[Objective]To evaluate the method and curative effect of posterior internal fixation and bone grafting fusion for atlantoaxial fracture or dislocation.[Method]Posterior internal fixation and bone grafting fusion were made on 26 patients with atlantoaxial fracture or dislocation in condition of tracheal intubation anesthesia.Occipitocervieal fixation(Aixs) and bone grafting fusion were performed on patients with fracture of vertebral lamina-arch.Vertebral lamina splint fixation (Apofix) was performed on patients without fracture of vertebral lamina-arch and decompression of vertebral canal.[Result]Followed up for 5 to 60 months(averaged,16.8 months),the vertebral artery and spinal cord injury were not occurred and clinical symptom was relieved in all patients.X ray examination showed screws in vertebral articular process and occipital condyle were normotopic without laxation and fragmentation.The bone grafting transformed into osseous fusion after 3 months.[Conclusion]Aixs fixation and bone grafting fusion and Apofix fixation are effective methods for atlantoaxial fracture or dislocation.

Objective To compare the glucose levels and associated factors among the normal glucose tolerance subjects with different age.Methods Totally a community-based population of 2098 residences aged above 30 years Were tested with OGTT,and classified into normal glucose tolerance group(NGT),impaired glucose tolerance group(IGT),impaired fasting glucose group(IFG),both IGT and IFG group(ICT/IFC),anddiabetes group(DM) according to fasting and 2 hours glucose level(2 hPG).The subjects in NGT group were further divided into 5 groups according to different ages.The levels of blood glucose and HBCI in different groups and subgroups were measured and analyzed statistically. Results For patients in NGT,the FPG([5.17.±0.48]mmol/L vs.[5.09±0.44]mmol/L,P<0.05)and HbA1c([6.01±0.62]%vs.[5.95±0.66]%.P<0.05)in group aged 60-69 Were higher than that in group aged 50-59.The FPG in group aged 60-69 was also higher than those in group aged 40-49([5.17±0.48]mmol/L vs.[5.00±0.47]mmol/L,P<0.01),and the FPG in group aged 50-59 Was also higher than those in group aged 40-49([5.09±0.44]mmol/L vs..[5.00±0.47]mmol/L,P<0.01).There was no correlation between age and FINS,while a tendency of decreasing HBCI could be observed along with increasing of age(F=33.75,P<0.05).Conclusion In NGT subjects,the FPG and HbA1 C inereased along with age.

Abstract On April 25, 2021, a case with hookworm infections was identified during the surveillance of soil-borne nematodiasis by Tiantai Center for Disease Control and Prevention, Taizhou City, Zhejiang Province. The patients was admitted to a county people's hospital due to dizziness and limb weakness on July 24, 2020. Laboratory tests showed 2.5×1012/L red blood cell counts, 45 g/L hemoglobin, 3.4% eosinophil percentage, 4.7 μmol/L serum iron and <1 μg/L ferritin, and severe iron-deficiency anemia was initially diagnosed. Following treatment with blood transfusion and ion supplement, subsequent three routine blood tests indicated elevated eosinophil percentages. On April 25, 2021, hookworm eggs were detected in stool samples using Kate-Katz technique, and Necator americanus was identified with the test-tube filter-paper culture method. Severe iron-deficiency anemia caused by hookworm infections was diagnosed based on field epidemiological surveys and laboratory tests. The health education pertaining to parasitic disease control knowledge among residents and the diagnosis and treatment of parasitic diseases in medical institutions are recommended to be improved in rural areas to avoid misdiagnosis and missing diagnosis.

Objective To observe the clinical,pathological features and prognosis of IgA nephropathy in children with crescent formation.Methods A total of 38 cases of children with IgA nephropathy diagnosed by renal biopsy at Qilu Hospital of Shandong University were retrospectively analyzed.According to whether there were crescent formation,they were divided into crescents formation group (crescent formation&ge;10％,n=18) and control group consisting of children with complete clinical data and matching age,gender and course of disease (no crescent formation,n=20).The clinical,pathological features and prognosis of the two groups were compared.Results Fourteen cases (77.78％) of crescents formation group were associated with nausea hematuria,and 12 cases (66.67％) had hypertension,8 patients in control group (40％) had gross hematuria,and 6 cases (30％)had high blood pressure.The differences were statistically significant (P ＜ 0.05).In crescents formation group,Alb and eGFR were significantly lower than those of control group.24 h urine protein and Scr were significantly higher than those of control group and there were significant statistically differences between two groups (P ＜ 0.05).Nephropathological changes in crescent formation group were mainly in grade Ⅱ and grade Ⅲ and were usually combined with tubular interstitial damages.In addition to IgA immunoglobulin deposition,they often accompanied by IgG and IgM immunoglobulin deposition.In control group,nephropathological changes were mainly in grade Ⅰ and grade Ⅱ and tubular interstitial damages were rare.IgA was the main form of deposition in control group.After 12 weeks steroid treatment and (or) immunosuppressive therapy,urinary protein turned negative in 7 cases in crescent formation group,24 h urinary protein level declined by half than before in 7 cases and no obvious change in 4 cases.In control group,urinary protein turned negative in 12 cases,6 cases showed a more than 50％ decline in urinary protein level and 2 cases had no obvious change.During the 1-3 years of follow-up,renal function of 14 cases and 19 cases was normal in the crescent formation group and control group respectively,serum creatinine of 3 cases and 1 case increased mildly in the crescent formation group and control group respectively,1 case needed dialysis treatment in the crescent formation group and the one in the control group who had slightly increasement of Scr did not reach the standard of dialysis treatment.Conclusions The clinical and pathological manifestations of children with IgA nephropathy with crescent formation are more severe and more likely to manifest renal insufficiency,suggesting that crescent formation is one of the indicators of poor prognosis.

ObjectiveTo understand the prevalence of hookworm infection and its relevant behavioral factors in rural areas of Tiantai County， Zhejiang Province， and to provide scientific evidence for prevention and control of hookworm disease. MethodsBy using a stratified cluster random sampling strategy， local residents aged ≥3 years was divided into 5 districts according to geographical location； furthermore， those in one administrative village （surveillance site） were investigated in each district. Species of hookworm were identified by filter paper culture in vitro， and enterobius vermicularis eggs were detected by cellophane anal swab in children aged 3‒9 year. Risk factors were determined by questionnaire. ResultsA total of 1 013 residents were investigated in 5 surveillance sites. Thirty nine cases with hookworm infection were detected， with the total infection rate of 3.85% . All species detected were determined to be Necator americanus. The infection rate significantly differed across the towns （χ²=48.32， P<0.05）， with the highest rate in Nanping Town （10.95%） . It significantly differed by age groups （χ²=65.65， P<0.05）， with the highest rate in those aged >70 years （9.75%）. Furthermore， it decreased with educational background. It was significantly associated with fertilize with fresh manure （χ²=6.87， P<0.05） and barefoot labor （χ²=157.69， P<0.05）. ConclusionThe overall infection rate of hookworm in Tiantai County remains low. Dominant species of hookworm is hookworm Necator americanus. It is necessary to strengthen the advocacy of hookworm prevention and control knowledge， improve hygiene in work and life style， and increase self-protection awareness.

COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread across the globe, posing an enormous threat to public health and safety. Traditional Chinese medicine (TCM), in combination with Western medicine (WM), has made important and lasting contributions in the battle against COVID-19. In this review, updated clinical effects and potential mechanisms of TCM, presented in newly recognized three distinct phases of the disease, are summarized and discussed. By integrating the available clinical and preclinical evidence, the efficacies and underlying mechanisms of TCM on COVID-19, including the highly recommended three Chinese patent medicines and three Chinese medicine formulas, are described in a panorama. We hope that this comprehensive review not only provides a reference for health care professionals and the public to recognize the significant contributions of TCM for COVID-19, but also serves as an evidence-based in-depth summary and analysis to facilitate understanding the true scientific value of TCM.

Consecutively hospitalized patients with confirmed coronavirus disease 2019 (COVID-19) in Wuhan, China were retrospectively enrolled from January 2020 to March 2020 to investigate the association between the use of renin-angiotensin system inhibitor (RAS-I) and the outcome of this disease. Associations between the use of RAS-I (angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB)), ACEI, and ARB and in-hospital mortality were analyzed using multivariate Cox proportional hazards regression models in overall and subgroup of hypertension status. A total of 2771 patients with COVID-19 were included, with moderate and severe cases accounting for 45.0% and 36.5%, respectively. A total of 195 (7.0%) patients died. RAS-I (hazard ratio (HR)= 0.499, 95% confidence interval (CI) 0.325-0.767) and ARB (HR = 0.410, 95% CI 0.240-0.700) use was associated with a reduced risk of all-cause mortality among patients with COVID-19. For patients with hypertension, RAS-I and ARB applications were also associated with a reduced risk of mortality with HR of 0.352 (95% CI 0.162-0.764) and 0.279 (95% CI 0.115-0.677), respectively. RAS-I exhibited protective effects on the survival outcome of COVID-19. ARB use was associated with a reduced risk of all-cause mortality among patients with COVID-19.
Angiotensin Receptor Antagonists/therapeutic use* ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use* ; COVID-19 ; Humans ; Hypertension/drug therapy* ; Renin-Angiotensin System ; Retrospective Studies