were all lower than those in the control group(all P<0.05); The AI values in the NDR group were slightly higher than those in the normal control group, and the GCC thickness and VD of peri-optic papillary were lower than those in the control group, but there was no differences between the groups(P>0.05).CONCLUSIONS: Compared to the healthy control group, NDR patients had increased FAZ area and perimetry, decreased VD of macular area and RNFL thickness and early retinal microvascular damage and neurodegenerative lesions. OCTA could be used as an auxiliary tool for early diagnosis of DR.

ObjectiveTo summarize the effect of visual electrophysiological diagnosis and treatment technology on postoperative urinary incontinence in early intervention after transurethral enucleation and resection of the prostate （TUERP）. MethodsTotally 86 patients with benign prostatic hyperplasia （BPH） who underwent TUERP in the Puji Branch Hospital of Dongguan People's Hospital from December 2020 to June 2022 were selected as the treatment group， who received electrophysiological treatment after postoperative removal of the catheter on the 6th day after surgery， while 79 cases who received no electrophysiological treatment after surgery were selected as the control group. The urinary incontinence rates of the two groups on the 6^th day， at 1 month and 3 months after surgery were observed. ResultsThere was no statistical difference between the two groups in the preoperative basic data. The rates of urinary incontinence after removal of the catheter in the two groups on the 6^th day after surgery were 13 cases （15.1%） in the treatment group and 12 cases （15.2%） in the control group. There was no significant difference between the two groups （P >0.05）， and the overall postoperative urinary incontinence rate in the two groups was 15.2% （25/165）. At one month after surgery， only 4 cases （4.65%） had slight urinary incontinence in the treatment group， while 13 cases （16.5%） in the control group still had urinary incontinence， and the difference between the two groups was statistically significant （ P=0.019）. After follow-up to three months after operation， there was no case of urinary incontinence in the treatment group， and there were still 7 cases （8.86%） of urinary incontinence in the control group. The difference between the two groups was statistically significant （P=0.005）. ConclusionThe early intervention of visual electrophysiological diagnosis and treatment technology can effectively prevent the occurrence of urinary incontinence after TUERP， and has good value in clinical application.

Child ; Consensus ; Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional ; Respiratory System

OBJECTIVE: To study the clinical characteristics, drug sensitivity of isolated strains, and risk factors of drug resistance in children with invasive pneumococcal disease (IPD). METHODS: The clinical characteristics and drug sensitivity of the isolated strains of 246 hospitalized children with IPD in nine grade A tertiary children's hospitals from January 2016 to June 2018 were analyzed. RESULTS: Of the 246 children with IPD, there were 122 males and 124 females. Their ages ranged from 1 day to 14 years, and among them, 68 (27.6%) patients were less than 1 year old, 54 (22.0%) patients were 1 to 2 years old, 97 (39.4%) patients were 2 to 5 years old, and 27 (11.0%) patients were 5 to 14 years old. Pneumonia with sepsis was the most common infection type (58.5%, 144/246), followed by bloodstream infection without focus (19.9%, 49/246) and meningitis (15.0%, 37/246). Forty-nine (19.9%) patients had underlying diseases, and 160 (65.0%) had various risk factors for drug resistance. The isolated Streptococcus pneumoniae strains were 100% sensitive to vancomycin, linezolid, moxifloxacin, and levofloxacin, 90% sensitive to ertapenem, ofloxacin, and ceftriaxone, but had a low sensitivity to erythromycin (4.2%), clindamycin (7.9%), and tetracycline (6.3%). CONCLUSIONS IPD is more common in children under 5 years old, especially in those under 2 years old. Some children with IPD have underlying diseases, and most of the patients have various risk factors for drug resistance. Pneumonia with sepsis is the most common infection type. The isolated Streptococcus pneumoniae strains are highly sensitive to vancomycin, linezolid, moxifloxacin, levofloxacin, ertapenem, and ceftriaxone in children with IPD.
Anti-Bacterial Agents ; Ceftriaxone ; Child ; Child, Preschool ; Drug Resistance ; Female ; Humans ; Infant ; Male ; Microbial Sensitivity Tests ; Pneumococcal Infections ; Streptococcus pneumoniae

The pretreatment serum albumin/globulin ratio (AGR) has been used as a prognostic biomarker for various cancer types. However, the prognostic value of the AGR for prostate cancer, especially for metastatic prostate cancer (mPCa) after maximal androgen blockade (MAB), remains unclear. The aim of this study was to evaluate the prognostic value of the pretreatment serum AGR for mPCa treated with MAB. This retrospective study included 214 mPCa patients receiving MAB from October 2007 to March 2017. The correlation of the AGR with survival was estimated using Kaplan-Meier analysis and Cox proportional hazards models. The cutoff value of the AGR was 1.45 according to the receiver operating characteristic curve. Kaplan-Meier analysis demonstrated that patients with a low AGR (<1.45) had poor outcomes in terms of progression-free survival (PFS) and cancer-specific survival (CSS). Multivariate Cox analyses showed that the AGR was an independent predictor of PFS (hazard ratio [HR] = 0.642; 95% confidence interval [CI]: 0.430-0.957; P = 0.030) and CSS (HR = 0.412; 95% CI: 0.259-0.654; P < 0.001). Furthermore, in a subset of 79 patients with normal serum albumin levels (≥40.0 g l^-1), the serum AGR remained an independent predictor of CSS (P = 0.009). The pretreatment AGR was an independent prognostic biomarker for PFS and CSS in patients with mPCa receiving MAB. In addition, the AGR remained effective for the prediction of CSS in patients with normal albumin levels (≥40 g l^-1). However, further prospective studies are needed to confirm our conclusions.

OBJECTIVETo investigate the optimal time window for intervention of BK virus (BKV) replication and its effect on the outcomes of kidney transplant recipients (KTRs).

METHODSA retrospective analysis of the clinical data and treatment regimens was conducted among KTRs whose urine BKV load was ≥1.0×10copies/mL following the operation between April, 2000 and April, 2015. KTRs with urine BKV load <1.0×10copies/mL matched for transplantation time served as the control group.

RESULTSA total of 54 recipients positive for urine BKV were included in the analysis. According to urine BKV load, the recipients were divided into 3 groups: group A with urine BKV load of 1.0×10-1.0×10copies/mL (n=22), group B with urine BKV load >1.0×10copies/mL (n=24), and group C with plasma BKV load ≥1.0×10copies/mL (n=8); 47 recipients were included in the control group. During the follow-up for 3.2-34.5 months, the urine and plasma BKV load was obviously lowered after intervention in all the 54 BKV-positive recipients (P<0.05). Eighteen (81.82%) of the recipients in group A and 19 (79.17%) in group B showed stable or improved estimated glomerular filtration rate (eGFR) after the intervention; in group C, 4 recipients (50%) showed stable eGFR after the intervention. In the last follow-up, the recipients in groups A and B showed similar eGFR with the control group (P>0.05), but in group C, eGFR was significantly lower than that of the control group (P=0.001). The recipients in group A and the control group had the best allograft outcome with stable or improved eGFR.

CONCLUSIONEarly intervention of BKV replication (urine BKV load ≥1.0×10copies/mL) in KTRs with appropriate immunosuppression reduction can be helpful for stabilizing the allograft function and improving the long-term outcomes.

[Objective]To explore the effects of family cohesion and child-teacher dependency on children's attention-deficit/hy?peractivity behaviors at one year after their kindergarten entry.[Methods]Based on a cohort of 7465 first-year preschoolers in Long?hua district of Shenzhen in 2014,the information about social-demographic characteristics,family cohesion(assessed with Family Environment Scale-Chinese Version)were collected from their primary-caregivers at kindergarten entry. The teacher rating scores of child-teacher dependency(assessed with Student-Teacher Relationship Scale)and parental rating scores of attention-deficit/hyperac?tivity behaviors(assessed with Conners'Parent Symptom Questionnaire)were examined at one year after their kindergarten entry. Lo?gistic regression were performed to analyze the relationship and interaction between family cohesion and child-teacher dependency in attention-deficit/hyperactivity behaviors,after adjusting for potential confounders.[Results]Children's attention-deficit/hyperactivity behaviors at one year after kindergarten entry were negatively associated with family cohesion (OR=0.85,95% CI=0.75~0.97,P=0.01),but were not significantly associated with child-teacher dependency(OR=1.00,95%CI=0.93~1.08,P=0.98). Furthermore, family cohesion moderated the impact of child-teacher dependency on children ' s attention-deficit/hyperactivity behaviors at one year after kindergarten entry(OR=0.96,95% CI=0.92~0.99,P=0.03). In addition,neither family cohesion(OR=1.08,95%CI=0.88~1.34,P=0.47)nor child-teacher dependency(OR=1.03,95%CI=0.93~1.15,P=0.53)could protect preschoolers from persistence of attention-deficit/hyperactivity behaviors in the first year of kindergarten.[Conclusion]The association of child-teacher dependency and onset of attention-deficit/hyperactivity behaviors is modified by the level of family cohesion in preschool children.

OBJECTIVETo investigate the clinical efficacy of Panlongqi tablet (Chinese characters) combined with lumbar facet joint release for lumbar spinal stenosis of type Fengshi Bizu (Chinese characters).

METHODSSince February 2012 to February 2013, 120 patients with lumbar spinal stenosis of Fengshi Bizu (Chinese characters) syndrome were retrospectively studied. According to different treatment methods, 120 patients with lumbar spinal stenosis were divided into Panlongqi tablet (Chinese characters)group and control groups, respectively. In Panlongqi tablet (Chinese characters)group, 60 patients were treated by Panlongqi tablet (Chinese characters) combined with lumbar facet joints release solution including 26 males and 34 females with an average age of (60.40±3.36) years old ranging from 46 to 65 ; the course of the disease was 2 to 15 years (averaged 7.6 years). In control group the other 60 patients were treated with lumbar facet joint release including 24 males and 36 females with an average age of (61.20±2.47) years old ranging from 48 to 63; the course was 3 to 14 years (averaged 6.9 years). The clinical effect of patients were evaluated by JOA and ODI score before treatment, at 4 weeks and 3 months after treatment.

RESULTSAll patients were followed up for 4 to 7 months (means 5.6 months). After 3 months,7 cases in control group recurrenced symptoms,only 1 case in Panlongqi tablet (Chinese characters) group recurrenced. At 4 weeks and 3 months of follow-up, ODI score and JOA score of Panlongqi tablet group were much better than those of the control group.

CONCLUSIONFor lumbar spinal stenosis of type Fengshi Bizu (Chinese characters),which were treated with lumbar facet joint release with Panlongqi tablet(Chinese characters), supplemented by back muscle exercise, in relieving waist and low back pain symptoms and improving functional status of lower lumbar spine, can obtain satisfactory clinical outcome, is a good method of conservative treatment for such diseases.

Aged ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Exercise Therapy ; Female ; Humans ; Lumbosacral Region ; physiopathology ; Male ; Middle Aged ; Punctures ; Retrospective Studies ; Spinal Stenosis ; drug therapy ; physiopathology ; therapy

OBJECTIVETo investigate Chinese medicine (CM) patterns and epidemiological characters of patients with influenza-like illness (ILI) syndromes in clinics in China.

METHODSA prospective multi-center observational epidemiology survey on the clinical CM patterns of ILI and its prevalence was conducted from September 2009 to April 2010. A unified survey questionnaire was developed for data collection of ILI symptoms and CM patterns. Totally 45 hospitals from 22 provinces, municipality cities and autonomous regions of China participated this study. The collected data were input by EPI-data v3.1 and analyzed by SPSS 18.0, which included descriptive analysis and Chi-square test for group comparison.

RESULTSA total of 5,967 ILI patients were included in the study. The proportion of the 18-34 aged group (56.2%) was the largest; students (41.0%) were more than other occupations. Majority of the patients had the wind-heat invading Lung (Fei) syndrome (76%), while in Southwest China mainly wind-heat invading Lung syndrome and wind-cold tightening the exterior syndrome occurred. The typical symptoms of ILI were ranked as fatigue (80.9%), cough (72.2%), sore throat (67.2%), muscular soreness (67.1%), headache (65.4%), aversion to cold (60.1%), thirst (55.1%) and nasal obstruction (48.1%).

CONCLUSIONSThe ILI patients in clinics were mainly teenagers and young adults. In regard to CM syndrome, wind-heat invading Lung syndrome prevailed in all regions except the Southwest China. The characteristics of CM syndrome of ILI patients may be relevant to age and region distribution.

Adolescent ; Adult ; Age Distribution ; Body Temperature ; China ; epidemiology ; Female ; Hospitals ; Humans ; Influenza, Human ; epidemiology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Prevalence ; Seasons ; Sex Characteristics ; Syndrome ; Time Factors ; Young Adult