Objective: To analyze the prevalence and related factors of pediatric flexible flatfoot (PFF) among 7-8 year old children in Changzhou, so as to provide a feasible basis for the prevention and treatment of PFF. Methods: From December 2023 to February 2024, a total of 1 685 children aged 7-8 from 10 primary schools in Changzhou were selected by stratified cluster random sampling method, and screened for PFF by using a foot optical assessment recording device. Information including sex, body mass index (BMI), diet, exercise and shoe wearing habits were collected. The valgus angle of the hindfoot was measured on the body surface by using an orthopedic measuring ruler in the standing position. Pain levels were evaluated by using visual analogue score (VAS) for children with flatfoot syndrome. Multivariate Logistic analysis was used to analyze related factors of PFF. Results: The overall detection rate of PFF was 27.4%, and there was a significant difference in the detection rate of PFF between boys and girls, with 30.3% and 24.1% respectively ( χ 2=7.96, P < 0.01 ). Most cases of PFF were mild flatfoot (60.8%) and bilateral ( 60.4% ). Approximately 13.2% of children with PFF had flatfoot syndrome, with a mean VAS of (2.86±0.73). About 56.1% of children with PFF had a normal valgus angle of the hindfoot. Sex, high BMI and preference for shoe last with front upturned shoe shape were positively correlated with the detection of PFF ( OR= 1.74, 1.54, 1.13, P <0.05). After stratified by sex, regular exercise in boys and age in girls were negatively correlated with the detection of PFF ( OR=0.40, 0.64, P <0.05). Conclusions The detection rate of PFF in 7-8 year old children is high. Additionally, PFF combined with flatfoot syndrome or valgus hindfoot is relatively rare and is likely to be underestimated, which emphasizes the importance of early detection and intervention for PFF.

Objective:To investigate the precautions and clinical effects of minimally invasive lateral bone transfer of tibia in the treatment of diabetic foot.Methods:A retrospective analysis was performed on 82 patients with diabetic foot admitted to the Trauma Department of Changzhou First People's Hospital from January 2019 to December 2022. According to the Wagner grade of diabetic foot, there were 12 cases of grade 2, 50 cases of grade 3, and 20 cases of grade 4. According to the surgical method, 45 patients were divided into bone transfer group. There were 29 males and 16 females, with an average age of 65.27±10.74 years (ranging from 44-87 years), who underwent minimally invasive bone transfer of tibia combined with local debridement treatment. In the non-bone transfer group, there were 37 cases (26 males and 11 females) with an average age of 66.05±11.08 years (ranging from 44 to 86 years), who were treated with local debridement. Gender, age, Wagner grade, surface temperature difference of the affected limb, visual analogue scale (VAS) score of the affected limb before and 1 month after surgery, wound healing rate 1 month after surgery, and recurrence rate of the affected foot 1 year after surgery were compared between the two groups. Outcomes of the cases of different Wagner grades were compared.Result:All 82 patients were followed up for 14.23±1.20 months. There was no significant difference in gender, age, Wagner grade and preoperative VAS between the two groups ( P>0.05). The skin temperature of the affected limb before and after surgery in the bone transfer group was significantly higher than that in the non-bone transfer group 1.93±0.31 ℃ ( P<0.05), and the VAS of the bone transfer group was 2.18±0.58 points 1 month after surgery, which was lower than that in the non-bone transfer group of 5.41±0.93. The VAS difference before and after surgery in the bone transfer group was 4.80±1.24 points, which was greater than that in the non-bone transfer group of 1.62±1.48 points with significant difference ( P<0.05). The wound healing rate was over 98.78%±2.17% in the bone transfer group and 52.57%±6.41% in the non-bone transfer group one month after surgery. No recurrence or recurrence was found in the bone transfer group one year after surgery, and the recurrence rate was 86% (32/37) in the non-bone transfer group with significant difference ( P<0.05). There was no difference in preoperative VAS for different grades of diabetic foot (grades 2, 3, and 4). There were significant differences in VAS, VAS decrease, postoperative limb surface temperature increase, local wound healing rate at 1 month, and lower limb ulcer recurrence or recurrence rate at 12 months in the bone transfer groups of Wagner grade 2, 3, and 4 ( P<0.05). Conclusion:Minimally invasive lateral bone transfer of tibia combined with local precision debridement could significantly increase the healing rate of diabetic foot ulcer, improve the peripheral microcirculation of the affected limb, reduce the pain of the affected limb, and decrease the recurrence rate of diabetic foot ulcer.

Objective:To investigate the one-stage surgical treatment method and short-term therapeutic effect for combined anterior cruciate ligament (ACL) injury in Schatzker IV-VI tibial plateau fractures.Methods:A retrospective study was conducted on 79 patients with Schatzker IV-VI tibial plateau fractures who underwent surgical treatment at the Department of Traumatic Orthopedics in The Third Affiliated Hospital of Soochow University from April 2016 to February 2021 and there were 47 males and 32 females with a mean age of 51.5±13.2 years (ranging from 21 to 73 years old). Combined with preoperative MRI manifestations, meniscus injuries and avulsion fractures of collateral ligament complex were all repaired in one stage, primary reconstruction was not performed for the combined substantive injury of ACL body, and the displaced avulsion fracture of ACL insertion was only reduced without separate fixation during open reduction and internal fixation for fractures. Visual analogue scale (VAS), knee flexion range of motion, and American Hospital for Special Surgery Knee Joint (HSS) scores were used to evaluate the treatment outcomes at 3, 6, and 12 months postoperatively and the last follow-up.Results:All 79 patients successfully completed the surgery and were followed up for 23.6±2.2 months. The incidence of combined ACL injury was approximately 23% (18/79) with the main manifestation being intercondylar ridge avulsion fracture of ACL (10/18, 56%), which was more common in SchatzkerIV fractures (60%, 6/10). Postoperative KT-1000 measurements on the side-to-side difference in forward displacement of the healthy and affected knee joint showed no significant change in patients with ACL avulsion fracture and body injury, and there was no statistically significant difference compared to the normal range ( P>0.05). No statistically significant difference could be observed in postoperative VAS between ACL avulsion fracture, ACL body injury, and non-ACL injury groups ( P>0.05). At 3, 6, 12 months and the last follow-up after surgery, knee flexion range of motion in patients with intercondylar eminence avulsion fracture of ACL 99.7°±8.9°, 110.5°±10.3°, 120.9°±10.5°, and 121.5°±10.2° was lower than that in patients without ACL injury 106.5°±10.1°, 119.1°±9.8°, 128.3°±10.4°, and 128.3°±9.3°, and the differences were statistically significant ( P<0.05). At 3 and 6 months after surgery, patients with intercondylar eminence avulsion fracture of ACL had lower HSS scores 72.7±5.3 and 80.4±4.6 points compared to those without ACL injury 76.3±4.1 and 83.6±4.5 points, and the differences were statistically significant ( P<0.05). Conclusion:During the surgical treatment of Schatzker IV-VI tibial plateau fractures, it is feasible to treat possible concomitant injuries such as meniscus on the basis of reduction and fixation of the fracture without reconstructing the ACL in one stage, and to treat displaced ACL intercondylar eminence avulsion fractures by correct reduction without separate fixation. This treatment method can achieve good short-term postoperative outcomes.

Objective:To investigate ultrasonographic manifestations of gonococcal infections of the penile skin and accessory glands in men, and to assess their clinical significance.Methods:From January 2014 to January 2021, male patients with gonococcal infections of the penile skin and accessory glands were collected from Department of Dermatology, Changshu No.1 People′s Hospital. The diagnosis had been confirmed by laboratory examinations, and these patients had not received relevant treatment. The real-time ultrasound imaging system SIEMENS ACUSON X300 was used to examine the penile skin and accessory gland lesions infected with Neisseria gonorrhoeae, with the probe frequency ranging from 7.5 to 15 MHz. Patients with tubular anechoic fluid-filled areas on the high-frequency ultrasound images received a single dose of intramuscular ceftriaxone (1 g) ; those with oval-shaped anechoic fluid-filled areas on the high-frequency ultrasound images received incision and drainage followed by intramuscular injection of ceftriaxone at a dose of 1 g once a day for 5 consecutive days; those with hypoechoic or mixed echoic areas on the high-frequency ultrasound images received intramuscular injection of ceftriaxone at a dose of 1 g once a day for 5 consecutive days, and if the nodules did not regress after 1-month treatment, local resection would be performed. One month after the treatment, the patients were followed up, and the efficacy was evaluated. Results:A total of 32 male patients with gonococcal infections of the penile skin and accessory glands were collected. They were aged 28.54 ± 3.27 years, all had a history of non-marital sexual contact, and the duration from non-marital sexual contact to the onset of symptoms was 4.45 ± 1.03 days. The disease course was 8.64 ± 1.87 days. Lesions were all solitary, and located at the external urethral meatus in 16 cases (50.00%) , at the glans penis in 7 cases (21.88%) , beside the foreskin frenulum in 5 cases (15.62%) , and at the penile raphe in 4 cases (12.50%) . Sixteen patients (50.00%) presented with sinus-like lesions, 9 (28.13%) with abscesses, 7 (21.87%) with nodules, and all had tenderness on palpation. High-frequency ultrasound examination showed tubular anechoic fluid-filled areas in 16 cases (50.00%) , oval-shaped anechoic fluid-filled areas in 7 cases (21.88%) , hypoechoic areas in 5 cases (15.62%) , and mixed echoic areas in 4 cases (12.50%) . Gonococcal infections involved the cavernous body of the urethra in 16 cases (50.00%) , cavernous body of the penis in 5 cases (15.62%) , and subcutaneous tissue of the penis in 11 cases (34.38%) . After the treatment, all the patients were cured.Conclusion:High-frequency ultrasound can be used in the assessment of skin lesions and selection of treatment regimens for male patients with gonococcal infections of the penile skin and accessory glands.

Objective To understand the prevalence of osteoporosis and its influence factors in residents of Chongqing, and to provide the reference for osteoporosis prevention and treatment. Methods The data were from ^“An epidemiological survey of osteoporosis in Chongqing in 2018^”, and the multi-stage stratified cluster random sampling method was used to select 1885 subjects (≥20 years old) from 32 villages/neighborhood committee in 4 areas (countries) of Chongqing. The investigation was performed by questionnaire (sociodemographic factors, lifestyle factors, history of orthopedics) and the bone mineral density was measured by QDR 4 500A dual energy X-ray absorptiometry. The chi-square test and multi factor multi-variant logistic regression analysis were utilized to analyze the data, the used software was SPSS 25.0. Results The morbidities of osteoporosis and osteopenia in residents (>20 years old) of Chongqing in China were 12.99% and 48.70%, respectively. The osteoporosis morbidity (19.08%) in females was significantly higher than that (4.42%) in males, and increased with age. The multi-variant logistic regression indicated that women (OR=6.10, 95% CI:4.08-9.14), the past medical history of fracture (OR=1.79, 95%CI:1.18-2.73) and age (OR=16.80, 95% CI:9.19-30.77) were risk factors for osteoporosis; milk intake (OR=0.65, 95%CI:0.47-0.89), overweight (OR=0.51, 95%CI:0.36-0.93)and obesity (OR=0.30, 95%CI:0.19-0.47), as compared with ≤primary school group, junior high school group (OR=0.57, 95%CI:0.39-0.82);≥high school group (0.40, 95%CI:0.26-0.61) were considered to be protective factors for osteoporosis. Conclusion The prevalence of osteoporosis among residents with age above 50 years old of Chongqing was very high. Health education and behavior intervention should be focused on the elderly or female residents to promote the formulation of healthy lifestyle.

Objective:To investigate the specific types of lateral meniscus injury in Schatzker type II tibial plateau fractures and its potential correlation with CT features of the lateral plateau.Methods:The data of 213 patients with Schatzker II tibial plateau fractures from August 2014 to June 2021 were retrospectively analyzed, including 132 males and 81 females, aged from 29 to 61 years, with an average of 44.9 years. All patients underwent arthroscopic evaluation of fracture reduction immediately after open reduction and internal fixation (ORIF). According to the actual situation during the operation, the types and locations of lateral meniscus injury were determined and the patients were divided into the meniscus injury group and non-injury group. By measuring lateral plateau depression (LPD) and lateral plateau widening (LPW) of the lateral tibial plateau on CT images, the correlation of which and lateral meniscus injury was analyzed. The optimal critical values of LPD and LPW for predicting lateral meniscus injury were obtained by drawing the relevant receiver operating characteristic (ROC) curves.Results:The meniscus injury group (109 patients) mainly showed injuries involving the mid-body and posterior horn of lateral meniscus (98.2%, 107/109) and LPD was 13.1±3.2 mm; while the LPD of 104 patients without meniscus injury was 9.1±3.0 mm with a statistical difference ( t=3.98, P<0.001). The LPW of meniscus injury group and non-injury groups was 8.0±1.3 mm and 6.7±1.6 mm, respectively, and the difference was statistically significant ( t=2.68, P=0.011). The optimal predictive critical point of LPD and LPW was 7.6 mm (sensitivity 90.3%, specificity 64.7%, area under the curve 0.834) and 7.3 mm (sensitivity 80.5%, specificity 58.8%, area under the curve 0.722). Conclusion:Schatzker II tibial plateau fractures combined with lateral meniscus injury is usually characterized by meniscus-joint capsule separation, rupture and longitudinal fracture. The mid-body and posterior horn of lateral meniscus injury is more likely to occur when LPD> 7.6 mm and/or LPW> 7.3 mm on coronal CT images.

Objective To analyze the awareness rate and treatment and control rate of hypertension as well as the related influencing factors among residents aged 35-75 years in Chongqing, and to provide a reference for comprehensive prevention and control of hypertension. Methods Residents between the ages of 35 and 75 years old were recruited from 8 sites of China Patient-centered Evaluative Assessment of Cardiac Events in Chongqing. All participants were interviewed with structured questionnaires, and physical examination, glucose test and lipid test were performed. The data were analyzed by SPSS 25.0. The differences in the rates of awareness, treatment and control of hypertension of different populations were compared by chi-square test. The related factors influencing the rates of awareness, treatment and control of hypertension were identified by step backward bivariate multivariate logistic regression model. Results A total of 101 036 cases were recruited into this study. The prevalence rates of dyslipidemia, hypertension and diabetes were 31.48%, 40.80% and 17.16%, respectively. The age standardized prevalence rates of dyslipidemia, hypertension and diabetes were 30.81%, 33.91% and 14.35%, respectively. The rates of awareness, treatment and control of hypertension were 45.65%, 36.03% and 11.60%, respectively. The result of multivariate logistic regression analysis indicated that factors including age, household registration, occupation, alcohol use, smoking status, body weight, central obesity, diabetes, and dyslipidemia were related to the awareness rate of hypertension. Factors including age, household registration, race, household income, alcohol use, body weight, central obesity, diabetes, and dyslipidemia were related to the treatment rate of hypertension. Factors including age, household registration, household income, alcohol use, central obesity and diabetes were related to the rate of blood pressure control. Conclusion The prevalence of hypertension was high in Chongqing, but the rate of awareness, treatment and control of hypertension was low. It is suggested that comprehensive measures should be implemented to raise the rate of awareness, treatment and control of hypertension for the prevention and control of hypertension.

Objective To analyze the epidemiological characteristic of stroke incidence and mortality in Chongqing, and to provide suggestions for targeted prevention and control of stroke. Methods Data of reported cases of ischemic stroke (I63), hemorrhagic stroke (I61-I62), subarachnoid hemorrhage (I60), and unclassified stroke (I64) in Chongqing in 2018 was collected. SPSS 25.0 was used to calculate the incidence, age-standardized incidence rate (ASIR), mortality, age-standardized mortality rate (ASMR) and proportion of stroke. The incidence and mortality of stroke were compared by Chi-square test between males and females, and between central urban areas and suburban counties. Results In 2018, the incidence and ASIR of stroke were 294.61/105 and 222.43/105 in Chongqing, respectively. The mortality and ASMR of stroke were 116.34/105 and 85.81/105. The incidence, ASIR and proportion of ischemic stroke were 186.63/105, 139.17/105 and 63.35%, respectively. The incidence of ischemic stroke in male was higher than that in female (χ²=18.52, P<0.001). The incidence of ischemic stroke in central urban areas was higher than that in suburban counties (χ²=29.50, P<0.001). The mortality of ischemic stroke in male was higher than that in female (χ²=6.67, P=0.010). The mortality of ischemic stroke in suburban counties was higher than that in central urban areas (χ²=17.55, P<0.001). The incidence, ASIR and proportion of hemorrhagic stroke were 78.15/105, 60.44/105 and 26.53%, respectively. The incidence of hemorrhagic stroke in male was higher than that in female (χ²=27.64, P<0.001). The incidence of hemorrhagic stroke in suburban counties was higher than that in central urban areas (χ²=18.60, P<0.001). The mortality of hemorrhagic stroke was the highest among all subtypes of strokes. The mortality, ASMR and proportion of hemorrhagic stroke was 64.44/105, 48.28/105 and 55.39%, respectively. The mortality of hemorrhage stroke in male was higher than that in female (χ²=23.46, P<0.001). The mortality of hemorrhage stroke in suburban counties was higher than that in central urban areas (χ²= 43.57, P<0.001). Conclusion The incidence and mortality of stroke in Chongqing were lower than the national average levels. The incidence of ischemic stroke was higher than that of hemorrhage stroke. The mortality of hemorrhage stroke was higher than that of ischemic stroke. Men and suburban counties were the focus of stroke prevention and control in Chongqing.

Objective To investigate the prevalence of hypertension and its risk factors among residents with age between 35 and 75 years old in Chongqing and provide evidence for the prevention and control of hypertension. Methods During 2016-2018, 101036 eligible subjects aged 35-75 years from 8 sites of China Patient-centered Evaluative Assessment of Cardiac Events in Chongqing were interviewed and examined. The data were analyzed by SPSS 20.0. The difference of the prevalence of hypertension of different population were compared chi-square test. Risk factors of hypertension was identified by step backward multivariate Logistic regression model. Results The crude prevalence and age standardization prevalence of hypertension was 40.80% and 33.91% respectively. The results of multivariate logistic regression indicated that the risk factors of hypertension were residence, ethnicity, age, medical insurance ,drinking, present smoking , indoor passive smoking , overweight , obesity , central obesity , diabetes and dyslipidemia ,while the protective factors of hypertension of those were education level and income. Conclusion The prevalence of hypertension was high among residents with age between 35 and 75 years old in Chongqing ; Residence, ethnicity, age, medical insurance, education level, income, drinking, present smoking , indoor passive smoking , overweight , obesity , central obesity , diabetes and dyslipidemia are the related factors of hypertension.

BACKGROUND: We aim to explore the association between self-reported snoring and hypertension among adults aged 30-79 in Chongqing, China. METHODS: A total of 23,342 individuals aged 30-79 were included at baseline from August 2018 to January 2019, and the final sample size for the analysis was 22,423. Face-to-face interviews and physical examinations were conducted by trained investigators. Logistic regression was performed to study age-specific and gender-specific associations between snoring and hypertension. RESULTS: Frequent snoring was associated with the risk of hypertension for each age and gender group, and the frequency of snoring was positively correlated with the risk for hypertension. For the three age groups (< 45, 45-59, ≥ 60), compared with the non-snoring group, those who snore often had a 64.5%, 53.3%, and 24.5% increased risk of hypertension (< 45: OR = 1.65, 95%CI 1.34-2.02; 45-59: OR = 1.53, 95%CI 1.37-1.72; ≥ 60: OR = 1.25, 95%CI 1.09-1.42), respectively. For men and women, those who snore often had a 46.8% and 97.2% increased risk of hypertension, respectively, than the non-snoring group (men: OR = 1.47, 95%CI 1.33-1.63; women: OR = 1.97, 95%CI 1.75-2.23). CONCLUSIONS People who snore frequently should pay close attention to their blood pressure levels in order to achieve early prevention of hypertension, particularly for snorers who are female and aged under 45; importance should be attached to their blood pressure control.
Adult ; Aged ; China/epidemiology* ; Cross-Sectional Studies ; Female ; Humans ; Hypertension/etiology* ; Male ; Middle Aged ; Self Report ; Snoring/complications*