Universal uhrasound screening in newborn has been accepted for reducing the incidence of late detected developmental dysplasia of the hip (DDH).Unfortunately, the neonatal ultrasound screening strategy has not been applied in the mainland of China, which leads to a high incidence of late-detected DDH.Before implementing the neonatal ultrasound screening strategy, the clinical screening by limited abduction is valid to early diagnose the dislocated hip joint.Additionally,it is necessary to screen all the newborn with high risk factors of DDH, such as positive family history, breech presentation and postnatal hip extended swaddling.Early screening of DDH is the common responsibility of child care doctors, including community health physician, pediatrician or pediatric orthopedist.Currently, it is imperative to build regional neonatal ultrasound screening system for DDH in the regions with tertiary pediatric orthopedic center.

[Objective]To investigate the expression of collagen type I and III at mRNA and protein level in the ligamentum teres of developmental dislocation of the hip(DDH) and the normal hip. [Method]There were 6 pairs joint laxity of patients of DDH group and normal control group with paired control of same sex and age.Semiquantity RT-PCR method was used to detect the COLlal and COL3al in the ligamentum teres at mRNA level. Western-Blot method was used to detect the COLlal and COL3al in the ligamentum teres at protein level. The quantitative analysis of the COLlal and COL3al were performed by professional image software and the results were analyzed with standard statistical methods.[Result]At both mRNA and protein level COLlal expression were decreased in the DDH group compared to the control group(P0.05).[Conclusion]The decreased collagen I expression at mRNA and protein level in the ligamentum teres of the children with DDH may lead to hip joint laxity.Hip joint laxity in DDH may be independent to the content of collagen III.

Increasing evidences have shown that intestinal microbiota may contribute to the etiology of colorectal cancer(CRC). Studies have shown some microbial species which can increase the risk of CRC. Intestinal bacteria can promote carcinogenesis by affecting DNA integrity,regulating immune reaction,inducing inflammation,increasing cell proliferation and altering stem cell dynamics. Modulation of intestinal microbiota may become an approach to prevent or treat CRC. This article reviewed the effect and mechanism of intestinal bacteria flora on CRC.

0.05).The eggs per gram feces and liver, eggs in uterus per female, and egg granulomas on the liver surface were(56.68?24.78),(5 826?437),(49.94?12.53) and(10.04?1.13)/0.25 cm2, respectively in immunized group, while in control group these were(89.93?32.18),(10 016?3 541),(76.54? 19.77) and(19.22?2.45)/0.25 cm2 respectively, all with significant difference(P

Objective The purpose of the study was to understand the resistance status of to anti-tuberculosis drug in Yunnan province, and to provide evidence for tuberculosis (TB) control. Methods The proportional method was used in drug sensitivity test according to the guidelines recommending by WHO. Results Of 301 mycobacterial isolates, 279 (92.7%) strains were complex (MTBC) . The total drug resistance rate was 31.5% (88/279),the initial drug resistance rate of was 27.3%, and the acquired drug resistance rate was 44.3%. The drug resistance rates to INH,RFP,EMB and SM were 19.7%, 10.8%, 12.9%and 19.0%, respectively. The multi-drug resistance (MDR) rate was 9.3%. Conclusion The drug resistant rate of is still high in Yunnan province,and TB control is still a long way to go. Early detection and regular treatment should be done for MDR patients. Drug resistance monitoring as an important part of TB control programs should be regular observation and research.

Objective:To study the effect of mindfulness-based training intervention on clinical efficacy in patients with nitrous oxide(laughing gas) addiction.Methods:From June 2019 to June 2020, sixty-six patients with nitrous oxide addiction in Beijing Gaoxin Hospital were selected and randomly divided into experimental group( n=33) and control group( n=33). The control group received Taijiquan training and physical training, while the experimental group added mindfulness-based training intervention on the basis of Taijiquan training and physical training.Symptom checklist 90 (SCL-90) scores and visual analog scales (VAS) craving scores were compared between the two groups at admission and 8 weeks after treatment.SPSS 22.0 software was used for statistical analysis.Independent sample t test and paired sample t test were used to compare the differences between groups and within groups. Results:(1)Before treatment, there were no significant differences in subscale scores of SCL-90 between the two groups except for depression factor((2.45±0.86), (2.03±0.46), t=2.474, P<0.05). After treatment, the subscale scores of somatization((1.38±0.35), (1.68±0.34), t=-3.656, P<0.05), phobic anxiety((1.49±0.37), (1.81±0.30), t=-3.993, P<0.05), paranoid ideation((1.50±0.47), (1.88±0.31), t=-3.898, P<0.05) and psychotism((1.34±0.54), (1.55±0.27), t=-3.094, P<0.05) of SCL-90 in the experimental group were significantly lower than those in the control group.(2)Before treatment, there was no significant difference in VAS craving score between the two groups( t=0.857, P=0.395). After treatment, the score of VAS in the experimental group was significantly lower than that in the control group( t=27.427, P<0.05). Conclusion:Mindfulness training intervention can effectively improve the clinical symptoms of patients with nitrous oxide addiction, which is worthy of clinical application.

Objective To explore and analyze the clinical application of perioperative functional exercise combined with rehabilitation guidance in the treatment of pediatric developmental hip dislocation.Methods From December 2015 to December 2017,40 children with developmental dislocation of the hip treated in Shengjing Hospital Affiliated to China Medical University were selected in the research.The patients were randomly divided into control group and observation group,with 20 cases in each group.The control group was given conventional perioperative rehabilitation guidance,the observation group was given new perioperative functional exercise combined with rehabilitation guidance.The limb function and mental status changes before and after the intervention were compared between the two groups.Results After intervention,the scores of FMA and Barthel were all increased in the two groups compared with those before intervention,and the improvements of the observation group wese more significant than those of the control group (all P ＜ 0.05).After intervention,the self-rating anxiety scale (SAS),self-rating depression scale (SDS),Hamilton depression scale(HAMD) and other negative emotions scores in the observation group were significantly lower than those in the control group (all P ＜ 0.05).Conclusion New perioperative functional exercise combined with rehabilitation guidance can effectively improve the limb function of children with developmental dislocation of the hip joint,at the same time improve the patients' mental state,and has positive significance to enhance the curative effect.

Objective:To compare the efficacy between metallic screw fixation and absorbable screw fixation after open reduction in the treatment of adolescent distal tibial epiphyseal fractures.Methods:A retrospective study was conducted to analyze the data of 82 patients with closed distal tibial epiphyseal fracture who had been admitted to Department of Pediatric Orthopedics, Shengjing Hospital Affiliated to China Medical University from January 2013 to December 2020. There were 61 males and 21 females (aged from 8 to 15 years), and 39 left sides and 43 right sides. The Salter-Harris classification: type Ⅱ in 25 cases, type Ⅲ in 8 cases, and type Ⅳ in 49 cases. They were divided into 2 groups according to different internal fixation methods. Group A (42 cases) was subjected to open reduction and metallic screw fixation and group B (40 cases) to open reduction and absorbable screw fixation. Preoperative data, operation time, total treatment cost and complications during follow-up were recorded and compared between the 2 groups. In both groups at the last follow-up, anteroposterior and lateral ankle radiographs were taken for radiographic evaluation of the injury to the distal tibial epiphysis and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was used to assess the ankle function.Results:The 2 groups were comparable because there were no significant differences in all their preoperative demographic data ( P>0.05). Group A was followed up for 18.0(16.0, 21.3) months while group B for 16.0(13.0, 20.0) months. The treatment cost for group A [27, 000 (25, 000, 33, 000) Yuan] was significantly higher than that for group B [23, 000 (19, 000, 27, 000) Yuan] ( P<0.05). The operation time was (112.4±34.3) min for group A and (101.0±41.1) min for group B, showing no significant difference ( P>0.05). The lateral distal tibial angle was 89.5 (88.0, 91.0)° on the affected side and 89.7°±1.8° on the unaffected sides in group A; it was 90.0 (88.3, 90.8)° on the affected side and 89.5°±1.8° on the unaffected side in group B. The anterior distal tibial angle was 81.9°±1.8° on the affected side and 81.8°±1.5° on the unaffected side in group A; it was 82.0 (81.0, 83.0)° on the affected side and 82.1°±2.2° on the unaffected side in group B. There was no significant difference in the above comparisons at the last follow-up in radiographic evaluation of the distal ankle joint between the affected and the unaffected sides in either group or between groups( P>0.05). There was a significant difference between the 2 groups in the rate of superficial skin infection [11.9% (5/42) versus 0% (0/40)] ( P<0.05), but there was no significant difference in the incidence of premature physeal closure between the 2 groups [11.9% (5/42) versus 5.0% (2/40)] ( P>0.05). The last follow-up revealed no significant difference in the AOFAS ankle-hindfoot score between group A [(90.6±4.9) points] and group B [(92.1±4.6) points] ( P>0.05). Conclusions:In the treatment of adolescent distal tibial epiphyseal fractures, compared with metallic screw fixation, absorbable screw fixation may lead to comparable efficacy in fixation, functional recovery and imaging evaluation, but no increased risk of premature physeal closure. Moreover, it spares the need for secondary surgical removal, and reduces operation time and treatment cost.

The acetabular labrum, a tough fibrocartilaginous structure attached to the periphery of the osseous acetabular rim, plays an important role in maintaining hip stability, pressure balance, and growth.In the developmental dysplasia of the hip(DDH), the abnormal stress on the acetabulum after dislocation or subluxation of the femoral head causes the labrum to become hypertrophy and degeneration, which become the obstacle of the central reduction.However, the treatment of acetabular labrum in DDH is still controversial.This article reviews the anatomical and imaging features of the normal labrum and DDH labrum and its effect on DDH treatment.

Objective:To analyze the risk factors for the lateral condyle fracture of the humerus concomitant with fractures of ulna olecranon and coronoid (triple fracture) in children.Methods:A retrospective study was conducted to analyze the data of 584 children who had been hospitalized for lateral condyle fracture of the humerus from January 2012 to December 2022 at Department of Pediatric Orthopaedics, Shengjing Hospital of China Medical University. There were 392 males and 192 females with an age of 60.5 (43.0, 86.0) months, and 327 left and 257 right sides affected. There were 546 cases of simple lateral condyle fracture of the humerus (simple group) and 38 cases of triple lateral condyle fracture of the humerus (triple group). The treatment methods for the triple group were recorded, and the elbow function of the children in the triple group was assessed using the Mayo Elbow Performance Score (MEPS) at the last follow-up. First, a univariate analysis was conducted of the gender, side profile, surgical age, height, weight, and distribution of the Jacob and Milch types of the lateral condyle of the humerus in the 2 groups. Next, the P<0.1 factors screened were further analyzed by the multivariate logistic regression to determine the final variables. Results:All the fractures of the lateral condyle of the humerus were treated by internal fixation with Kirschner wires after closed or open reduction. The 38 patients in the triple group were followed up for 15.0 (13.0, 21.3) months after surgery. There were no such serious complications as bone nonunion, malunion, ischemic necrosis, cubitus valgus, or delayed ulnar nerve paralysis. At the last follow-up, the MEPS score was 97.5 (95.0, 100.0) points. The univariate analysis showed that surgical age ( P=0.087), Jacob type ( P=0.044) and Milch type ( P<0.001) were the risk factors for a triple fracture. The multivariate logistic regression analysis showed that Milch type Ⅰ was an independent risk factor for a triple fracture ( OR=25.764, 95% CI: 11.645 to 57.001, P<0.001). Conclusion:Milch type Ⅰ is an independent risk factor for a triple fracture of lateral condyle fracture of the humerus in children.