Objective With the development of minimally invasion and the popularization of arthroscopy the technology of ar-throscopy has been widely applied for the treatment of acute and the safety of this has been validated.To analyze the clinical effect of ar-throscopically assisted double Endobutton plate reconstruction of coracoclavicular ligament in the treatment of acute acromioclavicular joint dislocation. Methods From November 2013 to December 2014, a total of 23 patients with Rockwood type III,Ⅳ,Ⅴshoulder joint dis-location were included, all cases was treated by arthroscopic double Endobutton fixaton technique.Patients were followed up for 6 to 18 months.The changes of shoulder joint forward elevation and external rotation, Japanese Orthopaedic Association score(JOA), and Visual Analogue score( VAS) of acromioclavicular joint in both perioperative and postoperative were recorded. Results The mean follow-up time was (9.3 ±2.4) months ( range from 6 to 18 months),and mean time from injury to surgery was(10.1 ±3.2)days.The therapeutic effects were achieved in all patients after the arthroscopically assisted double Endobutton plate reconstruction.All the measurements, in-cluding the mean forward elevation JOA scores before and after fixation (71.0 ±5.4 vs 93.5 ±3.6), and mean VAS scores (4.6 ±1.0 vs 1.9 ±0.9), mean forward elevation [(102.5 ±8.6) degrees vs (144.3 ±6.3) degrees], and mean external rotation[(107.1 ±6.2) de-grees vs (149.6 ±7.5) degrees] improved significantly (P<0.05) after the treatment. Conclusion Arthroscopic double Endobutton fixaton technique could provide an effective immobilization of shoulder and acromioclavicular joint, thus improving the function of the joint and achieving an excellent effect in the treatment of acute acromiocla-vicular joint dislocation.

Objective To investigate the clinical, electromyographic and cervical magnetic resonance imaging (MRI) characteristics of Hirayama disease. Methods Fifteen patients with Hirayama disease were observed for special clinical manifestations and underwent electromyographic examination of the bilateral distal upper limb muscles and peripheral nerve conduction velocity. MRI of the neck in neutral and fully flexed positions was performed to identify potential lower cervical cord atrophy and cervical curvature anomalies. Results All the 15 male patients had disease onset during puberty with asymmetric muscular atrophy and weakness of the hands and forearms. Concentric needle electromyography revealed prolonged duration and large amplitude of the motor unit potentials in the compromised distal limb muscles with also increased polyphasic potentials and poor recruitment, involving mainly the C7, C8 and T1 myotomes. In neutral neck position, MRI identified lower cervical cord atrophy in 9 patients, occurring mainly at C5, C6 levels;in fully flexed position, all patients showed forward displacement and flattening of the lower cervical cord, occurring mostly at C6 level. Conclusion Hirayama disease occurs mainly in puberty in young male patients, whose clinical features and electromyographic examination often indicate localized anterior horn anomalies in the lower cervical cord. MRI of the neck in neutral and fully flexed position can provide valuable assistance in the diagnosis of this disease.

Objective To understand the status on care and nutrition of children living in the rural areas (so called 'left-behind' children) while their parents were seeking for jobs in the urban areas. Methods Cross-sectional study was employed in this investigation.The group of‘left-behind' children (n=774) and the comparison group (n=774) were identified.The ascertainment methods mainly included questionnaire,anthropometries measurements,food-frequency,and laboratory examination.Results be poorly attended (X2=6.671,P=0.036;X2=15.053,P=0.001 ).Mothers who chose to work outside of their households would tend to choose bottle-feeding or decrease the duration of breastfeeding for their infants (X2=5.051,P=0.031;t=-7.201,P=0.001).The intake of milk and bean products in children were obviously lower than that seen in the control group (t=-2.150,P=0.032 ;t=-2.054,significant difference when comparing with the control group (X2=4.560,P=0.033 ).Conclusion communities,parents and extended families would facilitate more attention and effective intervention programs to improve the situation.

king condition before pregnancy were associated with the development of polydactyly and syndactyly.

OBJECTIVETo evaluate the influence of stenting main vessel on side branches and to compare the different effects on side branches between BMS and DES (Taxus and Cypher).

METHODSWe reviewed the angiograms and the medical records of 183 patients who had received stent implantation in coronary main vessels and had follow-up angiograms. Any side branch was jailed by stent was evaluated.

RESULTSSide branch occlusion occurred in 8.9% in all branches (10.5% in Cypher DES group, 11.1% in Taxus DES group and 7.8% in BMS group). Spontaneous recanalization of side branches was observed in 72% (90.9% in Cypher DES, 66.7% in Taxus stent group and 66.7% in BMS). The ostial side branch stenosis before stenting and the involvement of the side branch origin within the lesion of the parent vessel are the major independent predictors for side branch occlusion.

CONCLUSIONSThe influence of different DES implantations in coronary main vessels on side branches were similar and there was no difference between DES and BMS. Side branch occlusion had relatively benign clinical course. Most occluded side branches had late spontaneous reperfusion.

Aged ; Angioplasty, Balloon, Coronary ; Coronary Vessels ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; surgery ; Stents ; Treatment Outcome

BACKGROUNDCoronary computed tomographic angiography (CCTA) has been widely used in patients who are at intermediate risk for having stable coronary artery disease (SCAD), and 2013 European Society of Cardiology Guidelines on the Management of SCAD (2013G) recommended the appropriate application of CCTA. However, 2013G has not been subjected to systematic analyses for subsequent impact on clinical practice.

METHODSA total of 5320 patients suspected with SCAD were enrolled and scheduled for CCTA from March 2013 to September 2014. For each patient, pretest probability of SCAD was calculated according to updated Diamond-Forrester model (UDFM). Appropriate CCTA or appropriate stress test was determined as described in the 2013G. A generalized estimating equation model was used to determine the trends in the half-monthly rate of appropriate CCTA.

RESULTSOverall, only 61.37% of patients received appropriate CCTA, and there was insignificant change over time (P = 0.8701). The application of CCTA in patients who should have had a stress test accounted for most of the inappropriate CCTA before (22.29%) or after (19.98%) the publication of the 2013G. In all patients or any subgroup, no significant change in the adjusted half-monthly rate of appropriate CCTA was found after the publication of the 2013G (odds ratio, 1.002; 95% confidence interval, 0.982-1.021; P = 0.8678).

CONCLUSIONSThese findings suggest that the 2013G have not, to date, been fully incorporated into clinical practice, and the clinical utilization of CCTA remains unreasonable to some extent.

Aged ; Coronary Angiography ; methods ; Coronary Artery Disease ; diagnosis ; Female ; Humans ; Male ; Middle Aged ; Odds Ratio

Objective To evaluate the diagnostic performance of noninvasive fractional flow reserve (FFR) derived from coronary computed tomographic angiography (CTA) (FFRCT) for functional myocardial ischemia.Methods Thirty-nine patients undergone coronary CTA and FFR examination from Aug.2012 to Jul.2015 in PLA General Hospital were retrospectively included in present study.Measurements of invasive FFR value was used as reference standard,and FFRCT based on coronary CTA image was performed in either per-patient or per-vessel level to assess the accuracy,specificity,sensitivity,the positive predictive value and negative predictive value for functional myocardial ischemia.Results In per-patient level,the accuracy of FFRCT was 82.05％,sensitivity was 83.33％,specificity was 80.95％,positive predictive value was 78.95％ and negative predictive value was 85.00％.In per-vessel level,the accuracy of FFRCT was 76.79％,sensitivity was 69.57％,specificity was 81.82％,positive predictive value was 72.73％ and negative predictive value was 79.41％.The area under ROC was 0.826 in per-patient level,and 0.786 in per-vessel level.For per-vessel,FFRCT was positively correlated with FFR value significantly (r=0.644;95％CI:0.458-0.775).Conclusion With FFR as reference standard,domestic noninvasive FFRCT can be used for the diagnosis of functional myocardial ischemia with high diagnostic performance and clinical application prospect.

Objective:To investigate the safety and efficacy of mitoxantrone liposome in the treatment of children with high-risk acute myeloid leukemia(AML).Methods:The children with high-risk AML who received the mitoxantrone liposome regimen at Wuhan Children's Hospital from January 2022 to February 2023 were collected as the observation group,and the children with high-risk AML who received idarubicin regimen were enrolled as controls,and their clinical data were analyzed.Time to bone marrow recovery,the complete remission rate of bone marrow cytology,the clearance rate of minimal residual disease,and treatment-related adverse reactions were compared between the two groups.Results:The patients treated with mitoxantrone liposome showed shorter time to recovery of leukocytes(17 vs 21 day),granulocytes(18 vs 24 day),platelets(17 vs 24 day),and hemoglobin(20 vs 26 day)compared with those treated with idarubicin,there were statistical differences(P＜0.05).The effective rate and MRD turning negative rate in the observation group were 90.9％and 72.7％,respectively,while those in the control group were 94.1％and 76.4％,with no statistical difference(P＞0.05).The overall response rate of the two groups of patients was similar.Conclusion:The efficacy of mitoxantrone liposome is not inferior to that of idarubicin in children with high-risk AML,but mitoxantrone liposome allows a significantly shorter duration of bone marrow suppression and the safety is better.

Objective:To explore the status of osteoporosis in patients with ankylosing spondylitis in the Han and four other ethnic minorities in Xinjiang.Methods:From January 2019 to June 2020, 89 patients with ankylosing spondylitis who were hospitalized in the Rheumatology and Immunology Department of the First Affiliated Hospital of Xinjiang Medical University with complete data were collected. Age, sex, body mass index, course of the disease, blood calcium, phosphorus, alkaline phosphatase, 25 hydroxy-vitamin D 3 level, Creactive protein, erythrocyte sedimentation rate, human leukocyte antigen B27, family history, peripheral joint involvement were analyzed between Han and ethnic minority patients. Extra-articular manifestations, presence or absence of fracture, and bone mineral density were analyzed with SPSS 26.0. Quantitative data were described using s and independent sample t-test. Counting data was described using n (%) and Pearson χ2 test. The rank sum test was used for econometric data and grade data that were not meet with normal distribution. Results:Among the 89 patients, 46 were Han and 43 were ethnic minorities, with an average age of (37.2±8.4) years. Seventeen patients had osteoporosis, of which 7 were Han and 10 were ethnic minorities. The mean age was (34.2±10.4) years. and the course of disease was (11.6±4.9)months. Among the patients with osteoporosis, the age of ethnic minority patients was younger [ethnic minority (25.4±10.7)years vs. Han (37.8±10.5)years, t=2.48 , P=0.021], and the duration of disease was shorter (month) [ethnic minority (5.4±2.6)months vs. Han (8.5±2.0)months, t=2.63 , P=0.015]. Conclusion:Although ankylosing spondylitis is mainly in young people, osteoporosis is not uncommon. Ethnic minority patients with ankylosing spondylitis complicated with osteoporosis are younger in age and shorter in course of disease than Han patients.

Objective:To analyze the clinical characteristics of patients with spontaneous splenorenal shunt (SSRS) in liver cirrhosis, and to compare the effects and prognosis of different treatments.Methods:The data of cirrhotic patients with SSRS at the First Affiliated Hospital of Zhengzhou University between 2016-2022 were retrospectively analyzed.Patients were divided into Group A receiving conservative treatment, Group B by simple embolization, Group C undergoing TIPS combined with embolization, and Group D given liver transplantation. Life status, liver function changes, incidences of adverse events, and survival between groups were compared.Results:SSRS diameter was positively correlated with blood ammonia ( R=0.478) and negatively correlated with portal vein diameter ( R=-0.301). SSRS diameter is a protective factor for gastrointestinal hemorrhage and ascites and a risk factor for hepatic encephalopathy; Blood ammonia decreased and prothrombin time prolonged after treatment in group A ( P<0.05), blood ammonia decreased and albumin increased in group B ( P<0.05). Hemoglobin and bilirubin increased in group C ( P<0.05), blood ammonia and bilirubin decreased and platelets and albumin increased in group D ( P<0.05); Survival analysis showed that the prognosis of groups A and C was related to liver function, and the survival rate of group D was the highest of all ( P<0.05). Conclusions:SSRS embolization is safe and effective, and liver transplantation improves patient survival. Individualized treatment should be selected based on patient symptoms, liver function, and shunt diameter.