Objective To evaluate the value of computed tomography(CT) and magnetic resonance imaging(MRI) in diagnosis of avascular necrosis of the femoral head(ANFH). Methods The literatures of ANFH diagnosed with CT and MR imaging published in the last ten years were collected by searching. Of that,21 literatures were correspond for the standards in this study and were select-ed. These literatures in diagnosing ANFH with CT and MR imaging were analysed with Meta-analysis by the sofeware of StataSE10.1. Results MRI was more effective than CT in diagnosing ANFH. There was significantly different in statistics between them [OR=0.13,95%CI(0.03～0.51)]. Conclusion In comparison with CT,MRI is the better method in diagnosing ANFH.

Objective To evaluate the diagnostic value of ultrasonography and MRI in the diagnosis of placenta accrete.Methods First,the relevant literatures about placenta accrete were retrieved at home and abroad,then the data were extracted and Meta-analysis was performed.The combined sensitivity and specificity of ultrasound and MRI and AUC were obtained.Results The combined sensitivity of ultrasonography was 0.80,specificity was 0.88,AUC was 0.88;combined sensitivity of MRI was 0.86,specificity was 0.90,AUC was 0.93.Conclusion Ultrasound and MRI are very valuable in the diagnosis of placenta accrete.However,MRI is a useful complement of ultrasound,and the diagnostic value is slightly better than that of ultrasound.The diagnostic value will be higher when they combined together.

Objective:To compare the clinical outcomes between OTA/AO-C open and closed fractures of the distal humerus treated by open reduction and internal fixation.Methods:The clinical data were retrospectively analyzed of the 70 patients who had been treated at Department of Traumatology and Orthopedics, Beijing Jishuitan Hospital for OTA/AO-C fractures of the distal humerus from January 2014 to June 2017. Of them, 22 suffered from open fractures (Gustilo types Ⅰ/Ⅱ) and 48 closed fractures. There were 18 males and 4 females with an age of (42.6±13.0) years in the open group and 21 males and 27 females with an age of (42.2±17.1) years in the closed group. Analyzed were interval from injury to surgery, hospitalization time, injury energy and functional outcomes which included range of motion (ROM) in elbow flexion and extension, ROM in elbow rotation, Mayo elbow performance score (MEPS), Disabilities of the Arm, Shoulder and Hand (DASH), complications and rate of secondary surgery.Results:There was no significant difference between the 2 groups in age, injury energy or interval from injury to surgery ( P>0.05), but there were significantly more males in the open group than in the closed group ( P=0.011). The follow-up time for all the patients averaged 34.0 months (from 25 to 54 months). There were no statistically significant differences between the 2 groups in hospitalization time [9.5(6.0, 13.0) d versus 8.5 (6.0, 11.0) d], ROM in flexion and extension [120.0° (100.0°, 137.8°) versus 128.5° (110.0°, 140.0°)], ROM in rotation [155.0° (151.3°, 155.0°) versus 155.0° (155.0°, 155.0°)], MEPS [95.0 (80.0, 100.0) versus 95.0 (80.0, 100.0)] or DASH [2.6 (0.63, 9.2) versus 1.7 (0.0, 8.5)] ( P>0.05). There were no statistically significant differences between the 2 groups either in rate of secondary surgery [36.4% (8/22) versus 33.3% (16/48)], ulnar nerve symptoms [54.5% (12/22) versus 60.4% (29/48)], local irritability in the region of internal fixation [9.1% (2/22) versus 6.3% (3/48)] or elbow stiffness [13.6% (3/22) versus 10.4% (5/48)] ( P>0.05). Conclusion:Open reduction and internal fixation can lead to similar clinical outcomes in the treatment of both open (Gustilo types Ⅰ/Ⅱ) and closed distal humeral fractures of OTA/AO-C, with no significant differences in postoperative ROM, functional scores or complications.

OBJECTIVE:To investigate the development of related TCM evidence-based researches in China.METHODS:The literatures titled"Meta-analysis"and those with Chinese Library Classification Number of"R2(Chinese Medicine)"were searched from CJFD by computer. The retrieval time limit ranged from database establishment to Dec. 2017. Bibliometrics analysis was performed in respects of year of publication,source journals,publishers,authors,co-authors,funding and research content. RESULTS:A total of 1 540 papers from 321 journals were included,and the first paper was published in 1997;the first author came from 494 institutions which mainly distributed within the mainland institations of China. Guangzhou University of TCM had the largest number of publications. According to Price's law,there were 25 core authors who published 157 literature in total;the co-authoring rate was 95.1% and the collaborating degree was 4.00. 32.3% of the papers were obtained by the fund support, involving 236 literatured founded by National Science Foundation of China. There were 5 types of papers,including 1 512 applied research papers,14 quality evaluation papers,6 methodological studies;there were 17 categories of diseases involved in applied research. CONCLUSIONS:Meta-analysis of TCM research in China has developed rapidly,but related theoretical research is relatively lack. It is necessary to further strengthen the methodology research so as to promote the development of evidence-based research of TCM.

bjective? To explore the effects of animation demonstration combined with health education on the knowledge-attitude-practice and psychological status of parents of neonates with hyperbilirubinemia. Methods? Totally 136 neonates with hyperbilirubinemia and their parents admitted from February 2017 to February 2018 in Affiliated Hospital of Ji'ning Medical University were selected for the study and were divided into the observation group and control group according to the random number table method, with 68 cases in each group. The control group was given routine health education, and observation group was given animation demonstration combined with health education. The parents knowledge-attitude-practice level of jaundice prevention and treatment,compliance degree, Self-rating Anxiety Scale(SAS) score were compared between the two groups. Results? After intervention,the parents knowledge-attitude-practice level of jaundice prevention and treatment significantly increased in the two groups,and the observation group increased more than the control group with statistical difference (P＜ 0.05). After intervention, the parents compliance level in the observation group was higher than the control group with statistical difference (P＜ 0.05); SAS score of the observation group declined more than the control group with statistical difference (P＜ 0.05). Conclusions? Animation demonstration combined with health education can effectively improve the knowledge-attitude-practice level and execution compliance of parents of neonates with jaundice,and improve the psychological status of the parents.

OBJECTIVETo explore the influences of di-(2-ethylhexyl)phthalate (DEHP) and its principle metabolite mono(2-ethylhexyl)phthalate (MEHP) on spermatogenic cell apoptosis in young male Wistar rats.

METHODSNinety-eight 2-week-old male Wistar rats were randomly divided into 14 equal groups to receive daily intragastric administration of 0.2 ml/kg normal saline for 3 weeks (normal control), 100 mg/kg cyclophosphamide (CTX) for 1 week (positive control), 100, 200, and 300 mg/kg DEHP or MEHP for 1 week, or 100 mg/kg DEHP or MEHP for 1, 2, and 3 weeks. After the treatments, the pathological changes of the testicular tissues were examined, spermatogenic cell apoptosis was detected, and serum sex hormones levels were measured using TUNEL assay or radioimmunoassays.

RESULTSCTX, DEHP, and MEHP all caused shrinkage, development retardation and quantitative reduction of spermatogenic cells with and mitochondrial swelling vacuolar changes. The damage of spermatogenic cells increased significantly with the increment of DEHP and MEHP doses and exposure time. Both DEHP and MEHP treatments resulted in significantly increased cell apoptosis index (AI) in close correlation with the exposure doses and duration (P<0.01). DEHP and MEHP treatments also significantly increased serum levels of follicle stimulating hormone and luteinizing hormone and decreased testosterone levels in a dose- and time-dependent manner (P<0.05).

CONCLUSIONDEHP and MEHP can induce obvious apoptosis of spermatogenic cells in young male rats with a dose- and time-dependent effect.

Animals ; Apoptosis ; drug effects ; Diethylhexyl Phthalate ; analogs & derivatives ; toxicity ; Dose-Response Relationship, Drug ; Environmental Exposure ; Male ; Rats ; Rats, Wistar ; Spermatozoa ; cytology ; drug effects

Objective: To investigate expert opinions on the recommendations in Expert Consensus on Optimized Treatments of Ankle Fracture in Light of Enhanced Recovery after Surgery and Expert Consensus on Optimized Treatments of Distal Radius Fracture in Light of Enhanced Recovery after Surgery so as to provide a reference for orthopaedic surgeons when they refer to the 2 documents. Methods: At the symposium in November 2018, all members of Orthopaedic Trauma Committee of Bethune Public Welfare Foundation were interviewed through questionnaires. The questionnaires involved 30 recommendations from the 2 documents concerning optimized perioperative managements. The rates of recommendation and strong recommendation by these experts were calculated about the 30 recommendations from the 2 above documents. Results: A total of 68 experts from the 89 members of Orthopaedic Trauma Committee of Bethune Public Welfare Foundation finished the questionnaires. Of the 30 recommendations, 26 obtained recommendation from these experts at a rate of above 95%, and 4 recommendation from these experts at a rate from 80% to 90%. The rates of strong recommendation were not high, ranging from 60% to 80% in 26 recommendations and <60% in 4. Conclusions The recommendations from the above 2 documents have been highly agreed upon by these experts we investigated but obtained a relatively low rate of strong recommendation. The present investigation may serve as a significant complement for recommendations from the 2 documents of expert consensus and a necessary reference for orthopaedic surgeons.

Objective: To compare the clinical outcomes between young and elderly patients with humeral intercondylar fracture treated by open reduction and internal fixation (ORIF) with either parallel or orthogonal double-plate. Methods: From January 2013 to December 2017, 54 patients with humeral intercondylar fracture were treated at Department of Orthopedic Trauma, Jishuitan Hospital by ORIF with anatomical locking compression plate (LCP) (either parallel or orthogonal double-plate configuration). According to their age, the patients were divided into a young group (from 18 to 30 years old) of 29 cases with an age of 25.5±3.6 years and an elderly group (≥60 years old) of 25 cases with an age of 67.1±5.8 years. The 2 groups were compared in terms of perioperative data, ranges of motion (flextion, extension and rotation), numeric rating scale for pain (NRS), Mayo Elbow Performance Score (MEPS) and quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) at the last follow-up, complications and secondary surgery. Results: The 2 groups were comparable because there were no significant differences in the preoperative general data except in injury energy, combined injury and gender between them (P>0.05). The young group had significantly more cases of high-energy injury and combined injuries than the elderly group(P<0.05). All patients were followed up for 33.6±15.0 months (from 12 to 63 months). The total blood loss in the elderly group (643.9±298.7 mL) was significantly less than that in the young group (953.9±554.6 mL) (P<0.05). At the last follow-up, there were no significant differences between the 2 groups in ranges of motion, NRS or MEPS (P>0.05), but the elderly group had significantly higher Quick-DASH scores (13.9±14.4 points) than the young group (5.7±8.9 points) (P<0.05). There was no significant difference in postoperative elbow stiffness or postoperative ulnar nerve symptoms betwee the 2 groups (P>0.05), but the rate of secondary surgery in the young group (37.9%, 11/29) was significantly higher than that in the elderly group (4.0%, 1/25) (P<0.05). Conclusions In the treatment of humeral intercondylar fractures, ORIF with LCP (either parallel or orthogonal double-plate configuration) can lead to similarly safe and effective clinical outcomes for both young and elderly patients.

Objective:To analyze the risk factors of medical adhesive-related skin injury (MARSI) in preterm infants to establish a nomogram model to predict the risk of MARSI.Methods:From July to September 2018, 268 premature infants who were hospitalized in NICU were enrolled in this study. Their clinical data were analyzed and univariate analysis was used to detemine the risk factors related to MARSI, The significant variables were included in the multivariate logistic regression analysis to analyze the independent risk factors for MARSI. Then the R software was used to establish a predictive nomogram model, Bootstrap method was used to validate the nomogram model and the consistency test of the correction curve was used to explore the predictive efficacy of the model in predicting the MARSI.Results:A total of 64 cases out of 268 premature infants had MARSI. The prevalence rate was 23.9 % (64/268). Birth age (28 to 32 weeks) ( P value was 0.021, OR value was 2.736, 95 % CI 1.163-6.435), edema ( P<0.01, OR value was 33.782, 95 % CI 10.510-108.583), maternal diabetes ( P value was 0.039, OR value was 16.011, 95 % CI 1.146-223.692), easy to tear tape ( P value was 0.027, OR value was 13.567, 95 % CI 1.340-137.311) were all independent risk factors for MARSI. The nomogram model showed a conformance-index of 87.29 %, while the consistency test of the correction curve showed that the prediction probability is consistent with the actual occurrence probability. Conclusions:The nomogram built based on the indexes of fetal age, skin state, maternal disease, mucous product has good discrimination and accuracy which could be helpful for screening the patients with high risk, with potentially high clinical application value.

Objective:To evaluate the effect of oropharyngeal colostrum administration on building adequate enteral feeding process of very low birth weight neonates and extremely low birth weight neonates.Methods:A total of 62 very/extremely low birth weight neonates in NICU were selected from a tertiary hospital in shandong province. They were randomly assigned to the observation group ( n=32) and the control group ( n=30) according to the random number table. The observation group was given oropharyngeal colostrum administration. The control group was given oral care with 0.9% sodium chloride solution, and the wiping method and frequency was the same as the observation group. Gastric retention, enteral feeding time, adequate enteral feeding time, the weight at the time of discharge, etc. were compared between two groups. Results:Gastric retention times on the 10th day in the observation group (1.90±1.30) was significantly lower than that in the control group (2.77±1.50), and the two groups were statistically significant ( t value was -2.449, P<0.05). The duration of 100 ml·kg -1·d -1 enteral feeding and adequate enteral feeding (150 ml·kg -1·d -1) in the observation group [(24.63±9.42) days, (29.75±10.15) days] were significantly shorter than those in the control group [(33.90±2.73) days, (35.13±9.29)days], and the two groups were statistically significant ( t value was-4.621, P<0.01; t value was -2.362, P<0.05). The weight of the observation group was higher than that in the control group at the time of discharge ( t value was 4.677, P<0.05). Conclusion:Oropharyngeal colostrum administration can reduce gastric retention times, shorten the adequate enteral feeding time, promote growth and development in very low birth weight neonate and extremely low birth weight neonate.But it had not been proved to reduce the incidence of related infection indicators.