OBJECTIVE: To evaluate the short-term effectiveness of Ilizarov technique combined with steel needle internal fixation in treating Charcot neuroarthropathy (CN) of the foot and ankle. METHODS: Between June 2020 and December 2023, 12 patients with Eichenholtz stage Ⅲ CN of the foot and ankle were treated with Ilizarov technique and steel needle internal fixation. There were 9 males and 3 females with an average age of 48.6 years (range, 19-66 years). The disease duration ranged from 1 to 16 months (mean, 6.8 months). Ankle joint involvement predominated in 7 cases, while midfoot involvement occurred in 5 cases; 3 cases presented with skin ulceration and soft tissue infection. Preoperative American Orthopedic Foot and Ankle Society (AOFAS) score was 31.2±9.0, 36-Item Short-Form Health Survey (SF-36)-Physical Component Summary (PCS) score was 32.6±6.8, and Mental Component Summary (MCS) score was 47.8±8.4. Postoperative assessments included wound healing, regular X-ray film/CT evaluations of fusion status, and effectiveness via AOFAS and SF-36-PCS, MCS scores. RESULTS: All operations were successfully completed without neurovascular complication. Two patients experienced delayed wound healing requiring intervention, and the others achieved primary healing. All patients were followed up 15-43 months (mean, 23.3 months). Imaging confirmed successful joint fusion within 13-21 weeks (mean, 16.8 weeks). At last follow-up, the AOFAS score was 72.5±6.4, and the SF-36-PCS and MCS scores were 63.2±8.4 and 76.7±5.3, respectively, all of which improved compared to preoperative levels, with significant differences ( P<0.05). CONCLUSION Ilizarov technique combined with steel needle internal fixation effectively restores walking function and achieves satisfactory short-term effectiveness in CN of the foot and ankle.
Humans ; Middle Aged ; Male ; Female ; Adult ; Ilizarov Technique ; Arthropathy, Neurogenic/surgery* ; Aged ; Ankle Joint/surgery* ; Treatment Outcome ; Needles ; Fracture Fixation, Internal/instrumentation* ; Steel ; Young Adult ; Foot Joints/surgery*

Crigler-Najjar syndrome (CNS) and Gilbert syndrome (GS; OMIM: 143500) are rare autosomal recessive diseases that cause unconjugated hyperbilirubinemia due to decreased UGT1A1 enzyme activity. Crigler-Najjar syndrome type 2 (CNS2; OMIM: 606785) increases the risk of gallbladder stone formation and cholecystitis, while GS seldom causes health issues. We found a 28-year-old male patient with recurring right upper abdomen pain who experienced persistent jaundice from birth. CNS2 with gallbladder stones and cholecystitis was diagnosed after genetic testing revealed rare double homozygous mutations A(TA)₇TAA (rs3064744) and P229Q (rs35350960) in the UGT1A1 gene. After pedigree investigation, we found that the patient's parents with modestly increased bilirubin had compound heterozygous mutations A(TA)₇TAA and P229Q, which were GS. Bioinformatics analysis showed that A(TA)₇TAA is in the TATA-box region of the gene UGT1A1 promoter, affecting gene transcriptional initiation, whereas P229Q modifies protein three-dimensional structure and may be harmful. In this pedigree, double homozygous mutations have a more severe phenotype than compound heterozygous mutations. Inherited causes of hyperbilirubinemia should be suspected after ruling out biliary obstruction, and early bilirubin reduction (< 103 µmol/L (6 mg/dL)) may reduce the risk of complications like cholecystitis in CNS2 patients, though further studies with longer follow-up are needed to confirm this observation.
Humans ; Male ; Glucuronosyltransferase/genetics* ; Adult ; Crigler-Najjar Syndrome/complications* ; Cholecystitis/etiology* ; Homozygote ; Mutation ; Pedigree

Objective To develop an intelligent model for differential diagnosis of atrioventricular nodal re-entrant tachycardia(AVNRT)and atrioventricular re-entrant tachycardia(AVRT)using 12-lead wearable electrocardiogram devices.Methods A total of 356 samples of 12-lead supraventricular tachycardia(SVT)electrocardiograms recorded by wearable devices were randomly divided into training and validation sets using 5-fold cross validation to establish the intelligent classification model,and 101 patients with the diagnosis of SVT undergoing electrophysiological studies and radiofrequency ablation from October,2021 to March,2023 were selected as the testing set.The changes in electrocardiogram parameters before and during induced tachycardia were compared.Based on multiscale deep neural network,an intelligent diagnosis model for classifying SVT mechanisms was constructed and validated.The 3-lead electrocardiogram signals from Ⅱ,Ⅲ,and V1 were extracted to build new classification models,whose diagnostic efficacy was compared with that of the 12-lead model.Results Of the 101 patients with SVT in the testing set,68 were diagnosed with AVNRT and 33 were diagnosed with AVRT by electrophysiological study.The pre-trained model achieved a high area under the precision-recall curve(0.9492)and F1 score(0.8195)for identifying AVNRT in the validation set.The total F1 scores of the lead Ⅱ,Ⅲ,V1,3-lead and 12-lead intelligent diagnostic models in the testing set were 0.5597,0.6061,0.3419,0.6003 and 0.6136,respectively.Compared with the 12-lead classification model,the lead-Ⅲ model had a net reclassification index improvement of-0.029(P=0.878)and an integrated discrimination index improvement of-0.005(P=0.965).Conclusion The intelligent diagnostic model based on multiscale deep neural network using wearable electrocardiogram devices has an acceptable accuracy for classifying SVT mechanisms.

Objective To develop an intelligent model for differential diagnosis of atrioventricular nodal re-entrant tachycardia(AVNRT)and atrioventricular re-entrant tachycardia(AVRT)using 12-lead wearable electrocardiogram devices.Methods A total of 356 samples of 12-lead supraventricular tachycardia(SVT)electrocardiograms recorded by wearable devices were randomly divided into training and validation sets using 5-fold cross validation to establish the intelligent classification model,and 101 patients with the diagnosis of SVT undergoing electrophysiological studies and radiofrequency ablation from October,2021 to March,2023 were selected as the testing set.The changes in electrocardiogram parameters before and during induced tachycardia were compared.Based on multiscale deep neural network,an intelligent diagnosis model for classifying SVT mechanisms was constructed and validated.The 3-lead electrocardiogram signals from Ⅱ,Ⅲ,and V1 were extracted to build new classification models,whose diagnostic efficacy was compared with that of the 12-lead model.Results Of the 101 patients with SVT in the testing set,68 were diagnosed with AVNRT and 33 were diagnosed with AVRT by electrophysiological study.The pre-trained model achieved a high area under the precision-recall curve(0.9492)and F1 score(0.8195)for identifying AVNRT in the validation set.The total F1 scores of the lead Ⅱ,Ⅲ,V1,3-lead and 12-lead intelligent diagnostic models in the testing set were 0.5597,0.6061,0.3419,0.6003 and 0.6136,respectively.Compared with the 12-lead classification model,the lead-Ⅲ model had a net reclassification index improvement of-0.029(P=0.878)and an integrated discrimination index improvement of-0.005(P=0.965).Conclusion The intelligent diagnostic model based on multiscale deep neural network using wearable electrocardiogram devices has an acceptable accuracy for classifying SVT mechanisms.

By combing and summarizing the interpretation of"spleen-kidney-muscle-bone"related theories in tra-ditional Chinese medicine classics and combining with clinical practice,this paper innovatively puts forward the pathogenesis and treatment ideas of congenital flat foot in traditional Chinese medicine,in order to provide theoretical basis and beneficial reference for the holistic treatment of flat foot in traditional Chinese medicine.

{L-End}Objective To establish the norm of Core Occupational Stress Scale (COSS) for electronic manufacturing industry workers in China. {L-End}Methods A total of 3 049 workers from five electronic manufacturing enterprises in four prefecture-level cities concentrated distribution of the electronics manufacturing industry in China were selected as research subjects using a stratified sampling method. COSS was used to investigate occupational stress levels, and the mean norm, percentile norm and threshold norms were established. {L-End}Results The average score of COSS for the electronic manufacturing industry workers in China was (43.5±7.4) points, and the average scores of social support, organization and reward, demand and effort, and autonomy dimensions were (9.5±3.1), (15.1±3.9), (13.1±3.0), and (5.7±2.0) points, respectively. A total score of 0.0-<47.0 points was determined as no occupational stress, 47.0-<51.0 points as mild occupational stress, 51.0-≤54.0 points as moderate occupational stress, and >54.0 points as severe occupational stress. {L-End}Conclusion The norm of COSS for workers in China's electronics manufacturing industry has been established, which can provide a reference for the evaluation and intervention of their occupational stress levels.

Objective:To systematically describe the characteristics and trends of clinical studies on aesthetic and plastic devices from 2016 to 2020 in China.Methods:Clinical studies on aesthetic and plastic devices conducted in China from 2016 to 2020 were identified through ClinicalTrials.gov and the Chinese Clinical Trial Registry using predetermined search strings. Data on indications, medical device, sponsor type, and study design were collected and analyzed.Results:From 2016 to 2020, 118 registered clinical studies were identified and analyzed, among which 100 trials (84.7%) were initiated by medical institutions and the remaining were initiated by medical device enterprises. The number of studies increased from 12 to 42 from 2016 to 2020 with an average annual growth rate of 39.6%. For indication types, there are 90(76.3%) studies on skin defects, followed by 21(17.8%) on maxillofacial defects, 5(4.2%) on hair defects and 2(1.7%) on breast defects. The top four indications were scars, acne, nasolabial folds, and port-wine stains. For device types, photoelectric devices were involved in 73(61.9%) studies, followed by surgical devices [20(16.9%)] and injection devices [19(16.1%)]. Laser devices were the research focus among all photoelectric device categories. There were 11 clinical studies on scar treatment using laser treatment equipment, of which 6 trials applied parallel controlled study design, and the remaining trials applied self-controlled design. The sample size of these 11 trials ranged from 15 to 110.Conclusions:The number of registered clinical studies on aesthetic and plastic devices kept growing in the last few years. Skin related indications and photoelectric devices have become the hot spot in the field.

Objective:To systematically describe the characteristics and trends of clinical studies on aesthetic and plastic devices from 2016 to 2020 in China.Methods:Clinical studies on aesthetic and plastic devices conducted in China from 2016 to 2020 were identified through ClinicalTrials.gov and the Chinese Clinical Trial Registry using predetermined search strings. Data on indications, medical device, sponsor type, and study design were collected and analyzed.Results:From 2016 to 2020, 118 registered clinical studies were identified and analyzed, among which 100 trials (84.7%) were initiated by medical institutions and the remaining were initiated by medical device enterprises. The number of studies increased from 12 to 42 from 2016 to 2020 with an average annual growth rate of 39.6%. For indication types, there are 90(76.3%) studies on skin defects, followed by 21(17.8%) on maxillofacial defects, 5(4.2%) on hair defects and 2(1.7%) on breast defects. The top four indications were scars, acne, nasolabial folds, and port-wine stains. For device types, photoelectric devices were involved in 73(61.9%) studies, followed by surgical devices [20(16.9%)] and injection devices [19(16.1%)]. Laser devices were the research focus among all photoelectric device categories. There were 11 clinical studies on scar treatment using laser treatment equipment, of which 6 trials applied parallel controlled study design, and the remaining trials applied self-controlled design. The sample size of these 11 trials ranged from 15 to 110.Conclusions:The number of registered clinical studies on aesthetic and plastic devices kept growing in the last few years. Skin related indications and photoelectric devices have become the hot spot in the field.

ObjectiveTo observe the effect of Simiaowan on the intestinal ATP-binding cassette superfamily G （White） member 2 （ABCG2） expression and the intestinal uric acid excretion in hyperuricemia rats. MethodA total of 48 SD male rats were randomized into the normal， model， benzbromarone （4.7 mg·kg^-1）， and high-， medium-， low-dose Simiaowan groups （2 260.6， 1 130.3， 565.2 mg·kg^-1， respectively）， with 8 rats in each group. Potassium oxonate and hypoxanthine was employed to induce hyperuricemia in rats （21 days）. On the 8^th day， administration began （once a day for 14 days）. Rats were killed on the 21^st day， and serum uric acid， serum creatinine， blood urea nitrogen， and intestinal uric acid were detected. The protein expression of ABCG2 in the small intestine was detected by Western blot. The ABCG2 protein expression and localization in intestinal tissues were determined by immunohistochemistry. The ABCG2 mRNA expression in small intestine was measured by quantitative real-time PCR. ResultThe levels of serum uric acid， serum creatinine， and blood urea nitrogen in the model group were higher than those in the normal group （P<0.01）. Low level of serum uric acid in the three Simiaowan groups and benzbromarone group （P<0.01）， high level of intestinal uric acid in medium-dose and low-dose Simiaowan groups （P<0.05， P<0.01）， high level of serum creatinine in benzbromarone group （P<0.01）， and low level of blood urea nitrogen in low-dose Simiaowan group （P<0.05） were observed as compared with those in the model group. Serum uric acid showed insignificant difference between the low-dose Simiaowan group and benzbromarone group. The expression of ABCG2 protein in the model group was lower than that in the normal group （P<0.05）. The expression of ABCG2 protein in the medium-dose and low-dose Simiaowan groups （P<0.05， P<0.01）， the high-dose Simiaowan group， and benzbromarone group increased as compared with that in the model group. ABCG2 mRNA expression was insignificantly different between the model group and the normal group， while the expression in the medium-dose and low-dose Simiaowan groups was higher than that in the model group （P<0.05）. ABCG2 protein was mainly distributed in intestinal villi， and ABCG2 protein expression demonstrated no significant difference between the model group and the normal group. The ABCG2 protein expression in the three Simiaowan groups increased as compared with that in the model group （P<0.05）. ConclusionSimiaowan can significantly reduce the serum uric acid level in hyperuricemia rats. Particularly， the low-dose Simiaowan shows similar efficacy to benzbromarone in lowering uric acid and protects renal function. The mechanism is the likelihood that it up-regulates intestinal ABCG2 expression to promote intestinal excretion of uric acid.

【Objective】 To investigate and analyze the polymorphism of RHD gene in RhD-negative population in Jiayuguan using molecular biological technique, so as to accurately identify RhD-negative individuals, and formulate individualized transfusion strategies. 【Methods】 The RhD negative voluntary blood donors and patients (mainly pregnant women) were recruited. After informed consent, history of blood transfusion and pregnancy of them were investigated, and samples were collected for negative D confirmation, gene sequencing as well as antibody screening and identification. 【Results】 Among the 96 samples, 73 cases were RHD gene deletion, 18 RHD^*01EL.01(17 RHD1227A homozygous type and 1 RHD1227A heterozygous type), 2 weak RHD^*15 type (845G/A), 1 partial D type, i. e. RHD-CE(7) -D heterozygous allele, and 2 RHD^*01N.16 variant. Antibody was detected out in 4 cases, among which 2 were positive for anti-D, 1 anti-D plus anti-E, and 1 anti-Di^a. 【Conclusion】 The proportion of DEL gene in RhD negative Chinese Han population in Jiayuguan is slightly lower than that in general Chinese Han population. No anti-D or RHD-HDN was observed in DEL type women due to multiple pregnancy or delivery of D positive newborns.