[Objective]To investigate Y-shaped osteotomy and the internal fixation with geese-head steel plates for treatment of congenital coxa vara.[Method]Lesser subtrochanteric and greater laterotrochanteric osteotomy were performed for 7 cases(9 hips)of congenital coxa vara with the Y-shaped osteotomy line.The distal femoral section met the lateral greater trochanteric section,fixed with geese-head steel plates.[Result]The cases were followed up for 1~5 years(averaged 3.6 years).According to Shi Yingqi's evaluation,4 hips were excellent,4 good and 1 fair.[Conclusion]The Y-shaped osteotomy and internal fixation with geese-head steel plates can improve the abnormal structure of upper femur,increase the real length of the affected limb.Therefore,it is an ideal effective method for treatment of congenital coxa vara.

Objective To explore the clinical effect of Zishen Yutai pill combined with beimiheparin sodium in the treatment of recurrent spontaneous abortion(RSA)of kidney deficiency and blood stasis type.Methods A total of 98 RSA patients with kidney deficiency and blood stasis type admitted to Jiangxi Maternal and Child Health Hospital from January 2021 to June 2023 were randomly divided into observation group and control group,49 cases in each group.The patients of control group were treated with beimiheparin sodium,while the patients of observation group were treated with Zishen Yutai pill.Compare the clinical efficacy,traditional Chinese medicine syndrome score,sex hormone levels,uterine artery blood flow parameters,fetal protection status,and adverse reactions between two groups.Results After treatment,the total effective rate of observation group was higher than that of control group(P＜0.05);Observation group had lower rates of repeated pregnancies,falls,lumbosacral pain,vaginal bleeding,and knee soreness and softness scores than control group(P＜0.05);The levels of progesterone,human chorionic gonadotropin,and estradiol in observation group were higher than those in control group(P＜0.05);The uterine artery resistance index,systolic and diastolic flow velocity ratio,and pulse index in observation group were lower than those in control group(P＜0.05);The success rate and live birth rate of observation group were higher than those of control group(P＜0.05);There was no statistically significant difference in the adverse reactions between two groups of patients(P＞0.05).Conclusion The combination of Zishen Yutai pill and beimiheparin sodium can improve the therapeutic effect of RSA patients,improve their sex hormone levels,facilitate fetal preservation,and increase the final live birth rate.

OBJECTIVETo observe the efficacy of acupoint pressure therapy on relieving labor pain in primiparas.

METHODSOne hundred and twenty primiparas were randomized into an observation group (60 cases) and a control group (60 cases). In the observation group, Hegu (LI 4), Sanyinjiao (SP 6), Taichong (LR 3), Neiguan (PC 6), Ciliao (BL 32) and Zhongliao (BL 33) on bilateral sides were selected. The acupoint pressure therapy was applied when the uterine orifice was dilated to 2 to 3 cm. In the control group, the acupoint pressure therapy was not used. Separately, when the orifice was dilated as 2 to 3 cm, 5 to 6 cm, 7 to 8 cm and 9 to 10 cm, the pain response grade was assessed (including physician's analgesia score and patient's self-evaluation score of analge-sia). The in labor pain was observed and compared in the puerperas between the two groups. The time of the first, second and third stages of labor, the time of total stage of labor as well as the cesarean section rate were compared in the puerperas between the two groups.

RESULTS(1) Analgesic effect:when the uterine orifice was dilated as 2 to 3 cm, 5 to 6 cm, 7 to 8 cm and 9 to 10 cm, the self-evaluation scores of analgesia in the puerperas of the observation group at each time point were all apparently lower than those in the control groups (all<0.05). In the observation group, for the physician's analgesia score, 213 person-times presented analgesic effect and 18 person-times no effect. In the control group, 178 person-times presented analgesic effect and 44 person-times no effect. The analgesic effect in the observation group was better than that in the control group (<0.05). (2) Stages of labor:the differences in the second and third stages of labor were not significant statistically between the two groups (both>0.05). The time of the first stage of labor and the time of the total stages of labor in the observation group were shorter appa-rently than those in the control group[(8.07±2.08)h vs (9.58±2.79)h, (8.91±2.80)h vs (10.51±2.83)h, both<0.05]. (3) Cesarean section rate:the cesarean section rate in the observation group was lower than that in the control group[5.0% (3/60) vs 10.0% (6/60),>0.05].

CONCLUSIONSAcupoint pressure therapy has definite efficacy on relieving labor pain. It shortens the stages of labor and cesarean section rate.

OBJ ECTIVE To study the effect a nd mechanism of modified Yijing decoction on the decrease of ovarian reserve function（DOR）in rats. METHODS A total of 140 SPF female SD rats were randomly divided into control group ，model group ， positive control group （Estradiol valerate tablets 0.09 mg/kg），inhibitor group [modified Yijing decoction 23.6 g/kg+transcriptional inhibitor for hypoxia inducible factor- 1α（HIF-1α）YC-1 2 mg/kg] and modified Yijing decoction low-dose ，medium-dose and high-dose groups （5.9，11.8，23.6 g/kg）. Except for control group ，rats in other groups were given cyclophosphamide via femoral vein to induce DOR model ；after successful modeling for 2 h，rats in each group were given normal saline or relevant medicine intragastrically，once a day ，for 8 consecutive weeks.The estrous cycle of rats in each group was recorded ，and the ovarian index was calculated to observe the histopathological changes and autophagy in the ovary ；serum levels of follicle stimulating hormone （FSH），luteinizing hormone （LH），anti-Müllerian hormone （AMH）and estrogen （E2）were measured ；protein and mRNA levels of HIF-1α，B lymphoblastoma 2 gene/adenovirus E 1B interacting protein 3 recombinant protein （Bnip3）and yeast Atg 6 homolog of autophagy key molecule （Beclin1）in ovarian tissues of rats were all detected. RESULTS Compared with control group ，the ovarian indexes of model group and administration groups were decreased significantly （P＜0.05）. Model group possessed disturbed estrous cycle and the ovary tissues showed pathological morphology ，the autophagolysosomes appeared in ovary cells ，AMH and E 2 levels were significantly decreased （P＜0.05）；FSH and LH levels ，protein and mRNA expressions of HIF- 1α，Bnip3 and Beclin 1 were significantly increased （P＜0.05）. Compared with model group ，the estrous cycle of rats in positive control group and modified Yijing decoction groups gradually returned to normal ，the pat hological morphology of ovarian tissue and the autophagy of ovarian cells were improved ；the ovarian index ，AMH and E 2 levels were significantly increased （P＜0.05）；the levels of FSH and LH ，protein and mRNA expressions of HIF- 1 α ， Bnip3 and Beclin 1（except for protein of HIF- 1α，protein and wanyunhui188@163.com mRNA of Bnip 3 in modified Yijing decoction low-dose group ） were decreased significantly （P＜0.05）. The protein expressions of H IF-1α，Bnip3 and Beclin 1，mRNA expressions of HIF- 1α and Beclin 1 were decreased significantly in the inhibitor group （P＜0.05）. CONCLUSIONS Modified Yijing decoction can improve ovarian function ，regulate the secretion of sex hormone ，and protect ovarian tissue in DOR model rats ，and the mechanism of which may be related to the inhibition of HIF- 1α/ Bnip3/Beclin1 pathway.

AIM: To study the perception of first-order grating acuity and second-order spatial contrast sensitivity in patients with monocular anisometropia amblyopia.METHODS:A total of 715 children(715 eyes)diagnosed as monocular anisometropia amblyopia in our hospital from January 2018 to December 2022 were collected as amblyopia group, and 745 children(745 eyes)with normal corrected visual acuity were collected. The best corrected visual acuity(BCVA), first-order grating acuity and/or second-order spatial contrast sensitivity were measured, repectively. The perception ability of amblyopia patients to first-order grating acuity and second-order spatial contrast sensitivity were analyzed.RESULTS:There were significant differences between amblyopia group and normal control group in the perception of first-order grating acuity(11.58±6.10 vs. 20.27±3.47, P<0.001)and second-order spatial contrast sensitivity(0.33±0.16 vs 0.12±0.04, P<0.001). And there were significant differences between mild-to-moderate amblyopia and severe amblyopia patients in first-order grating acuity(12.10±6.23 vs. 8.13±3.70, P<0.001)and second-order spatial contrast sensitivity(0.32±0.16 vs. 0.37±0.17, P<0.05).CONCLUSION: The first-order and second-order visual pathway of the cerebral cortex in children with monocular anisometropia amblyopia have different degrees of damage. The injury of severe amblyopia is more serious than that of mild-to-moderate amblyopia.

ObjectiveTo analyze the epidemiological characteristics of senile dementia death in Jing’an District from 2016 to 2020， as well as the trends of mortality， standardized mortality， years of life lost （YLL） due to early death， years lived with disability （YLD）， and disability-adjusted life year （DALY）， and to provide scientific basis for the prevention and control of senile dementia. MethodsThe distribution of senile dementia in terms of gender， age， marital status and education level was investigated in the senile dementia death cases from 2016 to 2020 in Jing’an District. The YLL， YLD， DALY and their rates of the residents of Jing’an District from 2016 to 2020 were calculated by using Global Burden of Disease （GBD 2019） research method and results in combination with the corresponding population data. ResultsCompared to those without dementia， deaths with dementia were more likely to be female， more likely to be over 80 years old， less likely to be married， and more likely to have education level under middle school. Among the deaths with dementia， only 27.70% of the primary cause of death was dementia， and the other main causes were cerebrovascular disease， coronary heart disease and diabetes mellitus， which accounted for 25.54%， 17.81% and 7.28%， respectively. There was a significant gender difference in the burden of disease on senile dementia in Jing’an District. Mortality， standardized mortality， YLL， YLD and DALY rates of females were higher than those of males. The burden of disease on senile dementia increased with age. The change trend of mortality and YLL rate from 2016 to 2020 was not statistically significant， while the YLD rate and DALY rate showed an upward trend， which was statistically significant. ConclusionAs the life span of residents in Jing’an District increases and the population aging deepens， the burden of disease on senile dementia is still heavy. This requires extensive attention of the whole society， and active exploration of prevention and control strategies and measures for senile dementia， so as to improve the life quality of patients and reduce the burden of disease.

OBJECTIVE：To study the effects of Calpeptin inhibitor Calpeptin on the transformation and stemness markers expression induced by estradiol（E2），and to investigate its mechanism. METHODS ：Taking human mammary epithelial cells MCF-10A as research object ，transformed cells were induced by E 2 treatment. Cells were divided into control group （0.1％DMSO）， E2-transformed group （50 nmol/L），E2-transformed+Calpeptin group （50 nmol/L E 2+1 μmol/L Calpeptin），then continuously treated with corresponding drug-containing culture medium for 15 generations. Then ，MTT assay was used to determine the proliferation rate of cells （24，48 h）；plate colony test was used to detect the Clone formation rate of cells ；the number of sphere-forming cells was measured by suspension spheroidization test ；mRNA expressions of stemness marker （CD44，Nanog，OCT4）and extracellular sigal-regulated kinase （ERK）were detected by RT-qPCR ，and protein expressions of CD 44，Nanog，OCT4 ，ERK and p-ERK were detected by Western blotting assay. Another E 2-transformed cells were divided into control group （0.1％DMSO）and U0126 （ERK inhibitor ）group（10 μmol/L）. Clone formation rate ，the number of sphere-forming ，protein expressions of CD 44，Nanog， OCT4，ERK and p-ERK were determined with above methods ，and to validate the relationship of ERK inhibition with transformed cell behavior and the expression of stemness markers. RESULTS ：Compared with control group ，proliferation rate and clone formation rate of E 2 transformed group were increased significantly （P＜0.01），and the number of sphere-forming was increased significantly（P＜0.01）；mRNA expression levels of CD 44，Nanog，OCT4，ERK and protein expression levels of CD 44，Nanog， OCT4 and p-ERK in cells were increased significantly （P＜0.01）. Compared with E 2-transformed group ，proliferation rate （24，48 h）and clone formation rate of E 2-transformed + Calpeptin group were decreased significantly （P＜0.01），and the number of sphere-forming was decreased significantly （P＜0.05）；mRNA expression levels of CD 44，Nanog，OCT4 ，ERK and protein expression levels of CD 44，Nanog，OCT4，p-ERK in cells were decreased significantly （P＜0.05 or P＜0.01）. After treated with ERK inhibitor U 0126，clone formation rate of E 2-transformed cells ，the number of sphere-forming ，protein expression levels of CD44，Nanog，OCT4 and p-ERK were increased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ：Calpeptin can inhibit the transformation and the expression of stemness markers of human mammary epithelial cells MCF- 10A，and the mechanism of it may be associated with inhibiting the activation of Calpain-ERK signaling pathway.

Background Diabetes mellitus is a major public health issue at present. Previous studies have shown that ambient air pollution is a risk factor for diabetes. Objective This study aims to explore the acute effects of ambient air pollution on diabetes related death in Shanghai Jing’an District. Methods Daily air pollution data, meteorological data, and diabetes related mortality data in 2013−2019 in Shanghai Jing’an District were collected. A generalized additive model (GAM) was established to conduct time-series analysis on the short-term effect of ambient air pollution on diabetes related mortality, and gender- and age-stratified analysis on susceptibility of various groups to ambient air pollution exposures. Results For every 10 μg·m⁻³ increase of the concentrations of PM_2.5, PM₁₀, SO₂, and NO₂, the diabetes related mortality increased by 2.47% (95%CI: 1.56%−3.38%), 2.02% (95%CI: 1.29%−2.75%), 5.75% (95%CI: 2.99%−8.58%), and 3.93% (95%CI: 2.49%−5.39%) at lag05 respectively (P<0.05). In the stratified analysis, exposures to increased concentrations of PM_2.5, PM₁₀, SO₂, and NO₂ raised the mortality risks from diabetes in male, female, and ≥65 years oldgroups (P<0.05). However, the differences in mortality risks from diabetes due to air pollution within gender and age groups were statistically insignificant. Conclusion In Shanghai Jing'an District, the elevated levels of ambient air pollutants, including PM_2.5, PM₁₀, SO₂, and NO₂, are significantly associated with the increase of diabetes related mortality, and there are lag effects and cumulative effects. The ≥65 years olds are more susceptible to the impact of air pollution on diabetes related deaths.