Objective To improve the diagnosis and treatment of acute exacerbation in idiopathic pulmonary fibrosis(IPF)Methods A case with clinical proven acute exacerbation in IPF and treated with corticosteroid was described and the foreign literature was reviewed.Results Most patients with idiopathic pulmonary fibrosis(IPF)show slowly progressive deterioration.However,accelerated deterioration also occurs without any definite factors on infection,heart failure,et al in a few of patients with IPF who have previously shown slowly progressive deterioration,and for part of patients corticosteroid treatment is effective.Conclusion Some acute exacerbation in idiopatic pulmonary fibrosis can be idiopathic.

Objective To outline the characteristics of fractures of the coronoid process of the ulna in children and distinguish them from that of the adult. Methods Twenty eight cases of fractures of the coronoid process of the ulna in children in the past five years were reviewed. There were 18(64%) boys and 10(36%) girls. According to the extent of involvement, the fractures were classified as 3 types based on modified Regan and Morrey method. Of those, 10 cases were associated with other injuries such as dislocation of the elbow, fracture of the radial neck, fracture of the olecranon and so on. In this series, open reduction and internal fixation were applied in only 2 cases with type Ⅲ injury and conservative treatment including immobilization of the elbow in flexion with long arm plaster splint were done in all of the rest cases. Results Seventeen patients were followed up for an average of 14 months(range, 4 months to 5 years). The clinical results were evaluated according to pain, range of motion, muscular strength and stability of the elbow. The overall excellent result were achieved in 94%of the patients. No complaint and late complication were found in this series. Conclusion There are some obvious differences in the coronoid process fracture of the ulna between children and adult: 1)fewer cases associated with dislocation of the elbow in the children than in the adult; 2)the clinical results were relatively better in children than that in the adult whatever the surgical or conservative treatment was performed; 3)the prognosis of fractures of the coronoid process of the ulna was better and the complications were less in children than that in the adults.

Objective To explore clinical characteristics of the digestive tract obstruction due to annular pancreas. Methods We reviewed retrospectively clinical features, operative findings and the autopsy of 5 children with annular pancreas. Results Neonate patients usually present complete upper gastro intestinal obstruction because most of them were complicated with duodenal atresia. Infants present chronic incomplete intestinal obstruction duo to annular pancreas. 35.8% of duodenal constriction was caused by annular pancreas. Conclusions All the symptomatic patients with annular pancreas should undergo exploration to restore the consecution of the digestive tract and to detect if there is a concurrent malformation such as intestinal atresia.

Objective: To observe the preventive effect of alkaline drinking water on hyperuricemia in mice. Methods: Sixty male SPF Kunming mice were randomly divided into six groups: pH 7.3, pH 8.0, pH 9.3 intervention groups, in which the mice were given water with pH values of 7.3±0.5, 8.0±0.5 and 9.3±0.6, respectively; the control group, model group and positive drug group ( with 2 g/L allopurinol ) were given double distilled water. Except for the control group, the mice in each group were given yeast by gavage (1.5 g/mL) for 13 days. On the 14th day, the mice were injected with 300 mg/kg potassium oxyzinate by intraperitoneal injection, and then fasted for 1 day. On the 16th day, serum uric acid, creatinine and urea nitrogen were detected, and renal tissues were stained to observe the morphology.The expression levels of neutrophil gelatinase-associated lipocalin ( NGAL ), tissue inhibitor of metalloproteinase 1( TIMP1 ), organic anion transporter 1 ( OAT1 ) and urate transporter 1 ( URAL-1 ) in renal tissues were determined bywestern blotting. The mRNA expression levels of URAL-1 and OAT1 were detected by real-time fluorescent quantita⁃tive polymerase chain reaction. Results: The level of serum uric acid was higher in the model group than in the control group and in the pH 9.3 intervention group (both P<0.05). The number and area of renal tubular lesions were less in the pH 9.3 intervention group than in the model group (all P<0.05). The relative expression levels of NGAL and URAT-1 proteins were lower in the pH 9.3 intervention group than in the model group, and the relative expression level of OAT1 protein was higher in the pH 9.3 intervention group than in the model group ( all P<0.05). The relativeexpression level of URAT-1 mRNA was lower in the pH 9.3 intervention group than in the model group, and the rela⁃tive expression level of OAT1 mRNA was higher in the pH 9.3 intervention group than in the model group ( all P<0.05 ). Conclusion Alkaline drinking water with pH value of 9.3±0.6 can effectively prevent hyperuricemia and acute kidney injury in mice.

Objective To find out about the demands of health education in the border defense army .Methods A self-made questionaire was used to investigate both the demand of health education in the border defense army and the knowledge-attitude-practice of health .Comprehensive evaluation was conducted on the spectrum of disease in hospitals of border defense army in the previous year .Results Mental health (63.605%), lifestyle (53.829%) and knowledge on occupational protection (41.375%) were the most needed knowledge in the border defense army .Videos and lectures were the means of health education , accounting for respectively 69 .368%and 42 .936%.The total rate of awareness of knowl-edge about health education reached 64.156%.The total rates of holding health attitude and health behavior were 80.765%and 49.113%, respectively.Recently, intervertebral disc disorders,arthritis and other injuries (dislocation, sprain and strain ) were atop the disease spectrum at border defense hospitals .Conclusion Knowledge of mental health , lifestyle and occupational protection along with videos and lectures are the most urgent demand of the border defense army . What needs to be done right away is to improve the awareness of military occupation protection and develop healthy behaviors .

Abstract: Objective To investigate the prevalence of dissociative tendency and its influencing factors among middle school students, so as to provide insights into prevention and early interventions of adolescent dissociative tendency. Methods: Students at ages of 13 to 18 years that studied in 9 high schools were sampled using a multistage, stratified, cluster sampling method from 3 counties (districts) of Hangzhou City from January, 2021 and March, 2022. Participants' demographics and social, school, family environment and psychological factors were collected using self-designed questionnaires and standardized scales. The dissociative tendency was initially screened using the Adolescent Dissociative Experience Scale (A-DES), and the diagnosed by three psychiatrists according to Diagnostic and Statistical Manual of Mental Disorders (5th Edition). Factors affecting ADT were identified using a multivariable logistic regression model. Results: Totally 3 240 students were recruited, and 2 841 students were qualified, with a response rate of 87.69%. The respondents included 1 389 men (48.89%) and 1 452 women (51.11%), and had a mean age of (15.69±1.58) years. The prevalence of dissociative tendency was 24.04%, and the detection of dissociative tendency was higher among men than among women (29.23% vs. 19.08%; χ2=24.529, P<0.001). Multivariable logistic regression analysis identified negative teacher-student relationship (OR=1.055, 95%CI: 1.010-1.103), family emotional expressiveness (OR=0.872, 95%CI: 0.777-0.978), family conflict (OR=1.152, 95%CI: 1.045-1.271), family organization (OR=0.880, 95%CI: 0.780-0.992) and family cohesion (OR=0.871, 95%CI: 0.766-0.987) as factors affecting dissociative tendency among men, and somatization (OR=1.041, 95%CI: 1.002-1.082) and paranoid ideation (OR=1.094, 95%CI: 1.006-1.190) as factors affecting dissociative tendency among women. Conclusions The prevalence of dissociative tendency was 24.04% among middle school students. Negative teacher-student relationship, family emotional expressiveness, family conflict, family organization, and family cohesion may affect dissociative tendency among men, while somatization and paranoid ideation may affect dissociative tendency among women.

Objective To evaluate the effect of open reduction and internal fixation in treatment of calcaneal fractures in aged patients. Methods Between January 1997 and June 2007,37 patients (41 fractures)at a mean age of68.3 years(60-78 years)with calcaneal fractures underwent surgical operations.According to Sanders classification based on CT scanning.14 fractures were rated as typeⅡ,18 as type Ⅲ and 9 as type Ⅳ.Of all,5 fractures were treated with reconstruction plate,18 with shapeable titanic plate,4 with Y-shaped plate,12 Depuy titanic plate and 2 with AO locking titanic plate plus open reduction and internal fixation.The foot function was evaluated by X-ray,American Orthopedic Foot and Ankle Society(AOFAS)Score and Maryland Foot Score. Results A total of 27 patients (60.9%)with 31 fractures were followed up for 12-48 months(average 27.6 months),which showed that all fractures were healed,with morphous improvement of the calcanus determined by 8 parameters measured in X-ray films.The average active range of motion was 36°of plantar flexion,12°of dorsiflexion,15°of inversion,and 10°of eversion.According to Maryland Foot Score,functional foot score was excellent(90-100 points)in 16 fractures,good(75-89 points)in 13 and fair(50-74 points)in 2,with excellence rate of 94%(29/31). Conclusion Open reduction and intemal fixation can gain good clinical result in severe calcaneal fractures in aged patients with obvious dislocation of posterior articular facet.

Objective To develop an UPLC-MS/MS method for simultaneously determination of five components (adenosine,cytidine,guanosine,mannitol and adenine) in Qiangshenpaidu capsules. Methods The UPLC separation was performed on an Agilent ZOBAX SB-C18(2.1 mm×150 mm,5 μm) column.Isocratic elution was carried out with mobile phase consisting of methanol-0.1%formic acid (5∶95) at a flow rate of 0.2 mL.min-1.The mass spectrometer was operated in the positive ionization electrospray ( ESI) mode using multiple monitoring ( MRM) for analysis of five components. Results Adenosine,cytidine,guanosine,mannitol and adenine were all analyzed with good precision and accuracy. The linear ranges were 35-1 120 ng.mL-1( r=0.998 1) ,10-320 ng.mL-1( r=0.996 4) , 30-980 ng.mL-1( r=0.999 3) , 40-1 280 ng.mL-1( r=0.993 4), 25-800 ng.mL-1(r=0.996 5),respectively.The recoveries of six analytes ranged from 97.4% to 103.6% and the relative standard deviations were all below 4.7%. Conclusion A sensitive,accurate and suitable UPLC-MS/MS method has been developed,and the method could be applied for the determination of adenosine,cytidine,guanosine,mannitol,and adenine in Qiangshenpaidu Capsules.

ObjectiveTo evaluate the clinical outcome of new proximal femoral nail antirotation (PFNA) in treatment of subtrochanteric fractures. MethodsThere were 31 patients with traumatic subtrochanteric fractures intramedullarily fixed with PFNA. The patients included 14 males and 17 fe-males at a mean age of 54.6 years (range 34-90 years). According to Seinsheimer classification of sub-trochanteric fractures, 14 patients were with type Ⅱ fractures (including four patients with type ⅡA,seven with type ⅡB and three with type ⅡC), 12 with type Ⅲ fractures (including eight with type ⅢA and four with type ⅢB), two with type Ⅳ fractures and three with type Ⅴ fractures. Close reduction was performed under traction and C-arm fluoroscopy in 26 patients and open reduction through a mini-incision before inserting the nail in five patients due to difficult close reduction. ResultsThe operation lasted for a mean time of 72.5 minutes (range 45-120 minutes), with mean blood loss of 127.5 ml (range 100-350 ml). Of all, 27 patients (87.1%, 27/31) were followed up for a mean duration of 14.3 months (range 8-24 months), which showed fracture union in all patients, with a mean union period of 17.4 weeks (range 10-21 weeks). According to Harris Hip Rate Scale, the results were. excellent in 21 pa-tients, good in two and fair in four, with excellence rate of 85.2% (23/27). ConclusionsPFNA is an effective device for treatment of subtrochanteric fracture, with a high union rate and a low complication rate, for it has advantages of easy use and minor trauma, low bleeding and stable fixation in operation.

Hydroxyethyl chitin (HECH) is a water soluble chitin derivative made by etherification of chitin, ethylene chlorohydrin was used as etherification reagent in this reaction. A novel interpenetrating polymer network (IPN) composed of HECH/PAA was prepared. The IR spectra confirmed that HECH/PAA was formed through chemical bond interaction. The sensitivity of this hydrogel to temperature and pH was studied. The swelling ratio of this hydrogel in artificial intestinal juice is much greater than that in artificial gastric juice. The IPN hydrogel exhibited a typical pH-sensitivity, and its degree of swelling ratio increased with the increase of temperature. The sustained-release drug system of Dichlofenac potassium was prepared by using HECH/PAA as the drug carrier. The release experiment showed a perfect release behavior in artificial intestinal juice. This IPN is expected to be used as a good drug delivery system of enteric medicine.
Acrylates ; administration & dosage ; chemistry ; Anti-Inflammatory Agents, Non-Steroidal ; administration & dosage ; Chitin ; administration & dosage ; analogs & derivatives ; chemistry ; Delayed-Action Preparations ; Diclofenac ; administration & dosage ; Drug Carriers ; chemical synthesis ; Drug Delivery Systems ; Hydrogel, Polyethylene Glycol Dimethacrylate ; administration & dosage ; chemistry ; Hydrogen-Ion Concentration