Objective To investigate risk factors for neonatal clavicular fracture,to provide a reference for clinical treatment.Methods A retrospective analysis was performed towards 3 025 live births,47 cases had neonatal clavicular fracture.The birth weight,mode of delivery,maternal age,parity,gestational age,clavicle second stage of labor,the fundus height plus abdominal circumference,cord around neck,and other fracture potential risk factors were analyzed through univariate and multivariate analysis,and the risk factors were summarized.Results 3 025 cases of live births,of which 47 cases had neonatal clavicular fracture,clavicle fracture rate was 1.55%;univariate results sug-gested that the mode of delivery,birth weight,the second stage of labor,maternal age,gestational age,nuchal cord,ma-ternal weight's clinical data index had statistically significant differences between the fracture group and non -fracture group (χ2 =37.514,34.997,28.647,19.847,18.847,16.694,all P <0.05 );multivariate analysis showed that mode of delivery,birth weight,the second stage of labor,gestational age,nuchal cord,maternal body mass index were a newborn children collarbone fracture independent risk factors.Conclusion Mode of delivery,birth weight,the second stage of labor,gestational age,nuchal cord,maternal body mass index are independent risk factors for neonatal clavicu-lar fracture,obstetric should continue to improve midwifery skills,to develop prevention strategies to reduce the inci-dence of neonatal clavicular fracture.

OBJECTIVE:To establish a method for simultaneous determination of gallic acid,protocatechuic acid,catechuic acid,corilagin and brevifolincarboxylic acid in Geranium carolinianum. METHODS:HPLC was performed on the column of Won-daSil C18 WR with mobile phase of acetonitrile-0.1% Phosphoric acid(gradient elution)at a flow rate of 1.0 ml/min,the detection wavelength was 280 nm,the column temperature was 40 ℃,and the volume injection was 20 μl. RESULTS:The linear range was 0.02-20.02 for gallic acid(r=0.999 9),0.01-20.10 for protocatechuic acid(r=0.999 7),0.02-19.78 for catechuic acid(r=0.999 6), 0.02-20.02 for corilagin(r=0.999 9)and 0.02-20.10 for brevifolincarboxylic acid(r=0.999 5);RSDs of precision,stability and re-producibility tests were lower than <3.0%;recoveries were 95.1%-100.6%(RSD=2.20%,n=6),95.8%-100.6%(RSD=1.74%,n=6),95.1%-101.9%(RSD=2.71%,n=6),97.7%-103.1%(RSD=2.04%,n=6)and 95.3%-99.0%(RSD=1.46%,n=6). CONCLUSIONS:The method is simple,accurate and reproducible,and can be used for the contents determination of gallic ac-id,protocatechuic acid,catechuic acid,corilagin and brevifolincarboxylic acid in G. carolinianum.

Objective To compare the effects of heat-sensitive moxibustion and ginger-partition moxibustion on refractory peripheral facial paralysis. Methods Fifty-five patients with refractory peripheral facial paralysis were randomized into heat-sensitive moxibustion group (N=28) and ginger-partition moxibustion group (N=27). For two cases dropped out during the treatment, a total of 25 cases were finally enrolled into the ginger-partition moxibustion group. Two groups received oral use of mecobalamin tablets and conventional acupuncture, and heat-sensitive moxibustion group was given heat-sensitive moxibustion and ginger-partition moxibustion group was given ginger-partition moxibustion additionally. The moxibustion was performed once a day and ten times constituted one course, the treatment covered 6 courses. The clinical effect of the two groups was evaluated by 40-score method, House-Brackmann facial neurological function evaluation standard, blink reflex ( BR) , electromyogram and electroneurography. Results ( 1) Symptoms integral was increased in both groups after treatment ( P<0.01) , and the scores of heat-sensitive moxibustion group were higher than those of ginger-partition moxibustion group ( P<0.01). ( 2) The markedly effective rate of heat-sensitive moxibustion group was 75.00% and that of ginger-partition moxibustion group was 44.00%, and there was statistically significant difference between them ( P<0.05). ( 3) The results of electrophysiological examination showed that the difference values of ipsilateral and contralateral BR R1, R2, R2’ in both groups after treatment were less than those before treatment ( P<0.01) , and the abnormal rate of electromyography for heat-sensitive moxibustion group was improved obviously after treatment ( P<0.01) . The amplitude of compound muscle action potentials ( CMAP) of orbicularis oculi/orbicularis oris at the affected side of both groups showed a decreasing trend, but the differences were insignificant between the two groups after treatment ( P>0.05). Conclusion The curative effect of heat-sensitive moxibustion for the treatment of refractory peripheral facial paralysis is better than that of ginger-partition moxibustion.

Objective To explore the life style of the elderly in empty-nest family and need of community health service in shanggang community.Methods Using random sampling method, a group of 634 the aged more than 60 from empty-nest family in the community were investigated with questionnaires.Results In daily activities,40.9% of the elderly empty-nest took part in physical exercise,36.3% had hobbies.Really empty-nest group had rarely physical exercise and prepared staying alone.In community health service,about 82.65% ,72.82% ,55.21% of the aged empty-nest needed regular physical examination,health guidance and psychological counseling respectively.Conclusion Life style of the elderly in empty-nest family was reasonable,and empty-nest group,especially really empty-nest group had advanced demand about the community health service.Medical staff should often carry out physical exercise and psychological counseling,and also popularize common medical knowledge.Besides,regular physical examination and paying close attention to the healthy information of the elderly in empty-nest family was needed.

Objective To study the epidemic situation and associated risk factors of hypertension among the empty-nest elderly in Shangha of community. Methods Using pure random sampling method, a face-to-face questionnaire survey and the blood pressure measuring of the empty-nest elderly aged 60-year-old or above in the two communities of Shanggang were performed by trained investigators. Results There are 634 empty-nest elderlies in the two communities. The prevalence rate of hypertension was 51.7% in the subjects. The associated risk factors of hypertension among the empty-nest elderly include smoking, drinking, excess salt diet, lacking of sports and family history of hypertension. There was significant difference between the groups of hypertension and non-hypertension in the distribution of keeping healthy behaviors. The rate of awareness, management and control were 62. 8% ,49. 2%, and 28.7% respectively in the hypertension subjects. Conclusion The prevalence rate of hypertension among the empty-nest elderly is high, Public health education programs, multiple prevention and intervention measures of hypertension should be strengthened among the empty-nest elderly.

Objective:To explore the association between chest high resolution CT (HRCT) scoring and prognostic factors of interstitial lung disease (ILD) in patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (DM).Methods:The patients with DM admitted to Kailuan General Hospital between January 2017 and December 2019 were included into the study including 13 patients with positiveanti-MDA5 antibody (7 survivors, 6 deaths) and 18 patients with anti-synthase (ARS)-antibody positive. All patients underwent chest HRCT prior to treatment. The consolidation, ground-glass opacity (GGO) and fibrosis were scored to assess HRCT findings. The clinical manifestations were compared between the two groups. Cox regression analysis adjusted for age and sex was used to determine the prognostic factors for anti-MDA5 antibody-related ILD.Results:Compared with ARS patients, glutamyl transferase (GGT) and ferritin levels were significantly higher in MDA5-ILD patients [70.0(37.0, 122.5) vs 21.0(16.5, 33.5), Z=-3.37, P=0.001; 977.0(502.5, 1 366.0) vs 307.1(72.3, 546.9) , Z=-3.44, P=0.001]. The cumulative survival rate was significantly lower in patients with positive anti-MDA5 antibody than in those with positive anti-ARS antibody (100% vs 70%, P=0.001). The DM complicated with acute/subacute interstitial pneumonia (A/SIP) were found to significantly relate to death. There were no significant differences in chest HRCT scoringbetween the survivors and the deceased patients [ HR=1.08, 95% CI(0.95, 1.23), P=0.229; HR=0.97, 95% CI(0.72, 1.30), P=0.814]. Conclusion:Anti-MDA5 antibody is an important index for early diagnosis of DM complicated with acute/subacute interstitial pneumonia (A/SIP). The chest HRCT scoreis is not associated with the prognosis of anti-MDA5 antibody-related ILD patients.

Objective: To investigate the application of free anteromedial thigh (AMT) perforator flap in the reconstruction of tongue defect after radical resection of tongue carcinoma. Methods: From September 2010 to January 2015, 57 cases with tongue carcinoma underwent radical resection, leaving tongue and mouth floor defects which were reconstructed by AMT perforator flaps at the same stage.These 57 eases included tongue carcinoma at lingual margin (n=36), at ventral tongue (n=15) and at mouth floor (n=6). Results: The size of AMT perforator flap ranged from 5.5 cm×4.0 cm to 7.5 cm×5.5 cm, the thickness of flap ranged from 1.0-1.7 cm.The length of pedicle from descending branch of lateral circumferential femoral artery is (8.2±0.6) cm, found in 28 cases.The length of pedicle from profunda femoral artery is (8.5±0.4) cm, found in 17 cases.The length of pedicle from femoral artery is (8.1±0.7) cm, found in 12 cases.All 57 perforator flaps survived uneventfully, the defects at donor site were closed directly in all cases. All patients were followed up for 12-24 months with satisfactory esthetic and functional results in reconstructed tongue. No local recurrence happened. Only linear scar left in the donor sites, the function of thighs were not affected. Conclusions The free AMT perforator flap is an ideal choice for reconstruction of the tongue and mouth floor defect after radical resection of tongue carcinoma.

Objective To investigate the expression and potential diagnostic value of six-transmembrane epithelial antigen of prostate 1(STEAP1)in bladder transitional cell carcinoma.Methods 52 patients with transitional cell carcinoma of the bladder who underwent surgical treatment at the 940th Hospital of Joint Lo-gistics Support Force of the Chinese People's Liberation Army from June 2021 to December 2022 were select-ed as the observation group.In addition,52 patients with benign tumors of the bladder who matched basic clin-ical data such as age,gender,and disease incidence were selected as the control group.The relative expression levels of STEAP1 and STEAP1 mRNA in bladder tumor tissues of patients in the two groups were deter-mined by enzyme-linked immunosorbent assay and real-time fluorescence quantitative PCR,and the relative expression levels of STEAP1 and STEAP1 mRNA in bladder tumor tissues of patients with different patho-logical parameters were compared.Spearman correlation analysis and binary Logistic regression analysis were used to screen the risk factors for the occurrence and clinical stage of bladder transitional cell carcinoma.Re-ceiver operating characteristic(ROC)curve and area under the curve(AUC)were used to evaluate the diagnos-tic and predictive value of each indicator for bladder transitional cell carcinoma.Results The relative expres-sion levels of STEAP1 and STEAP1 mRNA in bladder tumor tissues in observation group were significantly higher than those in control group,with statistical significance(P＜0.05).The relative expression levels of STEAP1 and STEAP1 mRNA in bladder tumor tissues of patients with middle and advanced bladder transi-tional cell carcinoma were significantly higher than those of patients with early bladder transitional cell carci-noma,with statistical significance(P＜0.05).Binary Logistic regression analysis showed that the relative ex-pression level of STEAP1 and STEAP1 mRNA in bladder tumor tissues of patients were independent risk fac-tors for the development of bladder transitional cell carcinoma and middle and advanced bladder transitional cell carcinoma(P＜0.05).ROC curve analysis showed that the AUC of STEAP1 and STEAP1 mRNA inde-pendently predicting the occurrence of bladder transitional cell carcinoma was 0.841(95％CI:0.760-0.922,P＜0.001)and 0.936(95％CI:0.893-0.980,P＜0.001),respectively,both of which had high predictive ef-ficacy.Conclusion The relative expression levels of STEAP1 and STEAP1 mRNA in bladder tumor tissues of patients are positively correlated with the occurrence of bladder transitional cell carcinoma and the middle and advanced bladder transitional cell carcinoma,suggesting that STEAP1 can be used as a potential marker for di-agnosis and prediction of the occurrence and development of bladder transitional cell carcinoma.

OBJECTIVE: To explore the detection of autoantibodies in serum of patients with coal workers' pneumoconiosis( CWP).METHODS: Eight hundred and three cases of stage Ⅰ CWP patients were selected as study subjects by random sampling method.Anti-nuclear antibody and anti-neutrophil cytoplasmic antibody( ANCA) in serum were detected by indirect immunofluorescence assay; myeloperoxidased efficiency( MPO) antibody,anti-mitochondrial M2 antibody( AMA-M2) and anti-cyclic citrullinated peptide( CCP) antibody were detected by enzyme-linked immunosorbent assay;rheumatoid factor( RF) was detected by enhanced immunoturbidimetry of latexa.Group analysis was conducted according to age,lung function,length of dust exposure and the nature of dust exposure collection.RESULTS: In the serum of 803 CWP patients,the positive rate of anti-nuclear antibody,AMA-M2,RF,anti-CCP antibody,ANCA and MPO antibody were 9.7%,7.5%,7.3%,4.0%,2.6% and 0.8% respectively; the karyotype distribution of 78 cases of anti-nuclear antibody positive specimens was spotted( 43.6%), cytoplasmic( 20.5%), homogenous( 7.7%) and nucleolus( 5.1%),with a titer of 1:100.The positive rate of anti-nuclear antibody in the > 70.0 years group was higher than that of ≤60.0 and ≤70.0 years group( P < 0.017); the positive rate of anti-nuclear antibody in the abnormal lung function group was lower than that of the normal group( P < 0.01); the positive rate of anti-CCP antibody in the dust exposure length > 30.0 years group was higher than that of ≤30.0 years group( P < 0.017); the positive rate of anti-CCP antibody in silica-exposed group was lower than that in the coal-exposed group( P < 0.01).CONCLUSION: The positive rate of antinuclear antibody,AMA-M2,RF and anti-CCP antibody in CWP patients were high.The positive rate of anti-nuclear antibody is associated with age and lung function.The positive rate of anti-CCP antibody is related to the duration and nature of dust exposure.

OBJECTIVE: To explore the changes of serum levels and significance of surfactant protein( SP) A and SP-D in patients with stage Ⅰ coal workers' pneumoconiosis( CWP). METHODS: A random sampling method was used to select 88 cases of stage Ⅰ CWP patients as the CWP group,50 cases of healthy underground miners with similar dust exposure history as the dust exposure group and 38 cases of ground workers without dust exposure history as the control group. The serum levels of SP-A and SP-D in 3 groups were detected by enzyme-linked immunosorbent assays. RESULTS: The levels of serum SP-A and SP-D in the CWP group and the dust exposure group were higher than that of the control group( P <0. 05). The serum level of SP-D in the CWP group was higher than that of the dust exposure group( P < 0. 01). The serum level of SP-D in the smoking CWP subgroup was lower than that of the non-smoking CWP subgroup( P < 0. 05).CONCLUSION: The abnormal serum levels of SP-A and SP-D were related to the development of stage Ⅰ CWP. Smoking might affect the serum level of SP-D in stage Ⅰ CWP patients.