Objective To compare the outcomes of traumatic flail chest with multiple injuries treated by operative fixation versus conservative approach. Methods The clinical data of 60 patients with traumatic flail chest with multiple injuries were retrospectively analysed, and the outcomes between operation group (treated by operative fixation, n=32)and non-operation group (treated by conservative approach, n=28) were compared. Results The mean time of hospital stay, ICU stay and mechanical ventilation was significantly shorter, and the prevalences of chest wall deformity, pulmonary infection, pulmonary atelectasis and respiratory failure were significantly lower in operation group than those in non-operation group (P<0.05). Six months after discharge, the pulmonary function parameters such as inspiratory capacity, forced vital capacity, forced expiratory volume in one second, peak expiratory flow, total lung capacity and maximal midexpiratory flow were significantly higher in operation group than those in non-operation group (P<0.05). Conclusion Traumatic flail chest with multiple injuries treated by operative fixation may lead to less flail chest associated complications. Operative fixation has short- and long-term benefits to flail chest.

Objective To investigate the clinical effect of low-temperature plasma radiofrequency with endoscopic laryngoscope in the treatment of adult patients with laryngeal papilloma.Methods From January 2014 to April 2018,60 adult patients with laryngeal papilloma in Zhuji Central Hospital were enrolled in this study.According to the treatment methods,they were divided into control group and observation group,with 30 cases in each group.The control group was treated with laryngoscope tweezers,and the observation group was treated by low temperature plasma radiofrequency with endoscopic laryngoscope.The operation time,intraoperative blood loss,hospitalization time and postoperative complications were recorded.The follow-up was performed on the first day after operation.The recurrence rate and average recurrence time were recorded.Results The average operation time in the observation group was (29.54 ± 4.52)min,which was significantly shorter than (38.85 ± 5.47)min in the control group (t =7.186,P =0.000).The intraoperative blood loss of the observation group was (1.24 ± 0.76) mL,which was significantly lower than (35.69 ± 5.88) mL of the control group (t =31.825,P =0.000).The length of hospital stay of the observation group was (3.83 ± 1.17) d,which was significantly shorter than (4.79 ± 1.47) d of the control group (t =2.798,P =0.006).The incidence rate of postoperative complication in the observation group was 3.33％ (1/30),which was significantly lower than 23.33％ in the control group (x2 =5.192,P =0.022).The mean duration of postoperative recurrence in observation group was (2.42 ± 0.57) months,which was significantly longer than (1.28 ± 0.36) months in the control group(t =9.261,P =0.000).The postoperative recurrenc.e rate of the observation group was 6.67 ％ (2/30),which was significantly lower than that of the control group [40.00 ％ (12/30),x2 =9.316,P =0.002].Conclusion Low temperature plasma radiofrequency with endoscopic laryngoscope in the treatment of adult patients with laryngeal papilloma has less trauma,and can extend the recurrence time,reduce the postoperative recurrence rate.

Objective To explore the relationship between microelement intake and metabolic syndrome (MS) in elderly males and females in Zhejiang province. Methods Non-parametric Kruskal-Wallis tests were used to compare the intake of microelements by sex among different groups according to the diagnostic criteria of MS in 780 people(404 male,376 female).Logistic regression was used to explore the association between microelements and MS and its components.Results The percentages of inadequate intake of Mn,Zn and Se were relatively high among elderly people of Zhejiang province(males:30.45%,72.52%,75.74%;females:47.34%,33.78%,80.59%,respectively).Microelement intake in males were higher than females(P<0.05).The intake of Fe and Se were higher in the abdominal obesity group than the non-abdominal obesity group among elderly males,the intakes of Fe,Zn,Se in hypertension group were lower, and Se intake was higher in hyperglycemia and hypertriglyceridemia groups. Furthermore, enough intake of Fe(odds ratio OR,0.41;95% confidence interval CI:0.19,0.87)and Se(OR,0.30;95% CI:0.14, 0.63)decreased the risk of hypertension,and high Cu(OR,2.35;95% CI:1.18,4.71)intake increased the risk of hyperglycemia.Among females,Zn intake in the MS group was lower than in the non-MS group;the intakes of Cu, Zn and Se in the hypertension group were lower; the intakes of Fe, Mn and Zn in the hyperglycemia group were lower as well;and Se intake was lower in the low HDL-C group.Again,the high intake of Zn (OR, 3.21; 95% CI: 1.36, 7.59) and Se (OR, 2.79; 95% CI: 1.24, 6.27) increased the risk of abdominal obesity, but moderate intake of Cu (OR, 0.37; 95% CI: 0.19, 0.72) had a protective effect on hypertension. Conclusions The percentages of inadequate microelement intake were relatively high in elderly people of Zhejiang province. There is a relationship between dietary microelements and MS or its components. It is necessary to guide elderly people to adopt reasonable diet by referring to the Chinese dietary reference intake and Dietay Guidelines in order to improve the situation of microelements intake and promote health.

Objective:The study aimed to investigate the effects of exercise on the expression of ferroptosis-related proteins and the associated mechanisms in a post-traumatic stress disorder(PTSD)model induced by transient foot shock.Methods:Thirty-five male C57BL/6J mice(8 weeks old)were randomly divided into three groups:Control group,PTSD group,and Exe+PTSD group.PTSD model mice were established by foot-shock and PTSD behaviors were assessed using a fear conditioning box.Iron distribution areas were detected by Fe3+staining.Western Blot analysis were performed to determine the expression level of ferroptosis-related proteins in the mice.Results:Compared to the control group,the freezing time and Fe3+distribution areas in the cortex and hippocampus were significantly increased in the mice with PTSD(P＜0.05).The levels of ferroportin1(FPN1),glutathione peroxidase 4(GPX4),and brain-derived neurotrophic factor(BDNF)proteins were significantly decreased(P＜0.05),while the expression of high mobility group box 1(HMGB1)protein was significantly elevated(P＜0.05).Exercise significantly reduced freezing time and Fe3+accumulation in the cortex and hippocampus(P＜0.05),and it also up-regulated the expression of FPN1,GPX4,and BDNF proteins(P＜0.05),while down-regulating HMGB1 expression compared to the PTSD group(P＜0.05).Conclusion:This study demonstrates that PTSD induces the ferroptosis-related pathway in mice,and exercise can inhibit iron accumulation and reverse the expression of ferroptosis-related proteins induced by PTSD,there-by alleviating PTSD-like behavior in mice.