Objective To study mental status of recovered two year after in shake area crowd of gansu wen-xian. Methods Fifty former disaster crowd were assessed with SCL-90, Coping Style Questionnaire and Social Support Questionnaire two year after their discharge, 50 healthy medical staffs of gan-su CTM Affiliated Hospital of logistics ensure center were assessed with same instruments as control. Results The former disaster crowd and 5 subscores of SCL-90 with higher average scores than Chinese norm and results of control, they were somatization( F =4. 31) , phobia ( F = 5. 25) , obtrude ( F =5. 91) , P＜0. 01, depression ( F = 3. 11) anxiety ( F = 3. 74) , P ＜ 0. 05; The former disaster crowd felt more objective support, used more rationalization, but were less capable in problem solving. In former disaster crowd, problem-solving, objective social support and utility of the support were negatively correlated with subscores of SCL-90 ( r = -0. 31～-0. 40, P ＜0. 05) ; while immature coping, such as fantasy, withdrawal and rationalization were positively correlated with subscores of SCL-90 ( r = 0. 40 ~ 0. 60, P ＜ 0. 05).Conclusion Former disaster crowd still have psychosomatic symptoms and need social and psychology intervene and support.

OBJECTIVE: To study the influence of the number and position of anchor nails on the Bankart repair by the finite element analysis. METHODS: The 3D CT data of shoulder joints including normal adult volunteers were imported into Mimics 10.0 and Geomagic 2012 software to reconstruct the related tissues, and then meshed in Hypermesh 13.0 software to give material attributes. The position and number of MPC constraints were adjusted in Abaqus 6.14 to establish finite element model of shoulder joint under 6 working conditions including A model(normal control model), B model (Bankart damage control model), C model (1 anchor), D model (2 anchors), E model (3 anchors), F model (4 anchors). The humerus external rotation and forward load were added to simulate the fear test of the shoulder joint forward instability. RESULTS: (1)Normally, the inferior glenohumeral ligament complex accompanied by the external rotation of the humerus head has a wrinkle and a significant stress concentration around its anterior and posterior bundle terminations.(2)The stress of the anterior bundle and posterior bundle of the inferior glenohumeral ligament were increased by 52.33% and 45.67% respectively after Bankart's injury.(3)In each model of anchor repair, the stress concentration was obvious at the anchor site, and the stress of anterior and posterior bundle ligaments could be reduced; there were no obvious differences between C, D models and B model(>0.05), and there were significant differences between E, F models and B model(<0.05). CONCLUSIONS One or two anchors can reduce the stress of the anterior and posterior bundles of the inferior glenohumeral ligament in the repair of Bankart's injury, but when the angle of rotation is large, the stress concentration in the anchor position increases significantly, leading to the increases of the risk of failure. The application of three or four anchors can enhance the constraints on the inferior glenohumeral ligament and reduce the stress of the anchor itself through the "load sharing" effect between anchors, so as to ensure the stability of the shoulder joint and provide a mechanical environment for the early rehabilitation of patients.
Biomechanical Phenomena ; Cadaver ; Finite Element Analysis ; Humans ; Joint Instability ; Shoulder Dislocation ; Shoulder Joint

OBJECTIVETo explore the efficacy of one stage or staging treatment of cervical spondylotic myelopathy through combined posterior and anterior approaches.

METHODSFrom June 2001 to October 2008, 45 patients with pinching cervical spondylotic myelopathy and developmental stenosis of cervical spinal canal were decompressed through combined posterior and anterior approaches in one stage or staging operation. Among the patients, 35 patients were male and 10 patients were female, ranging in age from 45 to 72 years, with an average of 53 years. Five patients were decompressed through combined posterior and anterior approaches in one-stage operation, and other 40 patients were treated in staging operation. All the patients were treated with open-door posterior cervical expansive laminoplasty and anterior decompression, bone graft and titanium plate internal fixation. JOA scores were used to evaluate the therapeutic effects at the 3rd month and one year after operation.

RESULTSAfter the treatment, 44 patients were followed up from 13 to 62 months, with an average of 30 months. One patient was dead of lung infection at the 21th day after operation. The nerve root palsy of C5 was found in 3 cases. One patient had postoperative hoarseness. Axial symptoms were found in 14 cases. Two patients had donor site complications. There were no screws broken or back out, no screw loosening, no moving or sinking of bone block or Ti-net, no door re-closer and cervical deformity. Forty-four patients got spinal fusion. According to JOA score criteria: the average preoperative JOA score was (9.36 +/- 2.24) points, JOA score was (12.34 +/- 2.64) points in 3 months after operation, (12.77 +/- 2.61) points in one year after operation. Among 44 cases, 16 got an excellent result, 19 good, 6 fair, 3 invalid. There were statistically differences between preoperative score and 3 months or one year after operation.

CONCLUSIONDecompression through combined posterior and anterior approaches for the treatment of pinching cervical spondyoltic myelopathy and developmental stenosis of cervical spinal canal has good efficacy, as well as a safety operation method. The operation method with one or staging decompression through combined anterior and posterior approach should be chosen according to the conditions of the patients and the operations. Anterior decompression, bone graft and titanium plate internal fixation could restore the height of vertebral body effectively and prevent fusion complication.

Aged ; Bone Transplantation ; Cervical Vertebrae ; surgery ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Spinal Cord Compression ; Spinal Fusion ; Spinal Osteophytosis ; surgery

Objective To investigate the correlation and significance of S100A12 with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods Fifty-three patients with OSAHS were chosen as OSAHS group and 46 healthy volunteers were chosen as control group.The levels of S100A12 and hs-CRP in the two groups were compared,and its relationship with those of epworth (ESS),apnea hypopnea index (AHI),and minimum blood oxygen saturation (L-SpO2) were analysised.Results The scores of ESS,BMI,A HI,L-SpO2,hs-CRP and S100A12 in two groups were statistically significant (P＜0.05).The severity of hs-CRP in severe OSAHS group was significantly higher than that of mild OSAHS group (P＜0.05).There was no significant difference in hs-CRP between moderate OSAHS group and mild OSAHS group and severe group (P＞0.05).The level of S100A12 in severe OSAHS group was significantly higher than that of moderate OSAHS group and OSAHS mild group(P＜0.05).The level of S100A12 in moderate moderate group was significantly higher than that of mild group(P＜0.01).hs-CRP was negatively correlated with ESS and AHI (r=0.822,0.787,P＜0.01),was positively correlated with L-SpO2 (r=-0.740,P＜0.01),S100A12 was positively correlated with ESS and AHI (r =0.707,P ＜ 0.01),and negatively correlated with ESS and AHI (r =0.707,0.807,P＜0.01),and negatively correlated with with L-SpO2 (r=-0.670,P＜0.01).Conclusion S100A12 is associated with OSAHS.The higher the severity of OSAHS,the higher the S100A12 value,which can be used as a new predictor of cardiovascular disease risk in OSAHS patients.

Objective:To explore the feasibility in reconstruction of the muscular power with the superficial part of lateral femoral muscle through anatomical study on the superficial region of lateral femoral muscle.Methods:Studies on 4 sides of lower limbs of 2 cadaver specimen were conducted in the Department of Hand and Foot Microsurgery of Xi'an Fengcheng Hospital. Intraoperative observations and measurements were further carried out on 21 sides of 21 patients. Muscular fascia in superficial region, muscular gross morphology, thickness, length and width of muscles, length of muscle fibres and pinnate angles of muscle surface were observed and measured. Both blood vessels and nerves in the muscle were separated to measured.Results:The superficial region of lateral femoral muscle was in a shape of fusiform and started from the greater trochanter and ended at the patella and rectus femoris, with the fascia at proximal end and the muscle of distal end. The inferior muscle fibres of the fascia were arranged in sequence and ended at the deep fascia from proximal to distal. Mean muscle thickness was measured at 1.96 cm±0.48 cm, and mean pinnate angle was of 18.9°±3.3°. The superficial region was found being distributed by the descending branches of lateral circumflex femoral artery(LCFA) and the second branch of femoral nerve, and they accompanied each other. At 5.0 cm from the point of entry to the muscle, the diameter of the vessels was measured at 2.39 mm±0.52 mm, and the diameter of nerves was at 2.64 mm±0.61 mm. Both of arteries and nerves further branched out anteriorly and posteriorly in 1.0-1.5 cm intervals after having entered the muscle. At 0 - 2.5 cm away from the muscle entry point, a larger branch was often running posteriorly into the muscle, and this branch appears on all 4-sided specimens. While the occurrence rate in the 21 sides of patients observed in operations was of 90.5%, with a transverse diameter at 1.23 mm±0.28 mm.Conclusion:The superficial region of lateral femoral muscle is dominated by independent vessels and nerves and there are many branches from superior vessels and nerves, which form an anatomical basis for one or more muscular flaps.

Objective:To provide strategical reference for large-scale colorectal cancer screening with full regional coverage by analyzing the results of the first colorectal cancer screening in the target population in Linhai city,Zhejiang Province. Methods:The target population of 50-74 years old in Linhai were invited to take part in the colorectal cancer screening program from 2020 to 2021.The risk of colorectal cancer of the participants were preliminarily evaluated by questionnaire and qualitative fecal occult blood test(FOBT),and participants with positive screening results were suggested to take colonoscopy test for further evaluation.The screening results were collected and analyzed. Results:A total of 71 942 people were screened from 2020 to 2021,and 15 1 70 of them were found positive in preliminary screening.The positive rate in males was significantly higher than that in females(x 2=724.005,P＜0.001),and the positive rate was highest in the population of 60-69 years old during preliminary screening.The compliance rate of colonoscopy was 24.1 9％with no significant difference between males and females(x 2=0.256,P=0.61 3),showing a decreasing trend as the age increases.From 2020 to 2021,the detection rate of lesions by colonoscopy was 52.92％,with 47 case of colorectal cancer(CRC),333 case of advanced colorectal adenoma,561 case of non-advanced colorectal adenoma and 1 001 case of benign lesions.The detection rate of lesions in males was much higher than that in females(x 2=82.451,P＜0.001).The detection rates of lesions,advanced colorectal adenoma,and non-advanced adenoma showed increasing trends with the age.The compliance rate of colonoscopy,the detection rate of lesions,and the detection rate of CRC,advanced colorectal adenoma,and non-advanced adenoma were 32.94％,69.53％,2.87％,1 6.85％and 1 9.71％,respectively,in participants who were both assessed as high-risk according to questionnaire evaluation and FOBT positive,the highest among all participants.The compliance rate of colonoscopy in 2021 was obviously higher than that in 2020(32.11％vs 1 9.09％,P＜0.001),but no significant difference was found in the detection rate of lesions between 2021 and 2020(P＞0.05). Conclusion:From 2020 to 2021,the compliance rate of colonoscopy was low and the detection rate of colorectal lesions was high during the screening of colorectal cancer in the target population in Linhai,Zhejiang Province.It is necessary to enhance the public awareness of the importance of colorectal cancer screening,standardize the enrollment criteria,and improve the compliance of colonoscopy,in orderto give full play to primary screening in the general public.

Objective:To explore the pathogenic agents of acute respiratory infection (ARI) in children in Beijing.Methods:In the cross-sectional study, 3 groups of children from different departments were enrolled from Feb 6 th, 2023 (6 th week) to May 28 th (21 th week), 2023, including influenza-like case group from emergency department for nucleic acid testing of influenza virus (Flu) and human metapneumovirus (HMPV), the outpatient ARI group under nucleic acid testing for Flu, respiratory syncytial virus (RSV), adenovirus (ADV), and parainfluenza virus (PIV), and the inpatient ARI group under nucleic acid testing for Flu, RSV, HMPV, ADV, human bocavirus (HBoV), Rhinovirus (Rh), PIV, coronavirus (HCoV), Mycoplasma pneumoniae (Mp) and Chlamydia pneumonia (Cp). Results:There were 320 influenza-like cases enrolled, including 192 males and 128 females, aged 4.7 (3.6, 6.9) years, and 117 cases (36.6%) positive for Flu A, which contained similar proportion of pandemic H1N1 (H1N1) 47.0% (55/117) and H3N2 53.0% (62/117), and 13 cases for HMPV 4.1% (13/320). The rate of Flu reached its peak at the 10 th week, with H1N1 as the predominant one from the 6 th to 9 th week (10.0%-50.0%) and then H3N2 from the 10 th to 16 th week (15.0%-90.0%). HMPV was detected from the 15 th week 5.0% (1/20), and then reached to 30.0% (6/20) at the 20 th week. In the outpatient ARI group, 7 573 were enrolled, including 4 131 males and 3 442 females, aged 4.0 (2.1, 5.3) years, and the highest positive rate for RSV 32.9% (2 491/7 573), followed by Flu A 12.1% (915/7 573). The dominant one was Flu A in weeks 6-14 (23.2%-74.7%), then RSV in the 15 th week 24.8% (36/145). In the inpatient ARI group, 1 391 patients were enrolled, including 804 males and 587 females, aged 3.3 (0.4, 5.8) years, and the highest positive rate for Rh 18.7% (260/1 391), followed by RSV 12.4% (173/1 391), Flu A 10.2% (142/1 391, of which 116 cases (81.7%) were H1N1, and 26 cases (18.3%) were H3N2) and HMPV 3.1% (43/1 391). H1N1 was detected from the 7 th week 10% (6/60), to peak in the 11 th week 31.8% (21/66). H3N2 was detected from the 8 th week 1.5% (1/68), and then kept in low level. The proportion of H1N1 among Flu was 81.7% (116/142) in the inpatient ARI group. RSV was detected from 12 th week 1.3% (1/80), reaching 30.4% (35/115) at 19 th week. The positive rate of HMPV reached 12.1% (14/116) at 21 th week. Conclusions:In the spring of 2023, the first one in Beijing is the Flu epidemic, with H1N1 being the predominant one in the early stage and H3N2 in the later stage. Then, there is a postponed RSV epidemic and an increased HMPV detection. In addition, nucleic acid testing for outpatient children should be strengthened to provide early warning of epidemics.

Objective:To analyze the epidemiological features of respiratory syncytial virus (RSV) infection in Beijing, and monitor the sequence variations in RSV glycoprotein (G) gene and clinical features of infected children.Methods:Respiratory tract specimens were collected from children with acute respiratory infection in the Children′s Hospital Affiliated to Capital Institute of Pediatrics from January 1, 2023 to December 31, 2023. RSV-positive specimens screened by multiple nucleic acid testing were subjected to PCR to amplify the full-length RSV G gene. A phylogenetic tree was constructed after gene sequencing to analyze RSV subtypes and trace G gene variants. Clinical data were retrieved from the medical record system to analyze the clinical features of children with RSV infection in Beijing.Results:A total of 5 489 respiratory specimens were collected from 3 046 male patients and 2 443 female patients. The average age of the patients was 4.36 years. A total of 589 RSV-positive specimens (10.7%, 589/5 489) were detected with 349 from male patients and 240 from female patients. The average age of children with RSV infection was (2.51±2.78) years and the median age was 0.48 years. RSV had been circulating among children in Beijing since March 2023 with two epidemic peaks in May (24.6%, 122/496) and December (18.2%, 126/693). The predominant subtype of RSV in the first half of 2023 was subtype A, but it was replaced by subtype B from November 2023. Phylogenetic analysis revealed a novel G gene of RSV subtype B (RSV-B-BA9-954bp) with a length of 954 bp, which belonged to a new cluster in the phylogenetic tree. The percentage of patients admitted to the Intensive Care Unit (ICU) was higher in children with new variant of RSV subtype B infection than in those with common RSV subtype B infection [44.1% (15/34) vs 25.2% (31/123), χ 2=4.600, P=0.032], while the counts of white blood cells and the levels of C-reactive protein were lower in the children with new variant infection ( P<0.05). Conclusions:RSV has been prevalent among children in Beijing since March 2023 with two epidemic peaks. The predominant A subtype is gradually replaced by to B subtype. A new variant of RSV B G gene (RSV-B-BA9-954bp) is detected among the children.

Objective:To analyze the differentially expressed genes of human respiratory syncytial virus (RSV) subtype A genotype ON1, a predominant genotype in Beijing, after infecting A549 cells using transcriptomic sequencing, and provide potential targets for RSV prevention and treatment.Methods:A local strain (61397-ON1) identified by whole-genome sequencing as ON1 genotype of RSV subtype A was selected to infect A549 cells. Total mRNA was extracted, and the differentially expressed genes in infected and uninfected A549 cells were screened by transcriptomic sequencing. GO analysis and KEGG pathway analysis were performed. Besides, six genes with differential expression ratio greater than two times were randomly selected for qRT-PCR verification.Results:There were 1 632 differentially expressed genes between infected and uninfected A549 cells, of which 807 genes were up-regulated and 825 genes were down-regulated. The differentially expressed genes were mainly involved in immune response-related biological processes such as cytokine response and positive regulation of MAPK cascades, and were enriched in MAPK signaling pathway, NOD-like receptor signaling pathway, p53 signaling pathway, TNF signaling pathway, IL-17 signaling pathway and NF-κB signaling pathway. The results of qRT-PCR for six differentially expressed genes were consistent with the trend of transcriptome data.Conclusions:The differentially expressed genes of RSV A subtype ON1 genotype after infecting A549 cells are mainly involved in cytokine response and immune-related signaling pathways. This study provides basic data for further study of the molecular mechanism of RSV infection and the development of prevention and treatment strategies.

Objective:To investigate the spectrum of pathogenic agents in pediatric patients with acute respiratory infections (ARI) during the outbreak of coronavirus infectious diseases 2019 (COVID-19).Methods:Three groups of children were enrolled into the prospective study during January 20 to February 20, 2020 from Capital Institute of Pediatrics, including children in the exposed group with ARI and epidemiological history associated with COVID-19 from whom both pharyngeal and nasopharyngeal swabs were collected, children in the ARI group without COVID-19 associated epidemiological history and children in the screening group for hospital admission, with neither COVID-19 associated epidemiological history nor ARI. Only nasopharyngeal swabs were collected in the ARI group and screening group. Each group is expected to include at least 30 cases. All specimens were tested for 2019-nCoV nucleic acid by two diagnostic kits from different manufacturers. All nasopharyngeal swabs were tested for multiple respiratory pathogens, whilst the results from the ARI group were compared with that in the correspondence periods of 2019 and 2018 used by t or χ 2 test. Results:A total of 244 children were enrolled into three groups, including 139 males and 105 females, the age was (5±4) years. The test of 2019-nCoV nucleic acid were negative in all children, and high positive rates of pathogens were detected in exposed (69.4%, 25/36) and ARI (55.3%, 73/132) groups, with the highest positive rate for mycoplasma pneumoniae (MP) (19.4%, 7/36 and 17.4%, 23/132, respectively), followed by human metapneumovirus (hMPV) (16.7%, 6/36 and 9.8%, 13/132, respectively). The positive rate (11.8%, 9/76) of pathogens in the screening group was low. In the same period of 2019, the positive rate of pathogens was 83.7% (77/92), with the highest rates for respiratory syncytial virus (RSV) A (29.3%, 27/92), followed by influenza virus (Flu) A (H1N1) (19.6%, 18/92) and adenovirus (ADV) (14.1%, 13/92), which showed significant difference with the positive rates of the three viruses in 2020 (RSV A: χ 2=27.346, P<0.01; FluA (H1N1): χ 2=28.083, P<0.01; ADV: χ 2=7.848, P=0.005) . In 2018, the positive rate of pathogens was 61.0% (50/82), with the highest rate for human bocavirus (HBoV) (13.4%, 11/82) and followed by ADV (11.0%, 9/82), and significant difference was shown in the positive rate of HBoV with that in 2020 (χ 2=6.776, P=0.009). Conclusions:The infection rate of 2019-nCoV is low among children in Beijing with no family clustering or no close contact, even with epidemiological history. The spectrum of pathogens of ARI in children during the research period is quite different from that in the previous years when the viral infections were dominant. MP is the highest positively detected one among the main pathogens during the outbreak of COVID-19 in Beijing where there is no main outbreak area.