Objective:To investigate the influence of Bifidobacterium adolescence on the expression of HIF-1?and VEGF in rabbit VX2 tumor.Methods:Rabbit VX2 tumor models were established and were divided into two groups(n= 10).Animals in the experimental group were injected with Bifidobacterium adolescence and those in the control group received normal saline via ear vein.Animals were sacrificed and the liver,kidney,spleen,heart,lung and tumor tissues were removed,cultured and Gram stained.The changes of tumor tissue were observed by H-E staining;immunohistochemistry was used to detect the expression of HIF-1?and VEGF in tumor tissues.Results:Bifidobacterium adolescence could target the tumor tissue.H-E staining showed the necrotic area was obviously enlarged after treatment with Bifidobacterium. Immunohistochemistry demonstrated that the positive rates of HIF-1?and VEGF in the experimental group were significantly lower than those of the control group(P

Objective To explore the effect of hippophae rhamnoides on the level of plasma appetite factors neuropeptide Y ,the gastric motility and on their body fat in children with functional dyspepsia .Methods A hundred and twenty children with functional dyspepsia were simple random sampled divided into the three groups :Group Ⅰ( treated with hippophae rhamnoides ) ,Group Ⅱ( treated with domperidone ) , and Group Ⅲ( treated with hippophae rhamnoides plus domperidone ) .The treatment lasted for eight weeks .The level of plasma neuropeptide Y ( NPY) were measured before and after treatment .All patients underwent a gastric emptying ( GE) test by ultrasound ( US) to measure the rate of postprandial gastric antrum residual ,at 30min,60min,90min and 120min.The average value of subcutaneous fat,body fat percentage,upper arm girth,weight and height were also measured .Results There were no statistical difference between the level of NPY in plasma of groupⅠ,ⅡandⅢbefore treatment,which were (107.52 ±24.12)ng/L, (114.63 ±17.95)ng/L and(114.56 ±25.10)ng/L(F=1.307,P>0.05).After treatment,there were statistical difference between the level of NPY in plasma of groupⅠ,ⅡandⅢ,which were (137.38 ±29.86) ng/L,(121.43 ± 13.78)ng/L and (149.27 ±31.9)ng/L.The level of NPY in plasma of groupⅠandⅢwere markedly increased after treatment(t=4.95,5.40,all P<0.05).The postprandial gastric antrum remains in Groups ⅠandⅢwere less than that in group Ⅱat 60 min,90 min and 120 min,respectively(F=4.93,6.40,4.61,all P<0.05).The thickness of skin fold(SF),body fat percentage and upper arm girth and weight in groupⅠand Ⅲ increased more than those in group Ⅱ(F=16.80,46.9,21.06,all P<0.05).The level of plasma appetite factors ,the rate of gastric antrum remaing and SF,body fat percentage,arm girth and weight was similar in groupⅠand group Ⅲ (P >0.05). Conclusion In children′s functional dyspepsia ,the hippophae rhamnoides increases the level of appetite factor neu-ropeptide Y,The child′s body fat increases markedly and physical growth also has obvious improvement .

Objective To discuss the 3D printing modeling used to assist minimally invasive fixation with hollow screws for unstable pelvic fractures.Methods From January 2014 to January 2016,137 patients with unstable pelvic fracture received minimally invasive fixation with hollow screws and obtained complete follow-up at our department.In 65 of them,the fixation was assisted by 3D printing modeling;they were 37 men and 28 women,with an average age of 33.1 ± 4.9 years.In the other 72 cases,conventional fixation was performed without assistance of 3D printing modeling;they were 45 men and 27 women,with an average age of 32.6 ±4.7 years.The 2 groups were compared in terms of operation time,frequency of intraoperative fluoroscopy,reduction quality and curative effect.Results This cohort were followed up for 6 to 15 months (average,9 months).The 3D printing modeling group needed significantly less operation time (58.6 ± 13.4 min) and intraoperative fluoroscopy (29.3 ± 3.6 frequencies) than the conventional group (72.4 ± 12.4 min and 36.6 ± 2.8 frequencies) (P ＜ 0.05).According to the Matta scoring criteria,the quality of pelvic reduction was evaluated as excellent in 21 cases,as good in 30 cases,as fair in 13 cases and as poor in one in the 3D printing group,yielding an excellent and good rate of 78.5％ while as excellent in 22 cases,as good in 36 cases,as fair in 12 cases and as poor in 2 cases in the conventional group,yielding an excellent and good rate of 80.6％.According to the Majeed scoring criteria,the curative effect was evaluated at the last follow-up as excellent in 27 cases,as good in 26 cases,as fair in 11 cases and poor in one in the 3D printing group,giving an excellent and good rate of 81.5％ while as excellent in 30 cases,as good in 28 cases,as fair in 13 cases and as poor in one in the conventional group,giving an excellent and good rate of 80.6％.There were no statistically significant differences between the 2 groups in reduction quality or curative effect (P ＞ 0.05).No nonunion or iatrogenic neurovascular lesions happened during the follow-up period.Conclusion 3D-printing modeling is helpful for a good reduction and minimally invasive fixation with hollow screws for unstable pelvic fractures by reducing operation time and intraoperative fluoroscopy.

Objective: To explore the types of medication adherence and their influencing factors among inpatients with chronic diseases based on latent profile analysis, so as to provide the basis for improving medication adherence among patients with chronic diseases. Methods: The inpatients with chronic diseases admitted to the Second Affiliated Hospital of Hainan Medical University were selected as the study subjects. Demographic information, chronic disease status, and health education were collected through questionnaire surveys. Medication adherence was assessed using the Medication Adherence Scale and categorized based on the scores of its eight items through latent profile analysis. Factors affecting medication adherence among inpatients with chronic diseases were analyzed using a multinomial logistic regression model. Results: Totally 290 valid questionnaires were recovered, with an effective recovery rate of 97.64%. There were 157 males (54.14%) and 133 females (45.86%), with a median age of 61 (interquartile range, 21) years. The median score of medication adherence was 4.75 (interquartile range, 4.50). Based on latent profile analysis, medication adherence was categorized into three types: subjective neglect with poor adherence (38.97%), subjective confidence with fluctuating adherence (28.28%), and self-reflective with good adherence (32.76%). Multinomial logistic regression analysis showed that compared to the subjective confidence with fluctuating adherence, family monthly income (5 000-10 000 yuan, OR=2.981, 95%CI: 1.055-8.429), comorbidity of chronic diseases (OR=3.478, 95%CI: 1.579-7.661), number of health education sessions received in the past year (≤1 session, OR=0.329, 95%CI: 0.120-0.907; 2 sessions, OR=0.363, 95%CI: 0.138-0.950), and health information literacy scores (<60 points, OR=2.596, 95%CI: 1.209-5.573) were statistically associated with subjective neglect with poor adherence (all P<0.05). Conclusion Subjective neglect with poor medication adherence among inpatients with chronic diseases is associated with family monthly income, comorbidity of chronic diseases, the number of health education sessions received, and health information literacy.

Bosworth fracture and dislocation is relatively rare, accounting for about 1% of ankle fractures. It is characterized by the proximal fibula fracture embedded in the posterolateral distal tibia. Due to an insufficient understanding of this fracture, it is easy to cause missed diagnosis and misdiagnosis in clinical practice. Due to the insertion of the fracture, it is challenging to perform closed reduction, and improper treatment is easy to cause complications. Surgical treatment is recommended for this type of fracture. In order to improve the understanding of orthopedic surgeons about Bosworth fracture and dislocation, this paper reports the diagnosis and treatment of 2 cases of Bosworth fracture and dislocation, and reviews the literature on Bosworth fracture's mechanism, diagnosis, classification, complications, and treatment options in recent years.
Humans ; Ankle Fractures/surgery* ; Joint Dislocations/surgery* ; Fracture Fixation, Internal ; Fibula ; Tibia

Objective To examine the impact of loneliness on cognitive impairment among community-dwelling elderly people.Methods A cross-sectional survey was conducted between July and August 2015 with 895 community-dwelling elderly participants in four residential areas of Wuchang District,Wuhan.The Montreal Cognitive Assessment (MoCA) was used to measure cognitive function.Chi square test,t-test,and multivariate linear regression were used to analyze the data.Results Multivariate linear analysis showed that loneliness was independently and negatively associated with cognitive function among the participants (β=-1.2828,95％ CI:-2.27--0.30).Participants who felt loneliness recorded lower scores on visuospatial executive,attention,and language ability than those who did not (P＜0.05).Multivariate logistic analysis demonstrated that loneliness was also associated with cognitive function after adjustment for age and gender,with OR (95 ％CI) at 1.74(1.05 2.91) / 1.78 (1.07 2.94).Loneliness remained an independent risk factor for cognitive dysfunction after adjustment for age,gender,education level,monthly income,living arrangement,physical activity,mental activity,hypertension,diabetes,frequency of social interaction,and type of social interaction,with OR (95％CI) at 1.69(1.002.87) / 1.72(1.022.90).Conclusions Loneliness is a significant and independent impact factor for cognitive dysfunction among community dwelling elders.

Objective:To investigate the relationship between serum fibroblast growth factor 21/23 level, trauma severity and prognosis in middle-aged and older adult patients with traumatic fracture.Methods:A total of 126 middle-aged and older adult patients with traumatic facture who received treatment in the Second People's Hospital of Lishui, China between June 2017 and June 2019 were included in the study group. Fifty healthy controls who concurrently received physical examination in the Second People's Hospital of Lishui were included in the control group. The study group was divided into five subgroups according to relevant criteria: mild, moderate, severe, poor prognosis and good prognosis. The levels of C-reactive protein (CRP), procalcitonin (PCT), FGF21 and FGF23 were measured.Results:On admission, serum CRP, PCT, FGF23, FGF2 levels in the study group were (19.18 ± 5.66) mg/L, (0.71 ± 0.20) μg/L, (79.75 ± 18.62)μg/L,(52.10 ± 16.34) μg/L, respectively, and they were significantly higher than those in the control group [ (7.60 ± 2.61) mg/L, (0.30 ± 0.11) μg/L, (40.18 ± 10.33) μg/L, (30.11 ± 10.19) μg/L, t = 18.888, 17.750, 18.336, 11.032, all P < 0.001). On admission, serum CRP, PCT, FGF23, FGF2 levels in the study group were (19.18 ± 5.66) mg/L, (0.71 ± 0.20) μg/L, (79.75 ± 18.62) μg/L, (52.10 ± 16.34) μg/L, respectively, and they were significantly increased at 1 day [(21.59 ± 4.53) mg/L, (0.79 ± 0.22) μg/L, (83.85 ± 19.07) μg/L, (55.18 ± 16.55) μg/L, t = 3.72, 3.29, 1.56, 1.56, P < 0.05, P < 0.05, P = 0.122, P = 0.122] and 3 days after surgery [(23.15 ± 3.16) mg/L, (0.80 ± 0.24) μg/L, (88.11 ± 19.80) μg/L, (59.70 ± 16.07) μg/L, t = 6.65, 3.12, 3.59, 3.77, all P < 0.05] , and significantly decreased at 7 days after surgery [(14.35 ± 4.02) mg/L, (0.52 ± 0.16) μg/L, (50.06 ± 15.50) μg/L, (32.18 ± 12.52) μg/L, t = 8.31, 8.58, 13.77, 11.11, all P < 0.001]. On admission, there were significant differences in serum CRP, PCT, FGF23, FGF21 levels between mild, moderate and severe groups ( F = 25.087, 15.851, 15.831 and 12.645, all P < 0.001). On admission, serum CRP, PCT, FGF23, FGF21 levels in the poor prognosis group were significantly higher than those in the good prognosis group ( t = 5.757, 4.984, 3.189 and 4.006, all P < 0.001). The receiver operating characteristic curve (ROC) analysis results showed that serum CRP, PCT, FGF23, FGF21 levels in patients with traumatic fracture on admission had a certain value in the prediction of poor prognosis. Combined detection of these four indexes had the highest value, with AUC (0.95 CI) of 0.877 (0.783-0.982). Conclusion:Serum FGF21 and FGF23 levels have a certain value in the prediction of severity and prognosis of traumatic fracture in middle-aged and older adult patients.

Objective:To investigate whether the Garden indexes can serve as a criterion for rotational displacement of femoral neck fracture.Methods:Ten cadaveric specimens of healthy human proximal femur were used for this study. They came from 3 males and 2 females who had died at the age from 45 to 70 years old. A Kirschner wire of 2.0 mm in diameter was implanted into the center of the femoral head. Osteotomy was conducted perpendicular to the middle line of the femoral neck. The rotational angles were marked on the distal osteotomy surface. Each cadaveric specimen was rotated sequentially at pronation and supination angles of 0°, 10°, 20°, 30°, 40°, 50°, 70° and 90°, respectively. X-ray images of anterior-posterior and lateral views were taken to record all the rotations of the specimens. Picture Archiving and Communication Systems (PACS) were used to measure the Garden indexes and compare them among anterior-posterior and lateral X-ray films of different pronation and supination angles. Changes in the area of the femoral head fovea at different rotation angles were observed as well.Results:There were no significant differences in the auterior-posterior or latera Garden indexes from 0° to pronation or supination 30°, with all the Garden values >155° ( P>0.05); from pronation of 40° to pronation of 90°, the Garden indexes were 152.36°±1.41°, 146.04°±1.64°, 143.95°±0.60° and 141.73°±0.60° for anterior-posterior views and 172.54°±0.86°, 168.57°±0.98°, 157.18°±1.17° and 156.47°±1.63° for lateral views, showing a significant difference between rotational angles ( P<0.05); from supination of 40° to supination of 90°, the Garden indexes were 151.67°±1.06°, 147.32°±1.82°, 142.77°±0.75° and 139.88°±1.48° for anterior-posterior views and 172.28°±0.79°, 166.76°±1.02°, 155.67°±1.74° and 154.16°±1.27° for lateral views, showing a significant difference between rotational angles ( P<0.05). The area of the femoral head fovea decreased gradually with the increase in pronation angle, and increased gradually with the increase in supination angle. Conclusions:The Garden indexes cannot serve as an accurate indication of rotational displacement in reduction of femoral neck fracture when the pronation or supination angles ranges from 0° to 30°. Changes in the area of the femoral head fovea can help determine the rotational displacement of the femoral neck fracture.

Diagnostic Errors ; Humans ; Intervertebral Disc Degeneration ; Intervertebral Disc Displacement/diagnostic imaging* ; Lumbar Vertebrae/diagnostic imaging* ; Lymphangioma/diagnostic imaging* ; Magnetic Resonance Imaging

Objective: To explore the surgical methods and clinical outcomes of severe angular kyphosis with the length of the spinal cord constant in the osteotomy area. Methods: Clinical data from 20 patients with severe angular kyphosis who underwent surgical treatment from January 2017 to December 2020 in the Department of Spinal Surgery,Hangzhou Xiaoshan District Hospital of Traditional Chinese Medicine were retrospectively analyzed. There were 11 males and 9 females, aged (28.5±8.9) years (range:17 to 46 years).There were 15 cases with congenital angular kyphosis,5 cases with tuberculous angular kyphosis.The angle of kyphosis was (107.1±12.9)° (range:93.2° to 131.4°).Frankel classification:2 cases with grade B,4 cases with grade C,3 cases with grade D.The kyphotic vertex is located at the T₉ to T₁₂ segments.Pedicle screws were placed in 3 or 4 adjacent segments at the proximal and distal kyphosis apex of the patients using a surgical navigation system.Piezosurgery combined with a grinding drill was used to complete the osteotomy in the apical vertebral region.Titanium mesh or artificial vertebral body was implanted,and the osteotomy surface was closed using this as the fulcrum to complete osteotomy.Spinal X-ray examination was performed before surgery,immediately after surgery and at the last follow-up,and sagittal and coronal Cobb angle,sagittal and coronary balance parameters,anterior vertebral height,posterior vertebral height,and spinal cord length were measured.Pulmonary function,visual analogue scale (VAS),and Oswestry's disability index (ODI) were collected and estimated before and after treatment.The analysis of variance of repeated measurement data was used for each evaluation index before and after treatment,and the t test was used for pairwise comparison. Results: All patients successfully completed surgery,with artificial vertebral body in 11 cases and double titanium mesh in 9 cases.The follow-up time was (28.2±2.3) months (range:26 to 31 months).Sagittal vertical axis improved from (46.9±13.7)mm(range:21.7 to 75.7 mm) before surgery to (10.7±5.5)mm (range:3.6 to 28.1 mm) after surgery,and (11.0±5.7)mm(range:3.6 to 29.3 mm) at the last follow-up,the differences were statistically significant compared to before surgery (all P<0.01).The mean kyphotic Cobb angle was corrected from (107.1±12.9) ° (range:93.2 ° to 131.4°) before surgery to (30.6±8.5) ° (range:20.0 ° to 47.8 °) after surgery (all P<0.01),and (32.1±8.7) ° (range:18.2 ° to 50.8°) at the last follow-up,the differences were statistically significant compared to before surgery(all P<0.01).The anterior vertebral height improved from (14.2±2.9)mm(range:11.04 to 23.6 mm) before surgery to (45.3±7.5)mm(range:29.4 to 56.5 mm) after surgery,and (44.3±6.8)mm(range:29.6 to 56.0 mm) at the last follow-up,the differences were statistically significant compared to before surgery (all P<0.01).The posterior vertebral height was improved from (51.8±5.3)mm (range:43.1 to 61.4 mm)before surgery to (57.6±4.7)mm (range:45.7 to 64.1 mm)after surgery,and (56.3±5.0) mm (range:49.7 to 68.5 mm) at the last follow-up,the differences were statistically significant compared to before surgery (all P<0.01).The spinal cord length of the osteotomy segment was (73.1±12.0)mm (range:56.8 to 98.4 mm) before surgery and (74.8±12.8)mm (range:53.5 to 100.2 mm) after surgery and (75.2±13.7)mm (range:53.9 to 102.4 mm) at the last follow-up,the difference was not statistically significant among them(F=0.144,P=0.866).The ODI and VAS scores improved significantly after surgery and at the last follow-up,and the differences were statistically significant (all P<0.01). Conclusion: The posterior vertebral column resection technique combined with titanium mesh or an artificial vertebral body implant for the treatment of severe angular kyphosis can significantly improve the kyphosis,neurological function,and life quality of patients without affecting the length of the spinal cord.