Purpose To investigate the clinical outcome of induced membrane technique for treatment of post-traumatic tibial osteomyelitis.Methods A retrospective analysis was made on 17 cases of post-traumatic tibial osteomyelitis admitted from August 2011 to October 2012.There were 13 males and 4 females aged 19-67 years (mean,40.9 years).Mean length of bone defect was 6.7 cm (range,2.0-18.5 cm).Surgical treatments were performed including phase Ⅰ surgical debridement and antibiotics-loaded bone cement impregnation to induce a membrane and phase Ⅱ bone defect reconstruction by intramembranous bone grafting.Clinical effect of the treatment was evaluated.Results Bone healing was detected at the 27-month follow-up (range,24-32 months).Radiographic healing was obtained 4-6 months after operation.Two cases of recurrent infection were noted after phase Ⅰ surgery and had another debridement.External fixator proximal pin track infection occurred in one case and infection was controlled by hardware removal and dressing change.There was one case of metal rejection,two function disorders,one clubfoot,and one ankle stiffness.Conclusion Induced membrane technique is effective in the treatment of post-traumatic tibial osteomyelitis,especially in lone bone defect reconstruction,but limb functional complications are worth consideration during treatment.

Long bone osteomyelitis often results from serious open fractures or some closed fractures.Its treatment is a clinical difficultly in orthopaedics.Masquelet is a new strategy for bone reconstruction,validated by surgeons in their treatment of acute bone loss,bone tumor and bone infection.It is carried out in 2 stages.At the first stage,infection was eliminated by radical debridement and placement of antibiotic bone cement into the defect,which induces a pseudomembrane to facilitate the growth of bone graft.At the second stage,reconstruction of the bone defect is performed by bone grafting in the membrance after removal of the bone cement.The unique characteristics of this technique arouse more and more attention recently.Therefore,we would like to present a review about this Masquelet technique dealing with post-traumatic osteomyelitis of long bones.

Objective To investigate the effects of volatile oil from artemisia dracunculus on myocardial injury caused by viral myocarditis in mice and explore its possible mechanism.Methods Totally 160 adult male BALB/c mice were randomly divided into normal control group (10) and viral myocarditis group (150).Viral myocarditis mice models were reproduced by intraperitoneal inoculation with a solution of coxsackievirus B3 (CVB3),a viral strain with affinity to myocardium,and then randomly divided into model,astragalus group,and low-,medium-,and high-dose volatile oil from artemisia dracunculus groups.After 1 hour of viral infection,normal control group and model group mice were given normal saline by intragastric administration,astragalus group mice were injected with astragalus 0.1 mL in each mouse by intraperitoneal injection,and the mice in other three groups were given low,medium and high dose (2％,5％,10％) 0.3 mL volatile oil from artemisia dracunculus in each mouse by intragastric administration,respectively,once a day for one week consecutively.The mortality,heart/body weight ratio,the activity of natural killer cells (NK cell),virus titer in myocardial homogenate,serum cardiac troponin Ⅰ (cTnI) level and myocardial pathological changes were observed.Results ① Mortality:the mortality of model group was higher than that of the normal control group,astragalus group,low and medium dose volatile oil from artemisia dracunculus groups (60.0％ vs.0％,23.3％,20.0％,28.7％),and the difference in the mortality being of no statistical significance between model group and that of high-dose volatile oil from artemisia dracunculus group (60.0％ vs.47.6％,P ＞ 0.05);the mortality of astragalus group was obviously lower than that of high-dose volatile oil from artemisia dracunculus group (P ＜ 0.01),and the differences in comparisons between the mortalities of astragalus intervention group,and medium-and low-dose volatile oil groups were not statistically significant (all P ＞ 0.05),and the comparison of mortality between low-and medium-dose volatile oil groups were also not statistically significant (P ＞ 0.05).② Immunization parameters:on the 8th day after modeling,the activity of NK cells in the model group was significantly lower than that in the normal control group [(15.91 ± 3.87)％ vs.(38.50 ± 2.32)％],the activities of NK cells in astragalus group,medium-and low-dose volatile oil from artemisia dracunculus groups were significantly higher than that in model group [(19.38 ± 3.27)％,(18.54 ± 3.09)％,(18.36 ± 2.64)％ vs.(15.91 ± 3.87)％,all P ＜ 0.05].None of virus was detected in the myocardial homogenate in the normal control group,and the virus titers in astragalus group,low and medium dose volatile oil from artemisia dracunculus groups were significantly lower than the titer of the model group (10-9/mL:1.96 ± 0.44,1.95 ± 0.46,1.95 ± 0.48 vs.2.41 ± 0.51,all P ＜0.01).③ Myocardial injury parameters:the level of cTnI in the normal control group was less than 0.1 μg/L,obviously lower than that in the model group [(15.84 ± 3.89) μg/L],as well as the ratio of heart/body weight in model group was also significantly higher than that in normal control group (× 10-4:8.3 ± 1.3 vs.4.6 ± 0.1),and the cTnI and the ratio of heart/body weight of astragalus intervention group,low and medium dose volatile oil from artemisia dracunculus groups were markedly lower than those of model group [cTnI (mg/L):10.03 ± 2.35,10.81 ± 2.56,11.10 ± 1.89 vs.15.84 ± 3.89,ratio of heart/body weight (× 10-4):7.2 ± 0.8,7.3 ± 1.0,7.3 ± 0.6 vs.8.3 ± 1.3].In the normal control group,there were no inflammatory cell infiltration and necrosis in myocardial tissue,the scores of myocardial pathological changes were 0.In the model group,the scores of inflammatory cell infiltration (3.25 ± 0.45) and of necrosis (2.91 ± 0.51) were markedly higher than those in the normal control group.And the above scores in astragalus group,low and medium dose volatile oil from artemisia dracunculus groups were significantly lower than those of the model group (infiltration score:2.92 ± 0.39,2.95 ± 0.35,2.95 ± 0.37 vs.3.25 ± 0.45,necrosis score:2.46 ± 0.50,2.50 ± 0.51,2.54 ± 0.50 vs.2.91 ± 0.51,all P ＜0.05).Conclusions Volatile oil from artemisia dracunculus can protect cardiomyocytes by removing the virus and regulating the immune function in the body.But the protective effects of volatile oil from artemisia dracunculus is related to the dosage,and the effects of low and medium dose are better.

Objective To discuss the differences of inflammatory parameters such as procalcitonin ( PCT ), C-reactive protein ( CRP ), endotoxin, white blood cell ( WBC ), neutrophil ratio ( Neut%) in blood of septic patients caused by bacterial bloodstream infection, and their correlation with the severity of disease. Methods 292 septic patients with positive blood culture were enrolled in Beijing Shijitan Hospital Affiliated to Capital Medical University from February 2012 to March 2015, and their gender, age, acute physiology and chronic health evaluation Ⅱ( APACHEⅡ) score, bacterial species and other general information were retrospectively collected. The differences in inflammatory parameters ( PCT, CRP, endotoxin, WBC, Neut%) in septic patients caused by bacterial bloodstream infection were compared, their correlations with APACHEⅡ scores within 24 hours were analyzed, and their diagnostic efficacies were also analyzed. Results ①It was shown by Pearson correlation coefficients that positively statistical correlation was found between PCT ( r=0.638 ), CRP ( r=0.620 ), endotoxin ( r=0.284 ), WBC ( r=0.209 ) and APACHEⅡscore ( all P=0.000 ) in bacterial bloodstream infective patients ( n=292 ), and positively statistical correlation was found between PCT ( r=0.626 ), CRP ( r=0.616 ), Neut%( r=0.297 ) and APACHEⅡscore ( all P<0.01 ) in Gram positive bacterial ( G+) group ( n = 86 ), and positively statistical correlation was shown between PCT ( r=0.631 ), CRP ( r=0.616 ), endotoxin ( r=0.301 ), WBC ( r=0.226 ) and APACHEⅡscore ( all P<0.01 ) in Gram negative bacterial ( G-) group ( n=206 ).②It was shown that PCT and CRP of both G+/G-bacterial severe sepsis and septic shock subgroup were significantly higher than those of sepsis subgroup, respectively [ G+ group: PCT (μg/L ):0.92 ( 0.38, 4.75 ) vs. 0.43 ( 0.22, 1.00 ), CRP ( mg/L ):118.45±62.60 vs. 57.97±32.41;G-group:PCT (μg/L ):6.92 ( 1.94, 25.90 ) vs. 1.28 ( 0.27, 4.12 ), CRP ( mg/L ):130.99±60.18 vs. 49.18±26.87, all P<0.01 ], and the endotoxin and WBC in G-bacterial severe sepsis and septic shock subgroup were significantly higher than those of sepsis subgroup [ endotoxin ( ng/L ): 19.40 ( 9.62, 33.87 ) vs. 10.00 ( 5.00, 18.52 ), WBC ( ×109/L ): 12.13±6.72 vs. 9.61±5.01, both P<0.01 ]. The PCT and endotoxin in G-bacterial severe sepsis and septic shock subgroup were significantly higher than those in G+severe sepsis and septic shock subgroup [ PCT (μg/L ):6.92 ( 1.94, 25.90 ) vs. 0.92 ( 0.38, 4.75 ), endotoxin ( ng/L ):19.40 ( 9.62, 33.87 ) vs. 2.56 ( 1.11, 4.01 ), both P<0.01 ].③The diagnostic efficacy of inflammatory parameters for severe sepsis and septic shock subgroup were: PCT area under receiver operating characteristic ( ROC ) curve ( AUC ) = 0.683, the cut-off point = 0.55 μg/L, sensitivity 63.2%, specificity 69.0%; CRP AUC = 0.802, the cut-off point = 92.25 mg/L, sensitivity 73.7%, specificity 86.2%; WBC AUC = 0.614, the cut-off point = 7.35×109/L, sensitivity 75.4%, specificity 48.3%; Neut% AUC = 0.622, the cut-off point = 0.882, sensitivity 43.9%, specificity 79.3%in G+group. At the same time, it was shown that PCT AUC=0.780, the cut-off point=6.80μg/L, sensitivity 51.0%, specificity 93.9%; CRP AUC = 0.907, the cut-off point = 90.10 mg/L, sensitivity 73.2%, specificity 95.9%;endotoxin AUC=0.694, the cut-off point=17.54 ng/L, sensitivity 57.3%, specificity 75.5%;WBC AUC=0.611, the cut-off point = 10.54×109/L, sensitivity 54.1%, specificity 69.4%; Neut% AUC = 0.621, the cut-off point = 0.843, sensitivity 65.6%, specificity 61.2%in G-group. Conclusions The plasma PCT and CRP have the best correlation between inflammatory parameters and severity of disease in bloodstream infective sepsis patients. CRP has the best diagnostic effect in severe sepsis/septic shock patients with bloodstream infection.

Objective To investigate the results of Cierny-Mader type Ⅳ posttraumatic long bone infection treated by en bloc resection combined with induced membrane technique.Methods A retrospective case series analysis was made on 36 patients with posttraumatic long bone infection treated by en bloc resection combined with induced membrane technique from January 2013 to January 2015.There were 30 male and 6 female patients between 21 and 68 years (mean,41 years).Infection control,bone union,function activity and complications were detected after operation.Results After debridement in the first stage,a segmental bone defect of 5.5 cm in length (range,2-10.9 cm) was seen in all patients.Seven patients needed a local flap transfer to cover the wound and five patients had a second debridement.Mean duration of systemic antibiotic use was 2 weeks (range,1-6 weeks) and mean time interval of second-stage bone grafting was 12 weeks after debridement (range,6-36 weeks).Mean follow-up was 29.5 months (range,24-45 months).One patient had recurrence and was cured with radical debridement and a permanent acrylic spacers insertion,with the cure rate of bone infection of 97％ (35/36).All patients achieved bone union with a mean duration of 5.9 months (range,4-8 months),and were able to walk independently.Thirty patients returned to work or pre-operative physical labor.No pain and re-fracture occurred.Six patients had adjacent joint stiffness.Conclusion En bloc resection combined with induced membrane technique is associated with radical debridement,decreased recurrence rate and limb salvage,indicating a simple and effective method for Cierny-Mader type Ⅳ posttraumatic long bone infection.

A high quality medical editor creates a high quality medical journal , so the editor′s level directly impact on the journal quality .The first trail is the first process for editor dealing with papers .To improve first trail quality can play a significance for improving work efficacy , shortening publication circle and promoting journal quality .Hence, we should strengthen the training of medical journal editor′s first trail ability and construct a high quality editor team .

Objective: To understand the allocation of health staff and clinics in primary and secondary schools in Guangdong Province, so as to provide a reference for school health construction. Methods: In December 2020, a total of 17 205 primary and secondary schools in 21 cities in Guangdong Province were investigated by combining document verification and on site surveys. The allocation of health staff and clinics in different cities and types of schools was analyzed using SPSS 25.0 software. Results: The proportion of schools in Guangdong Province that met the national standard for school health staff ratio was 37.7%. Among different types of schools, the lowest ratio was found in nine year schools (33.1%), while the highest was in twelve year schools (61.3%). Among the 17 205 schools in the province, 12.6% had clinics with an area of >40 m 2, and 6.9% with occupational licenses for medical institutions. The proportion of full time health staff was 39.1%. Among all school health staffs, the proportions of permanent staff, temporary staff, and appointed staff were 47.5%, 29.0% and 23.6%, respectively. The rate of school health staff with professional qualifications was 44.9%, while 48.3% had graduated from medical related majors, and 20.9% held a bachelor s degree or higher as their first degree. There were differences among various types of schools, with primary schools having the lowest health staff configuration and professional level (24.0% and 35.7%, respectively). Conclusions There are still issues of insufficient staff and low professional level in health staff and establishment of clinics in primary and secondary schools in Guangdong Province, and the allocation is uneven across different types of schools. The allocation of clinics in the province is still in urgent need of improvement.

Objective: To analyze high myopia and dioptre changes in middle school students in Beijing from 2019 to 2022, so as to provide a basis for formulating preventive and control measures. Methods: Using stratified cluster random sampling, 16 districts of Beijing were divided into four groups, each of which was respectively composed of 83, 83, 84, and 84 middle schools, in order to examine non cycloplegic auto refraction among the senior grades 1 to 3 students from September to October in each year (from 2019 to 2022). Finally, the dataset results of each of the four groups (21 589, 21 161, 21 561, 21 123) were compared by the Chi square test and trend Chi square test. Trend changes were evaluated by annual percentage change (APC). Results: The rates of high myopia were higher in female students than in males from 2019 to 2022 (15.60%,14.59%; 15.33%, 14.44%; 14.65 %, 14.17%; 14.63%,13.84%), and the difference in 2019 was statistically significant ( χ 2=4.93, P <0.05). The rates of high myopia in middle school students in urban areas were significantly higher than those in rural areas(16.45%, 13.78%; 16.81 %, 13.00%; 15.84%, 13.06%; 15.85%, 12.72%), and the differences were statistically significant ( χ 2=30.18, 60.43, 33.92 , 42.23, P <0.05). With the increase of grade, the rates of high myopia increased ( χ 2 trend =674.56, 608.38, 655.21, 676.89, P <0.05), with junior grade 3 students being the most robust. The rate of high myopia in middle school students from 2019 to 2022 decreased from 15.09 to 14.22%, with an average annual rate of 2.08% ( APC=-2.08, t=-7.99, P ＜0.05). The refractive error of high myopia middle school students in 2019 and 2022 were -7.44(-10.25, -6.00) and -7.38(-10.00, -6.00)D, respectively, with no statistically significant difference ( H=4.30, P >0.05). Conclusions The rate of high myopia in middle school students in Beijing shows a decreasing trend, but it remains at a high level. It is necessary to classify the prevention and control strategy, and standardize the measures in order to manage early onset, high incidence rates, and severe myopia.

Objective: To understand the prevalence and related factors of tobacco use among junior high school students in Beijing, so as to provide evidence to effectively conduct tobacco control intervention strategy. Methods: From April to June in 2019 and 2023, 6 489 and 6 898 junior high school students were selected by the probability proportion to size(PPS) method, and a total of 13 387 questionnaires were completed. Questionnaire on tobacco monitoring among junior high school students in Beijing was completed by selffilling. The monitoring content included demographic information, secondhand smoke exposure, tobacco product use, tobacco awareness, etc. Chisquare test was used to compare the difference of various indicators in different groups, and multivariate Logistic regression analysis was adopted to analysis the influencing factors related to the current smoking among junior high school students. Results: In 2019,the current traditional cigarettes and ecigarette smoking rates among junior high school students in Beijing were 1.34%, 1.88%, respectively, and decreased to 0.81%, 1.06% in 2023 (χ2=8.36, 15.17, P＜0.01). The attempted traditional cigarettes and ecigarette smoking rates among junior high school students in Beijing decreased from 6.67%, 6.47% in 2019 to 3.93%, 4.16% in 2023 (χ2=49.99, 35.26, P＜0.01). In 2019, the secondhand smoke exposure rates of junior high school students at homes, indoor public places, and outdoor public places were 31.04%, 44.94%, and 49.88% respectively which decreased to 22.59%, 30.23%, and 36.14% in 2023 (χ2=121.63, 308.60, 257.41, P<0.01). In 2023, male students (OR=2.88), senior students (grade 2 and 3) (OR=4.37, 4.92), disposable pocket money>20 yuan/week (OR=2.01), secondhand smoke exposure at home (OR=2.74), indoor public places (OR=2.64), perception that smoking makes young people more attractive (OR=6.29), and perception that ecigarettes help quit smoking (OR=4.31) were associated with higher tobacco use (P<0.05). Conclusions Tobacco use and secondhand smoke among junior high school students in Beijing decrease significantly. Tobacco control interventions should be provided for junior high school students continuously with a focus on ecigarettes use to promote physical and mental health development among students.

OBJECTIVETo investigate the effects of nanosized cadmium sulfide (nano-CdS) on the male reproductive system in mice.

METHODSThirty-six specific pathogen?free male ICR mice were equally and randomly divided into three groups: two experimental groups and a control group. The two experimental groups were exposed to 100 mg/kg and 50 mg/kg nano-CdS once daily by gavage, respectively, while the control group was exposed to the same volume of physiological saline once daily by gavage. After 45 days, levels of cadmium accumulation and serum testosterone in the testis were determined, the epididymal sperm count, the rate of sperm abnormality, and histopathological changes in testis tissue were observed under a microscope, and the level of CYP11A1 mRNA was determined by qRT-PCR.

RESULTSCompared with the control group, the two experimental groups had a significantly increased level of cadmium accumulation in the testis (P < 0.05), and the 100 mg/kg nano-CdS group had a significantly decreased epididymal sperm count (P < 0.05) and a significantly increased rate of sperm abnormality (P < 0.05), but the 50 mg/kg nano-CdS group did not. The 100 mg/kg nano-CdS group showed different histopathological changes in testis tissue, but the 50 mg/kg nano-CdS group did not. The two experimental groups had significantly reduced levels of testosterone and CYP11A1 mRNA compared with the control group.

CONCLUSIONNano-CdS given through the digestive tract may have an effect on the male reproductive system in mice by affecting the key enzyme genes in the androgen synthesis pathway to reduce the levels of reproductive hormones.

Animals ; Cadmium ; Cadmium Compounds ; toxicity ; Gonadal Steroid Hormones ; Male ; Mice ; Mice, Inbred ICR ; Sperm Count ; Spermatozoa ; Sulfides ; toxicity ; Testis ; drug effects ; Testosterone