Objective:To investigate the clinical effects of arthroscopic debridement combined with intra-articular injection of sodi-um hyaluronate in the treatment of knee osteoarthritis. Methods:One hundred and seventy-two cases with knee osteoarthritis were ran-domly divided into the treatment group and the control group. The control group received arthroscopic debridement, while the treatment group received intra-articular injection of 2. 5ml sodium hyaluronate after arthroscopic debridement. Lequence score, Lysholm score and visual analogue scale for pain were compared between the two groups before the treatment and after the 1-week and 3-month treatment, and the clinical effects were compared after the 3-month treatment as well. Results: Lequence score, Lysholm score and visual ana-logue pain scores after the treatment were lower than those before the treatment with significant differences (P <0.01) in the two groups. After the treatment,Lequence score, Lysholm score and visual analogue pain scores of the treatment group was lower than those of the control group with significant differences (P<0. 05 or 0. 01). After the 3-month treatment,the clinical efficacy of the treatment group was better than that of the control group (P<0. 05). Conclusion:Arthroscopic debridement combined with intra-articular injec-tion of sodium hyaluronate in the treatment of knee osteoarthritis has better efficacy than arthroscopic debridement alone. The combina-tion can effectively improve symptoms, which is worthy of clinical promotion.

Objective To evaluate the effects of the treatment for femoral neck fractures with closed reduction and cannulated screw fixation.Methods The results of stabilization of the femoral neck fracture with cannulated screws in 62 patients(25 male,37 female)from 2001to 2008 were reviewed retrospectively.The mean age of the patients was 68.6 years old.Results 55 patients(88.7%)had cured,30 patients were been cured,25 patients were been good healthy ,7patients were not cured.The duration of follow up was 8-62 months in 62 patients.Conclusion Closed reduction and internal fixation with cannulated screw is an effective method of minimally invasive,safety and inexpensive for femoral neck fractures.

Objective To study the risk factors for pathological upgrading after diagnosis of esophageal low?grade intra?epithelial neoplasia with ESD preoperative biopsy. Methods The endoscopic and pathological data of 85 lesions with ESD preoperative biopsy were analyzed, and grouped based on pathological upgrading after ESD. The risk factors for pathological upgrading after ESD was studied through single and multiple factor analysis. Results Pathological upgrading occurred in 45(52?94%) lesions after ESD, among whom 38 lesions developed up to high?grade intra?epithelial neoplasia and 7 lesions developed to esophageal early cancer. NBI?ME was performed on 37 patients and the accuracy of detecting the pathological invasion was 83?8%(31/37).Multi?factor analysis showed that reddish surface(OR=9?478, 95%CI:2?775?32?368, P = 0?000 3 ) and nodular lesion ( OR = 15?628, 95%CI:1?475?165?617, P =0?022 5) were independent factors for pathological upgrading after ESD. Conclusion Pathological upgrading of low?grade intra?epithelial neoplasia was common, especially esophageal mucosa with red surface and nodular lesion.Biopsy combined with NBI?ME is of significant importance to improve diagnostic accuracy.

Objective To identify the risk factors for positive resection residues after endoscopic submucosal dissection ( ESD ) of early esophageal squamous carcinomas and precancerous lesions. Methods A retrospective analysis was performed in 315 patients with early esophageal squamous cancer and precancerous lesion who underwent ESD. The pathological features of all resection margins in the specimen and the follow?up outcome of the patients with positive resection margin were evaluated. Univariate and multi?variate analysis were used to determine the risk factors for resection margin residues after ESD. Results In 315 lesions,there were 290 lesions with negative resection margins and 25 with positive resection margins.The number of lesions with positive lateral, basal, or both resection margins was 13, 8, and 4, respectively. Multivariate analysis showed that the depth of invasion( submucosal layer invasion, P=0?048) was the only independent risk factor for positive basal resection margin. The proportion of circumferential extension (≥3/4,P=0?014) and the depth of invasion( exceeding muscularis mucosa, P=0?007) were independent risk factors for positive lateral resection margin. Conclusion The diameter of the lesions and the depth of tumor invasion are independent risk factors for esophageal ESD positive resection margins. Accurate evaluation of lesion extension and invasive depth is critical to avoid residual or recurrent tumor after esophageal ESD.

The cancer-associated systemic inflammatory response is one of the critical indicators of tumor progression. Serum systemic inflammatory markers, such as neutrophil-lymphocyte ratio, lymphocyte-monocyte ratio, systemic inflammation score, Glasgow prognostic score, prognostic nutritional index, C-reactive protein-albumin ratio, lymphocyte-C-reactive protein ratio, platelet-lymphocyte ratio, are associated with the prognosis of colorectal cancer (CRC) . Further research of the prognostic value of inflammatory marks in CRC can provide help for the prognosis of CRC.

Objective To investigate the clinicopathologic characteristics and relevance of main and minor lesions of synchronous multiple early gastric cancers ( SMEGC) and gastric high grade intraepithelial neoplasia ( GHGIN) . Methods Thirty-two patients with SMEGC or/and GHGIN who were diagnosed and treated with endoscopic submucosal dissection in Nanjing Drum Tower Hospital from July 2012 to September 2016 were enrolled in this study. Their clinicopathologic characteristics were summed up, and the correlation between main and minor lesions on the size, location, endoscopic classification, pathologic type, invasion depth and vascular invasion were analyzed. Results Among the 32 patients, with mean age of 66. 19±7. 46 years, 90. 62％(29/32) were male, 17 cases (53. 3％) had family history of gastric cancer, 25 (78. 13％) had smoking history, and 22 ( 68. 75％) were alcohol users. There were 30 cases ( 93. 75％) and 31 cases ( 96. 88％) with mucosal atrophy and intestinal metaplasia, respectively. The size of main and minor lesions showed a positive correlation (r=0. 4167, P=0. 018). The endoscopic classification of major and minor lesions had no statistical significant consistency ( P=0. 314 ) , but the pathologic type and invasion depth between major and minor lesions demonstrated a moderate significant positive correlation ( P<0. 05 ) . The comparison of location between the main and minor lesions did not show correlation. However, it showed a significant correlation between major lesion which on the upper 1/3 of stomach and minor lesion on the lower 1/3 of stomach ( r=0. 463,P=0. 003) . Further more, when the main lesion was at posterior gastric wall, the minor lesions on lesser curvature were increased, which showed a positive correlation( r=0. 417,P=0. 009) . Conclusion Old-age male with long-term smoking and alcohol history whose lesions combined with surrounding mucosa merger atrophy and intestinal metaplasia are considered as a high risk group in patients with SMEGC or/and GHGIN. Therefore, clinicians must keep high vigilant and make carefully observations on this group of patients during endoscopic examination, and consider the correlation between main and minor lesions to avoid misdiagnosis.

Objective To assess the clinical effects of simethicone emulsion combined with polyethylene glycol on bowel preparation for colonoscopy. Methods Two hundred out-patients, who underwent colonoscopy,were randomly divided into the study group and the control group. The study group was given simethicone in addition with polyethylene glycol, and the control group was given polyethylene glycol only. The differences on bowel preparation scores, air bubble reduction rate, colon lens sharpness, ileocecal region arrival time, colon polyp detection rate, the number of colon poly detection, and adverse event rate between the two groups were compared. Results The air bubble reduction rate, colon lens sharpness score and ileocecal region arrival time of the study group was 1(0-3)score,1.0(0-2)score,and 9(5-21)min,respectively,which was 2(1-3)score,1.5(0-2)score and 12(6-22)min, respectively in the control group. Differences between the two groups were statistically significant(Z=-9.490,P=0.000;Z=-6.768,P=0.000;Z=-5.521,P=0.000). For the bowel preparation score, colonoscopy polyp detection rate,the detection rate of colon polyp of diameter less than 5 mm, and number of colonoscopy polyp detection,there was no statistical difference between the two groups(P>0.05). No adverse events were observed in the both two groups. Conclusion The bowel preparation using simethicone combined with polyethylene glycol could effectively decrease the number of air bubble, enhance colon lens sharpness and shorten operation time,which contributes significant improvement for colonoscopy quality.

Objective: To construct and determine the weight of Index System for Assessing Parent s Ability on Child Injury Prevention, and to provide the basis for childhood injury intervention in family. Methods: Twenty four experts majored in related fields were invited to participate in Delphi consultation. The final index system was constructed according to the consulting results and the weight of primary and secondary indicators were calculated. Results: The final index system consisted of 5 subscales corresponding to 5 age groups: 0,1-2,3-5,6-11 and 12-17 years old. Each scale included 4 primary indicators and 11 secondary indicators. The weight of primary indicators obtained by analytic hierarchy process is 0.28 for "environment", 0.16 for "product", 0.31 for "behaviors and skills", and 0.25 for "psychology". The highest weight of secondary indicators for "environment", "product" and "behaviors and skills" was "water area", while the top secondary indicators for "psychology" included "parental style""emotional control" "family atmosphere", with all indicators weighted higher than 0.2. Conclusion The Index System for Assessing Parent s Ability on Child Injury Prevention by Delphi consultation is comprehensive in content, and with the focus on parental behaviors and skills on injury prevention.

Objective:To evaluate the influence on the results and safety of double-balloon enteroscopy (DBE) at different combination time.Methods:Patients who received combined DBE procedures in Nanjing Drum Tower Hospital from April 2019 to August 2020 were divided into the one-day combination group and the non-one-day combination group. The complete enteroscopy rate, time of anterograde approach, time of retrograde approach, total time of combined approach, adverse events, hospital stay and cost were compared.Results:Among 119 patients who received DBE, 23 patients were excluded due to small intestinal stenosis. The complete enteroscopy rate was 92.9% (39/42) in the one-day group and 74.1% (40/54) in the non-one-day group, showing significant difference ( χ2=4.390, P=0.036). There were significant differences in the time of retrograde approach (35.59±23.29 min VS 55.10±19.04 min, t=-4.080, P<0.001), total time of combined approach (89.10±27.82 min VS 114.20±24.55 min, t=-4.254, P<0.001), hospital stay (9.24±3.76 d VS 11.76±4.41 d, t=-2.599, P=0.011) between the two groups. There were no significant differences in the time of anterograde approach, hospital cost or adverse events between the two groups. Conclusion:Combined DBE on one day yields a higher complete enteroscopy rate, less examination time and less hospital stay, which is worth of clinical application.

Objective: To investigate child injury prevention practice and associated factors among parents of primary school students. Methods: Parents of 2 577 students were selected from three primary schools in three administrative regions of Shanghai by multi stage sampling method between May and June in 2021. Questionnaire survey was administered to parents based on the Index System for Assessing Parent s Ability on Child Injury Prevention, which was developed previously by the present research group. Results were converted into standardized scores for descriptive analysis, and the original scores were analyzed by multiple linear regression model. Results: The standardized scores of parents on environment safety, product safety, behaviors and skills and psychological safety were (0.91±0.08)(0.93±0.08)(0.97±0.04)(0.95±0.05), respectively. The standardized score of general ability was (0.95±0.04). The standardized scores on knowledge, attitude and practice of injury prevention were (0.99±0.03)( 0.97± 0.05)(0.89±0.10), respectively. Mothers performances were generally better than fathers . Parents with higher education performed better than those with lower education. Parents with "being a parent" in mind performed better on child injury prevention. Conclusion There is a gap between practice with the knowledge as well as attitude towards child injury prevention among parents of primary school students. Parenting role, educational background and parental awareness of the importance of parental role are primary factors that affect child injury prevention practice.