Objective To evaluate the effect of health education combined with lung function test on smoking cessation in smoking sanitation workers. Methods Sixty-nine sanitation workers who smoke were divided into two groups by using the table of random number, routine group (n=35) and lung function test group (n=34). The routine group was given health education. According to the lung function, those in the lung function test group were divided into normal lung function group (19 cases) and abnomal lung function group (15 cases) who received both health education and lung function test. Success rate of smoking cessation and the relapse rate were compared at 2 and 6 months follow-up. Results At 2 and 6 months follow-up, the smoking cessation rates of routine group were [10(29%), 4(11%)], which were lower than those of the normal lung function group [7(37%), 3(16%)], the differences were not statistically significant (P>0.05). The smoking cessation rates of routine group were lower than those in abnormal lung function group[11 (73%), 10(67%)] (P<0.05). The smoking cessation rates of the normal lung function group were significantly lower than those of abnormal lung function group (P<0.05). The relapse rate of routine group[6(17%) and the normal lung function group[4(21%)]at 6 months follow-up were not significantly different. The relapse rate of the normal lung function group and that of abnormal lung function group were not significantly different. Conclusion Health education combined with lung function test could help smokers with abnormal lung function to give up smoking successfully.

Objective To explore influence and variation of smoking and occupational exposure to air pollution on lung function.Methods Ninety eight sanitation staffs from Panyu District were divided into smoking and non-smoking sanitation groups; and all subject accepted the Chronic Obstructive Pulmonary Disease Assessment Test (CAT) scales,questionnaires,lung function test,and data statistical analysis.Healthy people accepted health examination from Guangzhou Panyu medical health center were used as the control group.Results (1) Forced expiratory volume in the first second (FEV1％),forced expiratory volume in the first second/ forced vital capacity(FEV1/FVC),maximal expiratory flow in 50％ vital capacity (FEF50％),maximal expiratory flow in 75％ vital capacity (FEF75％),maximal mid-expiratory flow (MMEF) of non-smoking sanitation group was significantly lower than non-smoking healthy group (P ＜ 0.01).(2) Abnormal rates of FEF50％,FEF75％,and MMEF of non-smoking sanitation group were significantly higher than non-smoking healthy group (P ＜ 0.01).(3) Abnormal rates of FEF50％,and FEF75％ of sanitation group were significantly higher than healthy group with or without smoking.(4) Abnormal rates of FEV1％ and FEV1/FVC did not have significant difference between non-smoking sanitation group and non-smoking healthy group,but had significant difference between non-smoking and smoking healthy groups.It means smoking and occupational exposure had different impacts on pulmonary function.(5)Moderate score of nonsmoking sanitation group and smoking healthy group were significantly higher than non-smoking healthy group by P =0.049 and P =0.001,respectively.Conclusions Occupational exposure to air pollution and smoking can lead to small airway damage,which was not as obvious as pulmonary function changes.It is necessary to regularly monitor lung function for sanitation staffs who risk occupational exposure to air pollution.Increasing physical exercise would benefit to improve sport lung endurance of the people in our country.

Methods: This retrospective analysis included a total of 155 patients who underwent single-level lumbar fusion, with 81 patients in the traditional group and 74 patients in the Wiltse group (less paraspinal muscle damage). QCT was used to measure the volumetric BMD (vBMD), Hounsfield unit value, and cross-sectional area of the paraspinal muscles at the upper instrumented vertebrae (UIV), vertebrae one segment above the UIV (UIV+1), and the vertebrae one segment above the UIV+1 (UIV+2). Statistical analyses were performed. Results: No significant differences in general data were observed between the two groups (p>0.05). Strong correlations were noted between the preoperative and 1-week postoperative vBMD of each segment (p<0.01), with no significant difference between the two time points in both groups (p>0.05). Vertebral BMD loss was significantly higher in UIV+1 and UIV+2 in the traditional group than in the Wiltse group (−13.6%±19.1% vs. −4.2%±16.5%, −10.8%±20.3% vs. −0.9%±37.0%; p<0.05). However, no statistically significant difference was observed in the percent vBMD changes in the UIV segment between the two groups (37.7%±70.1% vs. 36.1%±78.7%, p>0.05). Conclusions QCT can reliably determine BMD in the instrumented spine after lumbar interbody fusion. With QCT, we found that reducing paraspinal muscle destruction through the Wiltse approach during surgery can help preserve the adjacent vertebral BMD; however, it does not help increase the BMD in the instrumented vertebrae.

Hoffa fracture of tibial plateau is a special type of coronal fracture of tibial plateau, among which occult fracture accounts for a large proportion, resulting in missing diagnosis and delayed treatment. The current studies are all case reports, and the incidence, diagnostic protocol, injury characteristics and injury mechanism of Hoffa fracture have not been systematically studied. The commonly used classifications such as AO type, Schatzker type, three-column classification and comprehensive classification of tibial plateau cannot cover this type. In this study, a retrospective case series study was performed for the clinical data of 3 086 patients with tibial plateau fractures. There were 13 patients with Hoffa fracture of tibial plateau, and 23% of them were occult ones. The injury mechanism of this fracture was as follows: under the state of knee joint flexion, axial violence through femur concentrated on the posterior half of tibial plateau, with the knee joint in transient varus and pronation position, leading to the posteromedial coronal splitting fracture. According to the position and degree of fracture displacement involving the joint, the fracture was divided into three type: type I involving the articular surface of tibial plateau fracture less than 1/4, type II involving the articular surface of tibial plateau equal to or more than 1/4 and less than 1/2, type III involving the joint face equal to or more than 1/2. Each fracture type was divided into three subtypes, of which subtype A was non-displaced fracture, subtype B had articular surface displacement<2 mm, and subtype C had articular surface displacement≥2 mm. According to the classification characteristics, the treatment principles were proposed. The authors systematically summarized the Hoffa fracture of tibial plateau for the first time in aspects of the incidence, injury characteristics, injury mechanism, fracture classification and treatment principles, which is helpful to avoid missed diagnosis and improve treatment efficacy.

Objective:To understand and verify the biomechanical mechanism of tibial plateau Hoffa (coronal) fracture by simulating high-altitude falls and traffic injuries using knee joint specimens.Methods:Ten specimens of lower limb knee joint were used. They were from 6 males and 4 females, with an average age of 57.4 years (from 42 to 65 years). They were divided into 2 equal groups: one subjected to simulation of high-altitude falls (fall group) and the other to simulation of traffic injury (traffic injury group). After injury simulation, standard orthographic and lateral X-ray examinations and CT scans were performed of the knee joints in the extended position to observe whether there was a fracture, where the fracture occurred, and how the fracture line went.Results:A tibial plateau coronal fracture was successfully simulated in 6 cases, but not in the other 4 cases. The failure was attributed to femoral fractures and other types of tibial plateau fracture. In the 3 successful fractures simulated by high-altitude fall, the fracture line was located all on the posterior medial side, involving the posterior 1/3, 2/5, and 1/2 of the tibial plateau, respectively. The fracture line and the coronal plane formed angles of 21°, 19° and 12°, respectively. The fracture was not shown on X-ray film in one case which was a posterior medial fracture on CT. In the other 3 successful fractures simulated by traffic injury, the fracture line involved 1/6, 1/4 and 1/3 of the posterior tibial plateau, respectively. The angles between the fracture line and the coronal plane were 47°, 56° and 63°, respectively. One case showed no obvious fracture signs on the X-ray but a coronal fracture on CT.Conclusions:This study has confirmed for the first time that both high-altitude falls and traffic injuries can cause coronal fractures of the tibial plateau which vary significantly in the extent of involvement and morphology. X-rays are not sufficient to fully diagnose this type of fractures, suggesting that patients with a clear history of knee flexion or axial violence injury should be routinely scanned by CT to reduce risks of missed diagnosis and insufficient treatment.