ObjectiveThe purpose of this study was to analyze the outcomes of surgical treatment of displaced intra-articular calcaneal fractures (ICFs) in children and its characteristics.MethodsBetween January 2004 and October 2008,we review the results of 9 displaced,intra-articular fractures in 8 skeletally immature patients,who were treated with open reduction and internal fixation in our hospital.There were 7 males and 1 female,with the mean age of 13.1 years(range:10 to 15 years).Preoperative radiographs and computed tomographic scans were used to classify fractures.Clinical and radiographic evaluation were performed in postoperative follow-up visits.The functional outcomes were assessed with use of the modified American Orthopaedic Foot and Ankle Society(AOFAS) ankle and hindfoot score.The published literatures of child ICFs treated with ORIF were reviewed.ResultsIn the series,there were 4 tongue-type and 5 joint depression-type fractures according to Essex-Lopresti classification,and according to Sanders classification,we found 5 type-Ⅱ fractures,3 type-Ⅲ and 1 type-Ⅳ fractures.The mean follow-up time was 47.4 months (range:21 to 72 months).All fractures healed within 2 to 4 months.The average preoperative and postoperative Bohler angles were 5.7 and 33.1 degrees respectively,and the mean Gissane angles were 106.5 and 128.0 degrees respectively.The mean modified-AOFAS score was 65.2 points(range:53 to 68 points).Skin necrosis was found in one foot.After the review of literatures,78.6％ (48/61) of displaced ICFs were male in children.Based on the Sanders classification,36 of 67 (53.7％) were type-Ⅱ fractures,25 of 67 (37.3％) were type-Ⅲ and 6 of 67 (9.0％) were type-Ⅳ; And 15 of 37 (40.5％) were tongue-type,22 of 37 (59.5％) were joint depression-type fractures according to Essex-Lopresti classification.ConclusionMost children with displaced ICFs treated with ORIF had a good clinical outcome with few complications.The children and adolescents that were exposed to high-energy trauma suffer calcaneal fractures that were similar to adult fracture patterns.

Objective To retrospectively assess clinical outcomes of buttress plating in fixation of posterior pilon fractures.Methods The study involved 16 cases of posterior pilon fractures that had undergone buttress plate fixation between January 2005 and December 2009.There were 11 males and 5 females,at mean age of 37.6 years (range,23-62 years).All cases received radiography,CT scan and three-dimensional reconstruction preoperatively.Posterior malleolar fragments were reduced and fixed through posterolateral approach or combined approach (posteromedial plus posterolateral approaches) based on effect area of fracture line on CT films.Clinical and radiographic examinations were performed in postoperative follow-up.Clinical outcomes were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS).Results Posterior pilon fractures were classified into 3 types according to CT scans.Fourteen cases were followed up for average 37.6 months (range,16-52 months).Mean AOFAS score was 86.4 points (range,70-98 points) and mean VAS score was 1.4 points (range,0-3 points).All cases received favorable functional outcomes without hardware failure,except that one patient still suffered from peri-ankle swelling and long term walking discomfort two years after operation.Conclusion Buttress plating is effective in treatment of posterior pilon fractures and can facilitate early weight-bearing functional exercise.

Ophthalmology is interrelated with a variety of disciplines, and its features determine the need for interdisciplinary joint training of postgraduate students majoring in ophthalmology. The joint training can optimize the students' knowledge structures, enhance their innovation abilities and improve their overall qualities. However, there are still some factors restricting the interdisciplinary joint training in the existing education system. We propose to establish a full-time administrative management system, build a multidisciplinary communication platform, attach great importance to tutors' interdisciplinary researches, and establish dual mentor or multi-tutor training system. Moreover, a reasonable interdisciplinary evaluation system and various incentive mechanisms are advocated to improve the quality of postgraduate education in ophthalmology.

Objective:To investigate nurses' knowledge, attitude and behavior status about the safety management of enteral nutrition tube in a tertiary Class A hospital in Beijing.Methods:A self-designed questionnaire based on reliability and validity was used. Besides, a convenient sampling method was used to select 309 nurses working on enteral nutrition from the hospital.Results:Nurses scored (28.58±6.09)for knowledge, (37.65±5.03)for attitude and (70.01±5.45)for behavior. The percentage of average scores in the three indicators were 57.16%, 94.13% and 93.35%. According to the single factor analysis, the score of behavior differed among nurses with different working years( F=23.61, P=0.032). The score of knowledge differed among nurses with different titles( F=4.48, P=0.012). Besides, the frequency of tube feeding operations had great effects on nurses′ knowledge and behavior ( F=9.64, P<0.001; F=34.59, P=0.018). But there was no statistical difference in the knowledge, attitude, and behavior scores among nurses trained at different frequencies( F=0.85, P=0.497; F=12.56, P=0.231; F=18.97, P=3.479). Conclusions:Nurses have a positive attitude towards the safety management of enteral nutrition tube, but their knowledge level is poor and their behavior needs to be further regulated. It is necessary to carry out relevant training to standardize clinical operations and ensure the safety management of enteral feeding tube.

Glucose transporter 1(GLUT1)overexpression in tumor cells is a potential target for drug therapy,but few studies have reported screening GLUT1 inhibitors from natural or synthetic compounds.With cur-rent analysis techniques,it is difficult to accurately monitor the GLUT1 inhibitory effect of drug molecules in real-time.We developed a cell membrane-based glucose sensor(CMGS)that integrated a hydrogel electrode with tumor cell membranes to monitor GLUT1 transmembrane transport and screen for GLUT1 inhibitors in traditional Chinese medicines(TCMs).CMGS is compatible with cell membranes of various origins,including different types of tumors and cell lines with GLUT1 expression knocked down by small interfering RNA or small molecules.Based on CMGS continuous monitoring technique,we inves-tigated the glucose transport kinetics of cell membranes with varying levels of GLUT1 expression.We used CMGS to determine the GLUT1-inhibitory effects of drug monomers with similar structures from Scutellaria baicalensis and catechins families.Results were consistent with those of the cellular glucose uptake test and molecular-docking simulation.CMGS could accurately screen drug molecules in TCMs that inhibit GLUT1,providing a new strategy for studying transmembrane protein-receptor interactions.

Objective:To investigate dyslipidemia and relevant factors of AIDS patients in general hospital.Methods:From April 2017 to January 2018, 306 AIDS patients seen in Peking Union Medical College Hospital (PUMCH) were included, their general information such as demographic characteristics, underlying diseases, regimens for treatment and duration of antiretroviral therapy were recorded and dietary conditions were evaluated. General Self-Efficacy Scale (GSES), Social Support Rating Scale (SSRS), Internal Physical Activity Questionnaire (IPAQ) were adopted for the investigation.Results:Of the 306 patients, 179 had dyslipidemia. Univariate analysis suggested that singlehood, higher age and body mass index (BMI), proteinase inhibitor (PI) and non-nucleotide reverse transcriptase inhibitor (NNRTI) contained antiretroviral therapy (ART) (especially the former) were relevant risk factors. After multivariable analysis, higher age and BMI, high fat diet, high baseline CD4 counting and longer course of disease were related with dyslipidemia, whereas female and higher activity level may be associated with little benefit.Conclusions:Dyslipidemia was more common in AIDS patients than in general population, which were mainly due to the disease itself and ART regimens. Those patients were middle-aged or older, with high baseline CD4 counting, treated with PI and whose course of disease was more than two years should reserve more attention.

Objective:To explore the incidence of sudden deafness accompanied with tinnitus, the selection of examination protocols and treatment, and to provide reference for the establishment of new guidelines for sudden deafness.Methods:CiteSpace software was used for analysis and data mining to analyze and summarize the computer-retrieved articles on diagnostic examination and treatment of sudden deafness accompanied with tinnitus collected from CNIC, Wanfang and Web of Science databases from 2011 to 2021.Results:A total of 207 randomized controlled studies were retrieved in this study, including 121 in Chinese and 86 in English. Finally, 74 Chinese literatures and 16 English literatures were included. Among the 74 valid Chinese literatures, 64 (86.5%) were accompanied with tinnitus, 58 (78.4%) with dizziness/vertigo, 25 (33.8%) with aural fullness, 10 (13.5%) with headache, 4 (5.4%) with insomnia, 4 (5.4%) with a mixture of dizziness and tinnitus, and 2 (2.7%) with vomiting. Among the 16 English literatures, 15 (93.8%) were accompanied with tinnitus, 12 (75.0%) with vertigo, 1 (6.3%) with aural fullness, and 1 (6.3%) with a mixture of various symptoms. Among the 64 Chinese articles mentioning tinnitus, only 9 mentioned tinnitus matching tests, and 1 mentioned that the treatment for tinnitus accompanying symptoms was sound therapy and psychological counseling. The incidence rates of tinnitus accompanying four different types of sudden deafness, from low to high, are as follows: low-to-mid frequency, 82.4%; mid-to-high frequency, 90.7%; complete deafness, 92.4%; and flat type, 92.8%.Conclusion:Tinnitus is the most common accompanying symptom of sudden deafness, and tinnitus matching test is an effective evaluation method. When establishing a scientific, comprehensive, and systematic diagnosis and treatment system or guidelines for sudden deafness, attention should be paid to the diagnosis and treatment of tinnitus symptoms and their adverse psychological reactions, in order to reduce the incidence of tinnitus patients in the later stage of recovery from sudden deafness.

The construction and operation of the hospital-wide radiation protection management information system is of great significance for improving the efficiency and quality of radiation protection management. A hospital has built a hospital-wide radiation protection management system, which consisted of four modules: radiation staff management module, protection items management module, site and equipment management module, and self-inspection module. The system adopted B/S mode, carried the lightweight J2EE framework-SpringBoot framework, and used mybatis, which was flexible and practical, as the persistence layer of the system, to store the data completely in the SQLServer database.Java language was used as the system development language, and the front and back-end separation architecture was used. Each of the four modules implemented the management responsibility departments and responsible personnel to carry out the all-round management of radiation protection, and realized the integrated, information-based and standardized management of radiation protection management in the hospital.

OBJECTIVE To systematically evaluate the efficacy and safety of midazolam and dexmedetomidine/propofol for the sedation of critically ill patients undergoing mechanical ventilation， and to provide evidence-based reference for clinical treatment. METHODS Retrieved from PubMed， Embase， Web of Science， Cochrane Library， Clinical trials. gov， China Journal Full Text Database， Chinese Science and Technology Journal Database， Wanfang database and China Biomedical Literature Database， the data on the efficacy and safety of midazolam and dexmetomidine/propofol for the sedation of critically ill patients undergoing mechanical ventilation were collected from the establishment of the database to March 31， 2023. After extracting data from clinical studies that met the inclusion criteria， the meta-analysis was conducted by using the RevMan 5.3 statistical software. RESULTS A total of 31 literature were included， with a total of 2 765 patients. Results of meta-analysis showed that the mechanical ventilation time [MD＝14.13， 95%CI （13.75， 14.52）， P＜0.000 01] and the length of hospitalization in the intensive care unit [MD＝0.92， 95%CI （0.54， 1.30）， P＜0.000 01] of patients in the midazolam group was longer than dexmedetomidine/ propofol group. The incidence of bradycardia in midazolam group was lower dexmedetomidine/propofol group [OR＝0.60， 95%CI （0.41， 0.90）， P＝0.01]， but there was no statistically significant difference in the incidence of hypotension between the two groups [OR＝0.69， 95%CI （0.47， 1.01）， P＝0.06]. The incidence of delirium [OR＝3.88， 95%CI （2.74， 5.49）， P＜0.000 01]， ventilator- associated pneumonia [OR＝2.32， 95%CI （1.19， 4.51）， P＝0.01]， and respiratory depression [OR＝5.70， 95%CI （3.09， 10.52）， P＜0.000 01] in midazolam group were higher than dexmedetomidine/propofol group. CONCLUSIONS Compared with dexmedetomidine/propofol， midazolam increases patients’ mechanical ventilation time and the length of hospitalization in the intensive care unit in terms of efficacy， and increases the risk of delirium and pulmonary complications in terms of safety， but has a smaller cardiovascular impact.

AIM: To explore the factors influencing heart rate(HR)changes during small incision lenticule extraction(SMILE)surgery by monitoring HR trends at different time points of the procedure.METHODS: Prospective cohort study. A total of 69 patients who underwent SMILE surgery at the Laser Vision Correction Center of Xi'an No.1 Hospital from April to May 2024 were enrolled. Before the surgery, patients completed the State Anxiety Inventory(S-AI, questions 1-20)to assess their preoperative anxiety scores related to the next day's surgery. Baseline HR was recorded using medical pulse oximeter, and real-time HR was recorded during patient positioning, lenticule scanning, lenticule separation and extraction, and the application of postoperative eye drops.RESULTS: The HR during patient positioning was 83.61±13.87 bpm, which was significantly different from the baseline HR(77.52±10.88 bpm), HR during lenticule separation and extraction(75.54±12.52 bpm), and HR during postoperative eye drop application(76.65±10.54 bpm; all P<0.001). When stratified by median age, older patients(>26 years)had the HR during lenticule separation and extraction 76.27±9.93 bpm, which differed from the HR at positioning(84.82±14.10 bpm)and at lens scanning(82.76±13.72 bpm; all P<0.005). Stratified by gender, the HR of male patients at positioning was the highest(85.31±16.61 bpm), which differed significantly from the baseline HR(78.26±12.63 bpm), HR during lenticule separation and extraction(77.14±14.59 bpm), and HR during postoperative eye drop application(77.11±12.49 bpm; all P<0.005). There was no correlation between HR during positioning and preoperative anxiety scores(r=0.124, P=0.418).CONCLUSION: HR changes during SMILE surgery vary with different procedural stages, peaking during patient positioning and reaching the lowest point during lenticule separation and extraction. Older patients showed higher HR during positioning, and male patients exhibited higher HR during positioning.