Objective To compare the effectiveness of expandable intramedullary nail(EIMN) versus locked compression plate (LCP) in the treatment of humeral shaft fractures of AO types A and B.Methods The clinical data were retrospectively analyzed and compared of the 44 humeral shaft fractures which had been treated between May 2012 and February 2016.There were 26 men and 18 women,from 23 to 66 years of age (average,41.5 years).By AO classification,22 cases were type 12-A and 22 type 12-B.EINM was used in 22 patients with an average age of 41.3 ± 1 1.7 years and LCP in 22 ones with an average age of 41.6 ± 10.3 years.The 2 groups were compared in terms of intraoperative blood loss,operative time,hospital stay,union time,union rate,Constant and Mayo scores at the final follow-ups,and complications as well.Results The 2 groups were compatible without significant differences in the preoperative demographic data (P ＞ 0.05).All the 44 patients were followed up for 10 to 18 months (average,12 months).The intraoperative blood loss (76.4 ± 18.66 mL),operative time (69.1 ± 13.2 min),incision length (5.8 ± 1.5 cm) and union time (13.2 ± 8.4 w) in the EIMN group were significantly better than those in the LCP group (138.6 ± 39.4 mL,96.4 ± 14.2 min,8.5 ± 1.4 cm and 18.4 ± 6.6 w,respectively) (P ＜ 0.05).There was also a significant difference between the 2 groups in the total complication rate[18.2％ (4/22) versus 50.0％ (11/22)] (P ＜0.05).No deep infection or should pain was observed in either group.Conclusions Inthe treatment of humeral shaft fractures of AO types 42-A and 42-B,compared with LCP,EIMN may have advantages of less intraoperative blood loss,operative time,union time and complications.The 2 methods are similar in hospital stay and final functional recovery of the should joint.

Objective:To investigate the effects of anemoside B4 on apoptosis of retinal cells in diabetic rats.Methods:Sixty Sprague-Dawley rats were randomized into three groups: the normal control(control), diabetic rats(DM)and diabetic rats treated with Anemoside B4(B4)groups(n=20, each group). Rats in the DM and B4 groups were rendered diabetic with an intraperitoneal injection of streptozotocin(STZ, 60 mg/kg). After 3 days of successful modeling, rats in the B4 group were intraperitoneally injected with anemoside B4(5 mg/kg), twice/day, for 8 weeks, while rats in the control and DM groups were injected with an equivalent volume of normal saline.After 8 weeks of anemoside B4 and normal saline injection, rats were sacrificed and retinas were harvested for examination.Paraffin sections of retina were stained with the hematoxylin-eosin(H-E)method for morphological evaluation.Protein levels of Bax and Bcl-2 were detected by using Western blot.The expression of caspase-3 mRNA was detected with quantitative PCR.Results:H-E staining results showed the control group had intact retinal structure and clear morphological features, whereas disordered retinal structure, thinner layers, and sparse and disorganized cells were seen in the DM group.However, retinal structure and morphology were improved after treatment with anemoside B4.Compared with the control group, the protein expression of Bcl-2 was lower( t=57.81, P<0.01), the protein expression of Bax was higher( t=10.47, P<0.01), and the Bcl-2/Bax ratio was lower( t=23.98, P<0.01)in the DM group.Compared with the DM group, the protein expression of Bcl-2 was higher( t=41.07, P<0.01), the protein expression of Bax was lower( t=6.811, P<0.01), and the Bcl-2/Bax ratio was higher( t=14.70, P<0.01)in the B4 group.Caspase-3 mRNA expression was higher in the DM group than in the control group( t=7.916, P<0.01), but was lower in the B4 group compared with the DM group( t=6.221, P<0.01). Conclusions:Anemoside B4 can inhibit the apoptosis of retinal cells by up-regulating Bcl-2 expression and down-regulating Bax and caspase-3 expression in diabetic rats.

Objective:To study the serological and molecular biological characteristics and differences of occult hepatitis B infection (OBI) between blood donors and chronic hepatitis B (CHB) patients.Methods:Nineteen OBI samples from blood donors and Nineteen OBI samples from CHB patients were collected, and named as group A and group B, respectively. Chemiluminescence method was used for hepatitis B five items detection. Real-time PCR method was used for HBV DNA quantification, and S gene was amplified by nested PCR and sequenced by DNA sequencing.Results:The level of HBV DNA in group A was significantly lower than that in group B ( P<0.05), and there were no significant differences in the serological result between the two groups. The mutation rate in the " a" determinant of S gene in group B was significantly higher than that in group A ( P<0.05). Conclusions:Compared with CHB patients, OBI blood donors have lower levels of viral replication and less chance of S gene mutation, and the use of highly sensitive nucleic acid detection reagents and method during blood screening can maximize the safety of blood transfusion.

Objective To investigate the effect of long non-coding RNA F19 (lncRNA F19) on secondary brain injury following traumatic brain injury (TBI) in mice. Methods (1) A total of 96 C57BL/6J male wild-type mice were divided into sham group, sham+control lentivirus group, sham+F19 lentivirus group, TBI group, TBI+control lentivirus group and TBI+F19 lentivirus group according to the random number table. Each group consisted of two subgroups of 1 day and 3 days after TBI, with eight mice per subgroup. The expression and silence efficiency of lncRNA F19 were detected. ( 2 ) A total of 96 C57BL/6J male wild-type mice were divided into sham group, TBI+control lentivirus group and TBI + F19 lentivirus group according to the random number table. Each group consisted of two subgroups of 1 day and 3 days after TBI, with 16 mice per subgroup. The effect of lncRNA F19 on neuronal apoptosis after TBI was recorded. The mice TBI model was established using the controlled cortical damage method (CCI). The lncRNA F19 lentivirus or control lentivirus were administrated by intracerebroventricular injection 5 days before injury. The expressions of lncRNA F19 ( 2 -ΔΔct ) were detected by real-time quantitative PCR ( qRT-PCR ) at 1 day and 3 days after injury. The Toll-like receptor 4 (TLR4), B lymphocyte tumor-2 (Bcl-2) and Bcl-2 related protein (Bax) expressions were detected by Western blot. The TUNEL was used to detect apoptosis around the traumatic lesions. Results From the first day after injury, both in the sham operation and TBI groups, the control lentivirus had no effect on the level of lncRAN F19 (P >0. 05). One day after injury, compared with sham +control lentivirus group, the levels of lncRNA F19 in sham + F19 lentivirus group were significantly decreased (0. 07 ± 0. 07:0. 93 ± 0. 17);compared with TBI+control lentivirus group, levels of lncRNA F19 in TBI+F19 lentivirus group were significantly decreased (2. 91 ± 1. 18:0. 52 ± 0. 32) (P<0. 05). There were significantly lower protein levels of TLR4 (0. 51 ± 0. 13:0. 66 ± 0. 15), Bax (0. 45 ± 0. 06:0. 67 ± 0. 16), lower TUNEL-positive neurons ratio [(23. 55 ± 6. 85)％ : (31. 58 ± 7. 52)％], but higher protein levels of Bcl-2 (0. 76 ± 0. 16:0. 47 ± 0. 12) in TBI+F19 lentivirus group compared with the TBI+ control lentivirus group (P <0.05). Three days after injury, compared with sham + control lentivirus group, levels of lncRNA F19 in sham+F19 lentivirus group were significantly decreased (0. 11 ± 0. 09:0. 96 ± 0. 09); compared with TBI+control lentivirus group, levels of lncRNA F19 in TBI+F19 lentivirus group were significantly decreased (0. 54 ± 0. 24:3. 39 ± 0. 90) (P <0. 05). There were significantly lower protein levels of TLR4 (0. 60 ± 0. 20):(0. 85 ± 0. 09)], lower Bax (0. 60 ± 0. 12:0. 88 ±0. 21), lower TUNEL-positive neurons ratio [(29. 10 ± 7. 37)％ :(39. 22 ± 10. 64)％], but higher protein levels of Bcl-2 (0. 66 ± 0. 12:0. 35 ± 0. 16) in TBI+F19 lentivirus group compared with the TBI+control lentivirus group (P<0. 05). Conclusion Inhibition of lncRNA F19 can significantly reduce the TLR4-induced neuronal apoptosis in cortex after TBI in mice and alleviate reduce the secondary brain injury.

Objective:To understand the epidemiological characteristics of public health emergency events (PHEE) of varicella in China from 2006 to 2021 and related response performances.Methods:The data of varicella PHEE in 31 provinces of China from 2006 to 2021 were collected through the Public Health Emergency Management Information System, Microsoft Excel 2019 software and SPSS 26.0 statistical software were used to conduct descriptive epidemiological, statistical analysis on the time, area, location distribution, scale and epidemic management.Results:A total of 11 443 PHEE involving 341 048 related cases were reported from 2006 to 2021, with an annual attack rate of 1.78%-3.80% and a total attack rate of 2.33% (341 048/14 624 042). The number of PHEE and related cases of varicella decreased from 1 107 (35 349) in 2007 to 262 (6 884) in 2012 ( Z=-2.40, P<0.001), then increased year by year to 1 318 (42 649) in 2019 ( Z=2.58, P<0.001), with a significant decline since 2020. The varicella PHEE in China presents the seasonal characteristics,the peak is from April to June and from October to December, respectively. The sub-peak of varicella PHEE in eastern China generally appears 1-2 months earlier than in central and western China. Varicella PHEE reports are mainly distributed in eastern China, the attack rate is relatively high in western China, school-reported varicella PHEE was 88.26% of the total reports (10 099/11 443). The epidemic scale of varrcella PHEE typically range from 10 to 29 cases per year among the given outbreaks. The M ( Q1, Q3) of average number of cases, average duration, and average reporting interval of PHEE were 23 (16,35), 20 (14, 26) days, and 9 (5,19) days, respectively, and the reporting interval was positively correlated with the duration ( r=0.854, P<0.001). Conclusions:The varicella PHEE in China from 2006 to 2021 has not been effectively controlled. Schools are the key places to prevent and control varicella PHEE. Improving the sensitivity of varicella PHEE monitoring, strengthening the timely disposal of varicella epidemic, and promoting varicella vaccination are effective measures to prevent and control varicella PHEE.

Objective:To evaluate the early assessment of hepatocardiac integration based on ultrasonic elasticity and blood flow vector imaging (VFM) technology, in conjunction with unsupervised cluster analysis and supervised machine learning methods.Methods:An observational research design without any intervention was adopted from December 2021 to September 2022, 45 patients with liver cirrhosis, 43 patients with liver fibrosis, and 42 healthy volunteers were selected from the First Affiliated Hospital of Harbin Medical University. Liver combined elasticity technology and VFM technology were used to obtain information on the liver and heart of the subjects, respectively. The acquired data were standardized, and then clustered using topological data analysis (TDA) technology on the processed data. Subsequently, the clustering results were evaluated based on statistical analysis, and finally, supervised multi-classification tasks were realized through machine learning methods.Results:Patients were stratified into five distinct groups based on a network of patient similarities. The average characteristics of each group were as follows: Group 1 exhibited the most severe hepatocardiac conditions relative to the other groups. Groups 2 and 3 displayed moderately severe conditions.In contrast, Group 4 comprised entirely of healthy controls, all of whom presented with normal hepatocardiac function. Group 5 presented a unique case among the categories.Participants in this group showed poor liver conditions. However, according to the guidelines for cardiac diastolic function assessment, their heart function was generally unremarkable, with only a minority of indicators deviating significantly. Support Vector Machine (SVM), Random Forest Tree (RFT), and Multilayer Perceptron (MLP) were employed for multi-classification tasks on the test dataset. The average accuracies achieved by these models were 70%, 81%, and 84%, respectively.Conclusions:By combining liver combined ultrasonic elasticity, cardiac VFM technology and TDA technology to construct a patient similarity network, we successfully identified patients with liver fibrosis who did not show abnormalities in conventional cardiac indicators but may have potential abnormal cardiac function, which has important implications for guiding the selection of clinical intervention measures, and optimizing patient management stratification.

Objective:To develop and evaluate a medical experience assessment scale for debridement and dressing change in chronic wound patients in China, and to provide a reference for improving hospital service quality.Methods:Based on the framework of hospital consumer assessment of healthcare providers and systems survey (HCAHPS) in the United States, a preliminary draft of the scale was formed through a literature review and qualitative interviews with 12 chronic wound patients (7 males and 5 females aged 58.1±12.3 years). Five experts were invited for content validity testing, and 191 chronic wound patients (111 males and 80 females aged 53.5±19.1 years) were selected to evaluate the internal consistency reliability, half reliability, retest reliability, and structural validity of the scale.Results:The Chronic Wound Patient Debridement and Dressing Experience Scale covered 5 dimensions with 30 sub-items and 2 comprehensive evaluation items, including demand response, good and friendly communication, professional trust, optimization of the medical treatment process, and encouragement of patient participation. The scale Cronbach′s α coefficient was 0.967 and ranged from 0.890 to 0.962 for each dimension. The overall retest reliability of the scale was 0.940 and ranged from 0.895 to 0.940 for each dimension. The overall half reliability of the scale was 0.923 and ranged from 0.834 to 0.935 for each dimension. 5 factors were extracted, with a cumulative variance contribution rate of 82.061%.Conclusions:Based on the HCAHPS framework in the United States, the Chronic Wound Debridement and Dressing Experience Scale developed has high reliability and validity, and can be used to evaluate the dressing change experience of patients with chronic wounds. It has clinical practice significance for dressing change in chronic wounds.

Objective:To explore the impact of occupational stress and shift work on the mental health of railway workers and provide a scientific basis for occupational health protection.Methods:In April 2019, stratified cluster sampling method was used to select 613 railway workers from Fuzhou railway as subjects. Job Content Questionnaire (JCQ) , Symptom Checklist-90 (SCL-90) , Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to investigate railway workers' occupational stress and mental health conditions. The influencing factors of railway workers' mental health were analyzed.Results:The detection rates of mental health problems, anxiety and depression of railway workers were 40.5% (248/613) , 4.4% (27/613) and 9.0% (55/613) , respectively. There were 250 railway workers with occupational stress (40.78%) . There were statistically significant differences in the total scores of SCL-90 among different groups of working age and education background ( P<0.05) . And there were statistically significant differences in the SAS total scores among different groups of education background ( P<0.05) . The detection rates of mental health problems and anxiety in the night shift group were higher than that in the white shift group, and the differences were statistically significant ( P<0.05) . The detection rate of mental health problems in the group with occupational stress was higher than that in the group without occupational stress, and the difference was statistically significant ( P<0.05) . Logistic regression analysis found that night shift work was the main risk factor affecting railway workers' anxiety ( OR=2.38, 95 %CI: 1.04-5.46, P<0.05) . The results of interaction analysis showed that compared with the non-occupational stress+white shift group, the workers in the night shift+occupational stress group had the higher risk of mental health problems and anxiety ( OR=3.14, 95 %CI: 1.84-5.38; OR=4.29, 95 %CI: 1.36-13.54; P<0.05) . Conclusion:Night shift and occupational stress are the risk factors for the mental health of railway workers, and the interaction between night shift and occupational stress is the most harmful to the mental health of railway workers.

Objective To analyze the epidemiological characteristics of syphilis in Yangzhou City from 2013 to 2023,to understand the syphilis epidemic trends,and provide a scientific basis for formulating prevention and control strategies.Methods Syphilis case reports in Yangzhou City from 2013 to 2023 were collected through the infectious disease surveillance module of the Chinese Center for Disease Control and Prevention Information System.The annual average reported incidence rate and annual average growth rate were calculated.Descriptive epidemiological methods were employed to analyze the overview of syphilis and its temporal,geographical and demographic distribution char-acteristics.Linear trend chi-square tests were conducted to analyze the syphilis epidemic trends.Results A total of 19,457 syphilis cases were reported in Yangzhou City from 2013 to 2023,with an annual average reported incidence rate of 39.17/100,000.The overall incidence of syphilis showed an upward trend,with the reported incidence rate increasing from 37.26/100,000 in 2013 to 43.27/100,000 in 2023(x2=50.528,P＜0.001),representing an annual average growth rate of 1.51％.The majority of reported cases were latent syphilis,accounting for 64.99％(12,646/19,457).The number of reported cases of primary,secondary and congenital syphilis revealed an overall de-creased trend,while the number of reported cases of tertiary and latent syphilis increased trend.There was no significant seasonality or periodicity in the reported incidence rate of syphilis in Yangzhou City from 2013 to 2023.The top three districts with the highest annual average reported incidence rates were the Development District,Guangling District and Hanjiang District,with incidence rates of 50.93/100,000,50.89/100,000 and 43.18/100,000,respectively.There were 10,290 male syphilis cases(52.89％)and 9,167 female syphilis cases(47.11％).The top three occupations were farmers(8,682 cases),homemakers and unemployed individuals(5,379 cases)and retired personnel(2,559 cases),accounting for 85.42％(16,620/19,457)of the reported cases.Conclusion The incidence of syphilis in Yangzhou City generally shows an upward trend,and the disease epidemic spectrum changes annually,with latent syphilis currently being the primary form.The prevention and control situation is severe.Therefore,syphilis prevention and control efforts should be further strengthened to block its transmission and prevalence.

Objective:To screen T-cell exhaustion-related signature genes as the prognostic marker for osteosarcoma and establish a prognostic model for osteosarcoma patients based on weighted gene co-expression network analysis(WGCNA)and Least absolute shrinkage and selection operator(LASSO)-COX regression analysis. Methods:GSE21257 dataset was downloaded from Gene Expression Omnibus(GEO)database for the establishment of the prognostic model for osteosarcoma.4 T-cell exhaustion-related gene sets were downloaded from The Molecular Signatures Database(MisgDB)and their enrichment scores in GSE21257 samples were calculated by single sample gene set enrichment analysis(ssGSEA).WGCNA was carried out to screen the gene module that is highly associated with T-cell exhaustion based on ssGSEA results followed by GO(Gene Ontology)and KEGG(Kyoto Encyclopedia of Genes and Genomes)analysis of the biological processes and signaling transduction pathways that those genes are involved in.The signature genes that are highly associated with the prognosis of osteosarcoma patients were obtained through LASSO-COX regression and a prognostic model was established based on these signature genes.Osteosarcoma-related expression profile data from the GSE21257 and TAEGET datasets on XENA were downloaded from the Gene Expression Omnibus.Clinical information for the training and validation sets was obtained.T-cell exhaustion-related genes were screened using a weighted correlation network analysis.Realtime fluorescence quantitative PCR,COX regression analysis,external dataset and nomogram were used to evaluate the reliability and accuracy of the prognostic model.A immunotherapy-related dataset was used to assess the efficacy of this prognostic model for the prediction of patients'responses to immunotherapy. Results:Analysis results based on the ssGSEA scores showed that T-cell exhaustion-related genes were related to the metastasis and age of osteosarcoma patients.Many T-cell exhaustion-related genes were found to be differentially expressed in metastatic and non-metastatic osteosarcoma patients.1 256 T-cell exhaustion-related genes were identified through WGCNA and these candidate markers were mainly distributed in structures like secretory granule membranes and endocytic vesicles and were involved in T-cell activation.COX regression analysis screened 68 significant prognostic markers out of the 1 256 genes,and 12 signature genes were further confirmed with LASSO-COX regression analysis.A prognostic model was established based on the 12 signature genes.Results of real-time fluorescence quantitative PCR showed a similar trend in the expression of most of the signature genes in different osteosarcoma cell lines.COX regression analysis of the internal and external datasets verified that the risk score calculated with the prognostic model was an independent prognostic factor for osteosarcoma patients,and high-risk score was associated with poor prognosis of the patients.Receiver operating characteristic(ROC)curves demonstrated excellent prognostic efficacy of the model.Nomogram analysis verified the prognostic model is highly accurate and reliable in predicting the prognosis of osteosarcoma patients.Analysis using the immunotherapy-related dataset indicated that this prognostic model could also be used to predict patients'responses to immunotherapy. Conclusion:The 12 signature gene(CD300LB,TRO,SNX3,VENTX,PPM1M,DOT1L,CDC37,NAT9,TRMT1,PPP1R3C,CHTF18 and NSUN5)-based prognostic model can effectively predict the prognosis and responses to immune check-point inhibitors for osteosarcoma patients,which may provide evidence for the prediction of prognosis as well as the selection of immunotherapy plans in clinical practice.