Objective To investigate the changes in physique and the bone age,and the correlation between the changes in cardiac structure and function and the bone age index (BAI) in atrial septal defect (ASD) children.Methods The experimental group included 48 cases of ASD patients,and 30 cases of healthy children were assigned as the control group;the children of both groups were measured for height and weight.Philips ie33 ultrasonic detector was used to detect the indicators of cardiac structure and function,and Philips digital X-ray machine was used to radiograph the left hand and the wrist.Then the bone age was assessed in order to calculate the BAI.Fourteen cases of ASD patients who underwent repairing surgery were measured for orifice area in surgery.The differences in physique and the bone age between the 2 groups were analyzed,and Pearson correlation analysis method was used to observe the correlation between the cardiac structure and function indicators,defect area and BAI in the experimental group.Results There was no significant difference in the age,height,bone age (t =-0.02,-1.31,-1.69,all P ＞ 0.05),while the weight and BAI were significantly different between the 2 groups (t =-2.28,-9.06,all P ＜ 0.05).The height,weight and BAI were significantly different in different pulmonary artery systolic pressure (PASP) patients (F =27.630,23.537,16.704,all P ＜ 0.01),while the age and weight had no difference (t =-1.218,-0.046,all P ＞ 0.05).The height and BAI were significantly different in patients with different defect size(t =2.561,2.191,all P ＜ 0.05).There was no correlation between the age and the BAI in children with ASD(r =-0.175,P ＞ 0.05).The defect size,defect size/atrial septal stretched diameter,PASP were all negatively correlated with BAI (r =-0.349,P ＜ 0.05 ; r =-0.412,P ＜0.01 ;r =-0.539,P ＜0.01).The defect area was positively related to the defect size in 14 cases of children with ASD underwent surgery (r =0.599,P ＜ 0.05),and the defect area was negatively correlated with BAI (r =-0.655,P ＜ 0.05).Conclusions The physical development in ASD patients evidently lagged behind the healthy children,particularly for weight.The BAI of ASD patients is significantly smaller than that of the healthy children,in other words,the growing speed of bone in ASD patients is significantly slower than that of the healthy children at the same age.The lagging extent of physical development and the bone age are related to the PASP and defect size.PASP has more influence on the height,yet the defect size has influence on height and weight of ASD children.There is no correlation between physical development and the bone age with the course of disease.

This study was aimed to construct the pharmacophore models of endothelins A receptor antagonist in the application of screening traditional Chinese medicine (TCM) database for novel ETA Receptor antagonists. Qualitative and quantitative hypotheses were generated by HipHop and HypoGen separately on the basis of 36 compounds with antagonistic action on Endothelins A Receptor expressed in the aortic smooth muscle cells of rats. Database searching method was used to evaluate the generated hypotheses. The optimum hypotheses were used to search TCM database. The results showed that optimum qualitative hypothesis is with six features, which were one aromatic ring, one hydrogen-bond acceptors, one negative ionizable group and three hydrophobic groups, and the CAI value of 103.94. The optimum quantitative hypothesis is with six features, which were one aromatic ring, one hydrogen-bond acceptor, one negative ionizable group, two hydrophobic groups and one exclusive volume, and the CAI value of 45.96. Sixteen compounds from TCM were found in the database searching with the quantitative hy-pothesis. It was concluded that the pharmacophores are reliable and can be used to screen database for novel E-TA inhibitors. The qualitative and quantitative hypothesis can be used to screen database for active compounds and to predict the activity respectively.

Objective To evaluate the effectiveness of internet-based cognitive behavior therapy (CBT-I) on blood pressure in patients with hypertension comorbid with insomnia.Methods One hundred and six patients met the JNC-8 diagnostic criteria for hypertension and DSM-5 diagnostic criteria for insomnia were selected,and randomly assigned to CBT-I group (n=53) and regular treatment group (n=53).All the patients accepted relevant treatment for 8 consecutive weeks.Changes of systolic blood pressure (SBP),diastolic blood pressure (DBP),the sleep parameters and the anxiety and depression levels were observed between baseline and 8 weeks of follow-up.Results Compared with pre-treatment,SBP and DBP decreased significantly in both CBT-I group and regular treatment group (P＜0.01),the decrease was more significant in CBT-I group than in regular treatment group (P＜0.01).The sleep latency,sleep efficiency,bed time and rating anxiety scale were improved more significantly in CBT-I group than in regular treatment group (44.49 ± 22.75min vs.55.50 ± 34.96min;72.31％ ± 9.15％ vs.57.70％ ± 11.53％;302.65 ± 43.76min vs.262.70 ± 50.64min and 17.14 ± 6.45 vs.21.02 ± 6.64,respectively),the differences were of statistical significance (P＜0.05).In addition,no significant difference was found in the level of depression between CBT-I group and regular treatment group.Conclusion CBT-I can effectively shorten sleep latency,improve sleep efficiency,extend bed time and improve anxiety,meanwhile effectively lower the blood pressure of patients with hypertension comorbid with insomnia by optimizing sleep quality.

This study was aimed to optimize the near infrared (NIR) variable selection method based on multivariate detection limit (MDL). Using Qing-Kai-Ling (QKL) injection as object, three variable selection methods (interval par-tial least-squares, iPLS; backward interval partial least squares, BiPLS; moving window interval partial least squares, mwPLS) were used to establish the PLS models of baicalin in QKL injection, respectively. The prediction ability of different variable selection method was compared. MDL of all models were calculated in contrast to the MDL value of full spectra PLS model, to select optimal variable selection method. The results showed that different variable selec-tion methods had different prediction ability. Among them, iPLS had the best performance which determination coef-ficient of prediction (Rpre2) and the root mean square errors of prediction (SEP) were 0.996 5 and 602.3 μg·mL-1, re-spectively. All MDLs of different variable selection methods were reduced compared with the full spectra PLS model. The value of iPLS was the lowest comes to be 1.19 μg·mL-1. The results above indicated that the best variable se-lection method for baicalin in QKL injection was iPLS. MDL theory took the error of calibration and validation set and the leverage of external sample into account, which can comprehensively evaluate model detection performance compared to the classic chemical indicator parameters. This method was particularly suitable for the variable selec-tion method optimization of NIR quantitative model of low concentration sample such as Chinese herbal medicine.

Objective : To investigate the role and mechanism of bone formation caused by the ratio of advanced platelet-rich fibrin (A-PRF) and β-tricalcium phosphate (β-TCP) in rabbit femur defect model, which provides a new idea for clinical treatment of bone defect. Methods : Twenty-four New Zealand white rabbits were divided into model group, 1∶1 complex group (A-PRF∶β-TCP=1∶1), 2∶1 complex group (A-PRF∶β- TCP=2∶1) and 4∶1 complex group (A-PRF∶β- TCP=4∶1）, with 6 rabbits in each group. Femoral defect models were constructed in each group. In the composite group, the bone defect was filled with composite material, while in the model group, no material was filled. After 8 weeks, the animals were euthanized and specimens were collected. Bone mineral density (BMD), bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular separation (Tb.SP) and trabecular number (Tb.N) in femoral defect tissue were measured by micro-CT and photographed. Hematoxylin - eosin staining was used to detect the pathological changes of new bone tissue. The morphological changes of the new bone tissue were observed by scanning electron microscopy. Determination of phospho-mitogen activated protein kinase p38 (p-p38MAPK), CCAAT/enhancer binding protein homologous protein (CHOP) and phospho-cysteine aspartic protease-3 (p-Caspase3) in newborn femur by ELISA. The mRNA expressions of osteoprotegerin (OPG), bone morphogenetic protein-2 (BMP-2), receptor activator of nuclear factor kappa-B ligand (RANKL) and p38MAPK were detected by real-time quantitative PCR. The expression of OPG, BMP-2, RANKL, p-p38MAPK and p-Caspase3 protein in the new bone tissue was observed by immunohistochemistry. Results : In the model group, bone formation in the femoral defect area was slow and osteogenic quality was poor. Compared with the model group, the bone formation and neocapillaries of femoral defect area in the complex group was good, BMD, BV.TV, Tb.Th, Tb.N were increased, and Tb.Sp were decreased, the expressions of p-p38MAPK, CHOP and p-Caspase3 were decreased, and the mRNA and protein expressions of OPG and BMP-2 were increased. The mRNA expression of RANKL and p38MAPK was decreased. Apoptosis in new bone tissue of each group showed the lowest apoptosis rate in samples of the 2∶1 complex group (P<0.05); A-PRF: β-TCP=2∶1 ratio has the best osteogenic effect. Conclusion The complex composed of A-PRF and β-TCP can promote the expression of OPG, inhibit the expression of RANKL and phosphorylation of p38MAPK, reduce the apoptosis of new bone tissue cells, and promote osteogenic differentiation.

Objective To analyze the epidemiological features and trends of glenoid fractures from 2003 through 2012 in the Third Affiliated Hospital to Hebei Medical University.Methods The clinical data were collected of the patients with glenoid fracture who had been treated between January 2003 and December 2012 in our hospital.The patients' gender,age and fracture type of Ideberg classification were documented.The data from January 2003 to December 2007 were assigned into group A and those from January 2008 to December 2012 into group B.The 2 groups were compared to find out the general epidemiological characteristics and trends in the recent 10 years.Results A total of 225 patients with glenoid fracture were collected,including 176 males and 49 females.The total male/female ratio was 3.59∶ 1.The glenoid fractures predominated in an age range of 31 to 40 years (23.56％).According to Ideberg classification,there were 35 cases (15.56％) of type Ⅰ,58 ones (25.78％) of type Ⅱ,64 ones (28.44％) of type Ⅲ,21 ones (9.33％) of type Ⅳ,30 ones(13.33％) of type Ⅴ and 17 ones(7.56％) of type Ⅵ.The male/female ratio was 5.29∶1 in group A of 107 patients and 2.69∶1 in group B of 118 patients.The mean age of group A was 40.2 ± 16.0 years and that of group B 47.5 ± 14.8 years.The differences in male/female ratio,mean age and distribution of age were statistically significant between the 2 groups (P ＜ O.05).The fractures predominated in an age range of 31 to 40 years (28.97％) in group A and in the age group of 51 to 60 years (27.12％) in group B.The most frequent fracture type was type Ⅲ in both groups,accounting for 29.91％ and 27.12％ respectively.There was no significant difference between the 2 groups in distribution of Ideberg classification (P ＞ 0.05).Conclusions The peak age of glenoid fractures was from 31 to 40 years.There was an increasing trend in the mean age.There were more male patients than female ones.The high-frequency type was Ideberg type Ⅲ.

Humans ; Charcot-Marie-Tooth Disease/complications* ; Hoarseness/etiology*

Objective:To investigate the clinical effect and short-term and long-term effect of total hip replacement (THA) and hemiarthroplasty of hip (HA) in elderly patients with femoral neck fracture (FNF).Methods:59 elderly patients with FNF in South District of Guang′anmen Hospital, Chinese Academy of Traditional Chinese Medicine from March 2017 to January 2019 were retrospectively analyzed. The observation group ( n=29) was treated with THA; The control group ( n=30) was treated with HA. The operation related indexes, short-term and long-term clinical effect (average follow-up of 24.1 months), hip function improvement, pain and complications were compared between the two groups. Short term and long-term clinical effects: the short-term and long-term clinical effects of the two groups were observed by the Harris Hip Score (HHS) of the first month, the third month, the sixth month, the ninth month and the first year after operation. Results:Both THA and HA were effective on elderly FNF, but the effective rate of THA (96.6%) was significantly higher than that of HA (90.0%), with statistically significant difference ( P<0.05); in terms of operation related indicators, compared with the control group, the observation group had longer operation time [ (104.46±3.24)min vs (84.34±3.64)min], more amount of bleeding [(296.64±15.16)ml vs (281.44±12.16)ml], lower postoperative drainage volume [(101.24±4.15)ml vs (74.56±3.24)ml], while the functional recovery of the observation group was better than the control group by HHS ( P<0.05); the postoperative complications and HHS score of observation group were significantly lower than the control group ( P<0.05). Conclusions:THA has the advantages of low complication, fast functional recovery and better effect. The clinical decision should be based on the patient′s physical condition. THA should be used for elderly patients with good basic condition, good surgical tolerance and more daily activities. HA should be used for elderly patients with poor basic condition, low surgical tolerance and less daily activities.

Objective To compare and analyze the epidemiological features of adult talus fractures between East China and West China from 2010 to 2011.Methods The data of adult talus fractures from January 2010 to December 2011 in 63 hospitals in East China and West China were collected through the PACS system and medical records systems.The data of 35 hospitals in East China were assigned into group A while the data of 28 hospitals in West China into group B.The analytic items included gender,age,and type of AO classification.Results A total of 1,014 cases were collected.In group A of 825 cases,there were 624 (75.64％) males and 201 (24.36％) females;in group B of 189 cases,there were 130 (68.78％)males and 59 (31.22％) females.There was no significant difference between groups A and B in male to female ratio (x2 =3.788,P=0.052).The mean age was 36 years old (26,47) in group A and 35 (24,48) years old in group B,showing no significant difference between the 2 groups (Z =-8.244,P ＜ 0.001).There was a significant difference between the 2 groups in the constituent ratio of age ranges (P ＜ 0.05).The peak age range was from 21 to 30 years old in group A (27.76％,229/825),and from 31 to 40 years old in group B (24.34％,46/189).The high-risk type of fracture was AO type 81-A in both groups.Conclusions There were more male talus fractures than female ones in both East China and West China.Most talus fractures happened in patients aged from 21 to 30 years in East China and in patients aged from 31 to 40 years in West China.AO Type 81-A was the most common in both West and East China.

Objective To compare the epidemiological characteristics of glenoid fractures between the east and west areas in China from 2010 through 2011.Methods The data of glenoid fractures treated between January 2010 and December 2011 at 35 east hospitals and 28 west ones in China were analyzed retrospectively.The patients' gender,age and type of Ideberg classification were documented.The data from the 35 east hospitals were classified as group A while those from the 28 west ones as group B.Comparisons were made to find out the general epidemiological characteristics.Results A total of 347 glenoid fractures were collected.The total male/female ratio was 2.69∶ 1.The glenoid fractures predominated in 2 age ranges from 41 to 50 years and from 51 to 60 years (19.60％).According to the Ideberg classification,there were 75 cases (21.61％) of type Ⅰ,152 ones (43.80％) of type Ⅱ,27 ones (7.78％) of type Ⅲ,20 ones (5.76％) of type Ⅳ,46 ones (13.26％) of type Ⅴ and 27 ones (7.78％) of type Ⅵ.The male/female ratio was 2.80∶1 in group A of 228 patients and 2.50∶1 in group B of 119 patients.The median age of group A was 47 years old and that of group B 44 years old.The differences were not statistically significant in male/female ratio,median age or distribution of age between the 2 groups (P ＞ 0.05).The fractures predominated in the age range from 51 to 60 years old (23.68％) in group A and in the age range from 31 to 40 years old (21.85％) in group B.The most frequent fracture type was type Ⅱin both groups,accounting for 41.23％ and 48.74％ respectively.There was a significant difference between the 2 groups in distribution of Ideberg classification (P ＜ 0.05).Conclusions The peak age of glenoid fractures was from 41 to 60 years,the high-risk type was Ideberg type Ⅱ and there were more male patients than female ones.The proportion of Ideberg type Ⅴ in the east area was higher than that in the west area.