[Objective]To discuss the clinical results and treatments of the Monteggia's fracture in children.[Method]Total of 66 patients including 61 fresh and 5 old fractures were reviewed.There were 47 males and 19 females.According to the Bado classification system: 46 of type Ⅰ,4 of type Ⅱ,15 of type Ⅲ,1 of type Ⅳ,all patients received conservative or operatire treatment.The conservatively treated patients received manipulation and plaster immobilization.In the operative group,the patients were fixed with single or/and double Kirschner's wires after reduction of the radiohumeral joints or/and fractured ulna.Neither reparation nor reconstruction was needed.[Result]All patients were available at the final follow up with 0.5～5 years.According to the Li Hanmin's scoring system for the motion function in children: excellent and good rate was 95.7% in conservative group and 84.2% in operative group.There was no complication such as myositis ossificans,synostosis of radius and ulna,ulna nonunion,radial head dislocation and profundus radial nerve injury.The cases of nerve injury were complete recovered after operation two or four months later.[Conclusion]The clinical results of the Monteggia's fracture in children was very good with immediate reduction and internal fixation in proper cases,a good overall therapeutic outcome can be expected in children with Monteggia's fracture.It is very important to prevent missed diagnosis.

Background and purpose: With characteristic but non-specific features, subsolid pulmonary nodules (SSPN) is closely associated with early lung cancer. This study aimed to estimate the imaging value of SSPN in stageⅠA lung cancer, and summarized the radiological features of various SSPNs, retrospectively. Methods:The clinical data and imaging data of 405 patients with solitary pulmonary nodules (SPNs) from Apr. 2008 to Apr. 2014 at Fudan University Shanghai Cancer Center were collected. According to ground-glass opacity (GGO) proportion, SPNs were divided into 3 groups:pure ground-glass opacity (pGGO), mixed ground-glass opacity (mGGO) and solid nodule (SN). The malignant ratios were calculated based on the postoperatively pathological results. Besides, SSPNs were classiifed into stageⅠA lung cancer group and benign lesions group aiming at identifying the differentiating computed tomography (CT) features. Results:Of the enrolled 405 SPN patients, there were 367 SSPNs (including 124 pGGOs and 243 mGGOs) whose incidence in stageⅠA lung cancer group was signiifcantly higher than those in benign group [95.9%(257/268) vs 80.3%(110/137), P<0.001]. The total malignant ratio of SSPN was 70.0%(257/367), mGGO had a higher malignant ratio (72.0%) than those of pGGO (66.1%) and SN (28.9%). The malignant SSPNs were frequently detected in upper lobe of middle-aged women with a higher incidence of irregular edge, spiculation, lobulation and pleural retraction than benign group (P<0.05). Conclusion:SSPN is one of the signiifcantly malignant indicators, and mGGO has the highest malignant tendency. Senility, female, irregular edge, spiculation, lobulation, pleural retraction and pulmonary upper lobe distribution are demonstrated the signiifcant discriminators from benign lesions.

Objective To develop a chemiluminescence imaging DNA microarray method for simultaneous,fast and accurate detection of nine rash-and fever-causing pathogens,namely,Measles virus,Rubella virus,Enterovirus type 71, Varicella zoster virus,Dengue fever virus,Human small FDNA virus B19,Coxsackie virus type A16,A-βStreptococcus pyogenes (hemolytic streptococcus)and Salmonella typhi.Methods Primers and probes were designed based on the specific sequence in the conserved region of genomes of the nine pathogens.The nucleic acids of the nine pathogens were amplified and labelled by multiplex PCR method.The multiplex PCR amplification products were hybridized with specific probes of microarray that was scanned after washing and chemiluminescence coloration to identify the nine pathogens.After the optimization of the multiplex PCR system,hybridization and chemiluminescence imaging,the specificity,sensitivity and reproducibility of the chip were evaluated.The serial diluted nucleic acid of Enterovirus type 71 was detected using microarray and real-time PCR approach to compare the sensitivity of these two methods.Results Nine specific primers and eleven specific probes were selected.The microarray demonstrated high sensitivity and specificity.The minimum detection limit of plasmid DNA and in vitro transcribed RNAs was 3 ×103 copies per reaction.The detection sensitivity of this microarray was 10 percent of that by the real-time PCR method.The rate of sensitivity and specificity of clinical sample detection was 95% and 85.7% respectively,and the rate of accuracy was 93.2%.Conclusion A chemiluminescence imaging DNA microarray method for simultaneous,fast and accurate detection of nine pathogens that cause rash and fever illnesses is established successfully,which can serve as a new high throuthput screening method for clinical diagnosis and epidemiological investigation of rash and fever illnesses.

Objective To evaluate the feasibility,safety and clinical value of CT-guided localization with a Hook-wire system for nodular pulmonary lesions before video-assisted thoracoscopic resection (VATS). Methods The records of all patients undergoing VATS resection for solitary pulmonary nodules preoperatively localized by CT-guided a Hook-wire system were assessed with respect to failure to localize the lesion by the Hook-wire system, conversion thoracotomy rate, duration of operation, postoperative complications, and histology of nodular pulmonary lesions. Results Sixty-eight patients with seventy four nodules underwent VATS resections. Preoperative CT-guided Hook-wire localization succeeded in all patients ( 100. 0% ). Conversion thoracotomy was necessary in 2 patients. The average operative time was ( 15 ±6)min. Asymptomatic complication rate was 70.6% (48/68), asymptomatic pneumothorax rate, asymptomatic hemorrhage rate and simultaneous pneumothorax and bleeding rate were 45.6% (31/68),25.0% ( 17/68 ) and 4. 4% ( 3/68 ), respectively. The mean hospitalization was ( 15 ± 6 ) days.Histological assessment revealed primary lung cancer (NSCLC) in 30, metastasis in 18, and nonmalignant disease in 26 nodules. Conclusions Video-assisted thoracoscopic resection of nodular pulmonary lesions previously localized by a CT-guided Hook-wire system is related to a low conversion thoracotomy rate, short operation time, and high safety. It for differential diagnosis and treatment.

Objective: To analyze the nutritional literacy and influencing factors among students from Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) in Chongqing, and to provide a scientific basis for improving the nutritional literacy of middle school students in the NIPRCES. Methods: Using cross sectional survey, a total of 3 365 students in the grade 7 and 8 were selected from the middle schools in 12 national pilot districts and 2 Chongqing pilot districts by online survey in September 2020. Students filled out a self designed nutritional literacy questionnaire anonymously. The relative evaluation method was used to convert the nutritional literacy of scores into a percentile, and the median score was used as the criterion for qualified nutritional literacy screening. Results: The median score of nutritional literacy of participants was 63.5, and 64.2% achieved the qualified level. The results of multivariate Logistic regression analysis showed that boarding school ( OR =1.28, 95% CI =1.08- 1.51 ) and no parents as the primary caregiver ( OR =1.22，95% CI =1.05-1.42) were associated with poor nutritional literacy. Urban residence ( OR =0.75, 95% CI =0.63-0.90), NIPRCES local pilot ( OR =0.83, 95% CI =0.71-0.97) and high paternal education ( OR =0.70, 95% CI =0.52-0.95) were associated with higher nutritional literacy ( P <0.01). Classroom was the main channel for students to obtain nutrition information at present (65.1%) and in the future (72.8%). Conclusion The nutritional literacy among students in the NIPRCES in Chongqing needs to be improved. Nutritional literacy level of students can be strengthened by nutritional education in boarding schools, rural areas, national pilot areas, and primary caregivers.

Objective To investigate the application value of choledochoscopy and imaging examination in the diagnosis and treatment of residual bile duct stones.Methods The retrospective descriptive study was conducted.The clinical data of 618 patients who underwent choledochoscopy and imaging examination after operation of hepatolithiasis in the First Affiliated Hospital of Zhengzhou University between April 2014 and September 2018 were collected,including 300 males and 318 females,aged from 19 to 89 years,with an average age of (58 ± 12)years.Observation indicators:(1) situations of residual bile duct stones diagnosed by choledochoscopy and imaging examination;(2) stone extraction situations of patients with hepatolithiasis.Measurement data with normal distribution were represented as Mean±SD,and measurement data with skewed distribution were described as M (range).Count data were represented as absolute number or percentage,and analyzed using the chi-square test or Fisher exact propability.Results (1) Situations of residual bile duct stones diagnosed by choledochoscopy and imaging examination:all the 618 patients underwent choledochoscopy,and 505 of them underwent the imaging examination before choledochoscopy.① Of patients undergoing single imaging examination,72 received ultrasonography,with false-negative rate of 29.17％ (21/72);37 received CT examination,with false-negative rate of 10.81％(4/37);33 received T-tube cholangiography,with false-negative rate of 39.39％ (13/33).② Of patients undergoing combined two imaging examinations,61 received ultrasonography + CT,with false-negative rate of 8.20％ (5/61);129 received ultrasonography + T-tube cholangiography,with false-negative rate of 12.40％ (16/129);52 received CT + T-tube cholangiography,with false-negative rate of 5.77％(3/52).③ There were 121 receiving ultrasound+CT+T-tube cholangiography,with false-negative rate of 7.44％ (9/121).There were statistically significant differences in the false-negative rates of combined two or three examinations of ultrasound + CT+ T-tube cholangiography and single imaging examination (x2=40.83,P＜0.05).The further analysis showed a statistically significant difference among the single imaging examination (x2=7.70,P＜0.05).There was no statistically significant difference among the combined two of imaging examinations (x2=2.10,P＞0.05).There were statistically significant differences in the combined three examinations of ultrasound +CT+T-tube cholangiography and ultrasound and T-tube cholangiography examination respectively (x2=16.23,21.62,P＜0.05).There was no statistically significant difference in the combined three of imaging examinations and CT examination and combination of CT+T-tube cholangiography respectively (P＞ 0.05).There was no statistically significant difference in the combined three of imaging examinations and combination of ultrasound+CT examinations and combination of ultrasound+T-tube cholangiography (x2=0.33,1.71,P＞0.05).Seventy-one patients without residual bile duct stone by preoperative imaging examination were detected residual bile duct stones by intraoperative choledochoscopy,and residual bile duct stones of 36,31 and 4 patients are respectively distributed around the distal common bile duct,small intrahepatic bile duct,left and right hepatic ducts,common hepatic duct and remaining common bile duct.(2) Stone extraction situations of patients with hepatolithiasis:of 618 patients,cases with 1,2,3,4,5,6,7,8,9 and 10 times of residual bile duct stones clearance were respectively 392,116,48,39,9,6,3,2,2 and 1.Residual bile duct stones clearance frequency of patients was an average of 1.73 times.There were 63.43％(392/618) and 96.28％(595/618) of patients had stone clearance with once and ≤ 4 times of stone extraction,respectively.Conclusion The negative results of preoperative imaging examinations cannot be as standards of bile duct stone clearance before choledochoscopy,and the best choice is to detect whether there are residual bile duct stones and remove the stones combined with choledochoscopy.

Background and purpose:As one of the most fatal malignant tumors in China, the morbidity and mortality of lung cancer remain high. Early diagnosis and normative treatment is the key to improve the prognosis of lung cancer. The aim of this study was to explore the practice of early lung cancer screening with low-dose spiral computed tomography (CT) based on the current situation in community health service, with integration of superior resources of med-ical institutions at all levels in Shanghai.Methods:From Aug. 2013 to Aug. 2014, we screened high-risk population in selected communities of Minhang District, Shanghai, for early diagnosis of lung cancer with low-dose spiral CT combined with multidisciplinary comprehensive treatment models including minimally invasive surgery, exploring the medical service network covering prevention, diagnosis, treatment, rehabilitation and follow-up.Results:Screening population is 11 332 (male 7 144, female 4 188); Twenty-nine cases with pathological diagnosis of malignant tumor, including 27 cases of pri-mary lung cancer, 1 case of lung metastasis, 1 case of breast cancer. The morbidity of primary lung cancer is 238.26×10-5. There were 22 cases of Stage 0-Ⅰ lung cancer accounting for 81.48% of all diagnosed primary lung cancer.Conclusion:Based on community health service, screening with low-dose spiral CT could improve the early diagnosis rate of lung can-cer with feasibility and validity, which could be applicable in qualified eligible medical center and community in China.

【Objective】 To investigate the expression of pyruvate kinase M2 (PKM2) in intrahepatic cholangiocarcinoma (ICC) and the effect of PKM2 on the proliferation and epithelial-to-mesenchymal transition (EMT) of ICC cells. 【Methods】 PKM2 expression was evaluated in ICC tissues and cell lines by Real-time quantitative reverse-transcription polymerase chain reaction (RT-PCR), and immunohistochemistry assays. In vitro, we knocked down PKM2 expression in ICC cell lines and investigated the biological function and the underlying mechanism of PKM2 in ICC. 【Results】 RT-PCR results showed that PKM2 was highly expressed in ICC (P<0.05). Moreover, PKM2 knockdown inhibited cell proliferation and the invasive capacities of ICC cells, and inhibited Wnt/ β-Catenin signaling, which subsequently regulated EMT signaling pathway in vitro. 【Conclusion】 PKM2 expression in cholangiocarcinoma is significantly higher than that in adjacent tissues. PKM2 can regulate EMT and invasion and metastasis of ICC via the Wnt/β-Catenin signal.