Objective To explore the short axial strain of left ventricle in patients with atrial septal defect(ASD)before and after the transcatheter closure by using two-dimensional speckle tracking imaging (2D-STI).Methods A total of 30 patients with ASD underwent echocardiography before and after the transcatheter closure.The procedure was performed to obtain the peak of circumferential strain(Sc)and radial stain(Sr)of left ventricle by 2D-STI.Thirty healthy volunteers were enrolled as controls.Results ①Compared with the control group,regional myocardial Sc of ASD group decreased(P <0.05).Sc of anterior septum (AS),anterior wall (AW),laterior wall (LW)and posterior wall (PW)increased (P <0.05)at 2-days after the transcatheter closure and those parameters were higher than control group.At the six-months after the transcatheter closure,those parameters reduced to the normal level (P <0.05).Sc of inferior wall (IW)and mid-posterior septum (MP-Sept)increased to the normal level at 2-days after the closure surgery (P <0.05).②Compared with control group,regional myocardial Sr of ASD group decreased(P <0.05 ) except PW,two-days after the transcatheter closure these parameters increased to the normal level.Sr of PW in ASD group increased compared with control group(P <0.05),and there were no statistical changes at 2-days after the transcatheter closure.Sr of PW in ASD decreased (P <0.05 )to normal level until 6-months after the transcatheter closure.③ Global circumferential strain (GCS)of left ventricular in ASD group were lower than control group (P <0.05 ).At two-days after undergoing transcatheter closure the GCS increased (P <0.05)and those parameters were higher than control group (P <0.05).Six-months after the transcatheter closure those parameters reduced to the normal level (P < 0.05 ).There were no statistical differences of left ventricular global radial strain (GRS)between control group and ASD group. However,the GRS of ASD group increased (P < 0.05 )and those parameters were higher than control group (P <0.05)after 2-days undergoing the transcatheter closure.At six-months after the transcatheter closure those parameters were reduced to normal level (P <0.05 ).Conclusions 2D-STI can quantitative evaluate left ventricular circumferential strain and radial strain in patients with ASD before and after the transcatheter closure.

Objective To evaluate the clinical effect of talonavicular arthrodesis and the influence of adjacent joints use trephine percutaneous osteotomy in the treatment of talonavicular arthralgia.Methods From June 1999 to June 2009,24 patients were performed talonavicular arthrodesis due to a variety of painful disorder of talonavicular joint with trephine percutaneous osteotomy.There were 13 males and 11 females,with an average age of 45 years(range,37-72 years).The indications for the procedure included 15cases with posttraumatic arthritis,6 cases with rheumatoid arthritis,and 3 cases with degenerative arthritis.AOFAS system and visual analogue scale(VAS)were used to evaluate the change of function and arthralgia.Graves score system was used to evaluate the influence of adjacent joints.Results All patients were followed up 10-120 months,with the mean of 48 months.Only one case suffered skin brim necrosis of incision and got delayed healing after 3 weeks.The average AOFAS ankle-hind foot score improved from 45.2 points preoperatively to 84.5 points postoperatively.The excellent and good rate was 87.5%.VAS pain scores decreased from 8.1 to 2.4 postoperatively.Twenty-three patients were satisfied and one dissatisfied with the results.Postoperative radiology showed the union evidence in 23 patients at 6 months postoperatively(successful fusion rate of 95.8%).One joint nonunion occurred and required revision arthrodesis with iliac crest bone graft.There was an increase of Ⅰ grade in arthritic scores for 8 cases and Ⅱ grade for 1 case.Conclusion Talonavicular arthrodesis with trephine percutaneous osteotomy has the advantages of low trauma,high successful fusion rate and can acquire satisfactory clinical effect in the treatment of painful malalignment of talonavicular joints.

Objective:To investigate the clinical efficacy of robot-assisted screw fixation for unstable pelvic ring multifocal fractures.Methods:A retrospective analysis was performed on 76 patients with unstable pelvic fractures treated with orthopaedic robot-assisted screw fixation in the Trauma Center of the Affiliated Central Hospital of Shandong First Medical University from January 2015 to June 2022, including 43 males and 33 females, aged 52.53±13.68 years (range, 16-87 years). There were 43 cases of falling injuries from high places, 22 cases of traffic accidents, 11 cases of crushing injuries and heavy objects. Fifty-five patients were employed before the injury, while 21 were not. Fractures were classified according to the Tile classification, with 72 cases classified as type B and 4 cases as type C. Robot-assisted fixation techniques included internal fixator (INFIX), anterior ring screws, sacroiliac screws, and LC-II screws. Intraoperative blood loss, fluoroscopy frequency, surgical time, and the success rate of initial guidewire placement were recorded. Fracture reduction quality was evaluated using the Matta criteria, and postoperative pelvic function recovery was assessed using the Majeed criteria.Results:A total of 150 surgical procedures were performed on 76 patients, including 34 cases of INFIX fixation, 48 cases of anterior ring screws, 61 cases of sacroiliac joint screws, and 7 cases of LC-II screws. The mean intraoperative fluoroscopy frequency was 46.63±17.50 times (range, 15-93 times). Intraoperative fluoroscopy frequency varied among different fixation techniques, with INFIX group at 16.44±4.32 times, LC-II group at 21.59±5.80 times, anterior ring screws group at 29.44±11.65 times, and sacroiliac screws group at 23.10±11.87 times. The intraoperative blood loss was 20 (10, 47.5) ml (range, 5-300 ml), and the surgical time was 105 (86, 150) min (range, 30-290 min). The mean surgical time varied among different fixation techniques. All patients were followed up for an average of 6.46±2.26 months (range, 3-16 months). Clinical healing was achieved in all patients within 6 months, with an average time of 3.14±0.50 months. At the last follow-up, fracture reduction quality assessed by the Matta score was excellent in 21 cases and good in 43 cases, with an excellent/good rate of 84% (64/76). The Majeed score was 81.82±9.14 points (range, 50-92 points). For patients who were employed before the injury, the Majeed score was 86.55±4.85 points (range, 60-92 points), with 49 cases rated as excellent, 5 cases as good, and 1 case as fair. For patients who were not employed before the injury, the Majeed score was 69.43±5.34 points (range, 50-73 points), with 18 cases rated as excellent, 2 cases as good, and 1 case as fair. The overall excellent and good rate was 97% (74/76). Among patients who underwent INFIX internal fixation, 8 cases experienced lateral femoral cutaneous nerve injury postoperatively, all of which recovered sensation after 3 months; 1 case using LC-II screws experienced screw loosening postoperatively and was advised to reduce activity, then the screw was removed after fracture healing at 6 months postoperatively; 1 case using anterior ring channel screws experienced surgical site infection postoperatively, which was controlled after debridement.Conclusion:In the treatment of unstable pelvic ring multiple fractures, robot-assisted screw fixation has less blood loss, less fluoroscopy times, high success rate of planning guide needle, satisfactory reduction quality and postoperative function.

Objective To investigate the fluctuations in the population density of Aedes albopictus and changes in the population density of Ae. albopictus in different geographical areas and different breeding habitats in Guangdong Province from 2018 to 2023, so as to provide insights into prevention and control of mosquito-borne infectious diseases in the province. Methods Ae. albopictus surveillance sites were assigned in 1 609 townships (streets) from 121 districts (counties) of 21 cities in Guangdong Province during the period between March and November from 2018 to 2023. The surveillance of the population density of Ae. albopictus was performed once a month in each surveillance site, and once a month in specific settings in cities where dengue were highly prevalent in Guangdong Province from December to February of the next year during the period from 2018 through 2023. Four streets (villages) were selected in each surveillance site according to the geographic orientation, and mosquito ovitraps were assigned in gardens, rooftops or public green belts at residential areas, parks, hospitals and construction sites. All mosquito ovitraps were collected, and the mosquito ovitrap index (MOI) was calculated. The population density of Ae. albopictus was classified into four grades in each surveillance site according to MOI, including no risk, low risk, medium risk and high risk. The risk classification of the Ae. albopictus density was analyzed in each surveillance site each year from 2018 to 2023, and the population density of Ae. albopictus was analyzed at different months and in different geographical areas and breeding habitats. Results A total of 118 241 Ae. albopictus surveillance sites were assigned in 21 cities of Guangdong Province from 2018 to 2023, and there were 68.26% of the surveillance sites with the population density of Ae. albopictus that met the requirements for dengue prevention and control, among which low, medium and high risk surveillance sites accounted for 23.61%, 6.67% and 1.47%. The risk classification of the Ae. albopictus density increased rapidly in Guangdong Province since April to May each year from 2018 to 2023, and then gradually reduced since September to October, with the peak during the period between May and July. The mean MOI was 4.21 at each surveillance site in Guangdong Province during the period from 2018 to 2023, with 4.69, 4.80, 4.38, 3.82, 3.38, and 4.33 from 2018 to 2023, respectively. The MOI was 4.35, 4.43, 3.53 and 3.58 in the Pearl River Delta region, and eastern, western, and northern Guangdong Province, respectively, and was 4.18, 5.44, 4.75, 3.24, 4.27 and 3.70 in residential areas, parks, construction sites, hospitals, waste collection stations, and other breeding habitats, respectively. Conclusions The population density of adult Ae. albopictus peaked in Guangdong Province during the period between May and July from 2018 to 2023, with a high density of Ae. albopictus in the Pearl River Delta region and eastern Guangdong Province. Targeted Ae. albopictus control measures are recommended to be implemented prior to the peak of the Ae. albopictus population density to reduce the development of mosquito-borne infectious diseases.