Objective To discuss the outcomes of repaired supraptellar bursa for preventing knee joint stiff in condylar comminuted fracture of femer after operation.Methods 25 patients with condylar comminuted fracture of femer were repaired supraptellar bursa after internal fixation.And 16 supraptellar bursa were sutured directly,9 supraptellar bursa were repaired with fat-fascia petal.All the patients were followed up for 6 to 18 months to evaluate the function of knee joints.Results The function of knee joint were evaluated according to merchan system after operation,19 patients were excellent,6 patients were good.Conclusion Repaired supraptellar bursa for preventing knee joint stiff in condylar comminuted fracture of femer after operation is an effective method.

Objective To investigate the prevalence, clinical features and complications of gastrointestinal diverticula in Chinese people. Methods 551 patients with gastrointestinal diverticula were analyzed retrospectively. Results Among the 551 patients, 58.6% were over 60 years, and 11.6% were below 40 years. The incidence of esophageal diverticula, gastric diverticula, duodenal diverticula, jejunoileal diverticula and diverticula of the large intestine was 2.5%, 1.8%, 71.7% , 12.7% and 11.3% respectively. There were 6 and 11 patients, 9 and 6 patients, 69 and 271 patients, 1 and 24 patients, and 21 and 33 patients who were diagnosed by endoscopy and double contrast barium examination respectively. Among the 14 esophageal diverticula patients, the incidence of midesophageal diverticula (78.6%) was higher than that in pharyngoesophageal diverticula (11.2%). Among the 62 diverticula of the large intestine patients, the incidence of right side diverticula (56.5%) was higher than that of left side diverticula (38.7%). Almost esophageal diverticula and gastric diverticula were asymptomatic, while about half of the diverticula of the small and large intestine was symptomatic. The incidence of cholelithiasis and pancreatitis in patients with duodenal diverticula was 34.2% and 10.1% respectively. And the incidence of cholelithiasis and pancreatitis in descending segment was significantly higher than that in non descending segment ( P

Objective To investigate the prevalence,incidence,death causes and natural course of nonalcoholic fatty liver disease (NAFLD) as well as the risk factors of NAFLD development in population of Guangdong province.Methods On the basis of previous epidemiological survey in 2005,3545 subjects were followed up (medium 4 years) for death causes.Of which,624 subjects (re-survey group) received interview,physical examinations,biochemical tests and ultrasonography again.The natural course and the risk factors of the NAFLD were analyzed.Results Of 3543 subjects,219subjects were failed to followed up and 4 out of 467 NAFLD patients (8.6‰) died of cardiovascular and cerebrovascular diseases during follow-up period.In rest 2857 subjects,22 (7.7‰) died of cardiovascular/cerebrovascular diseases and cancers.However,there were 117 NAFLD patients in resurvey group at the baseline.The NAFLD remained in 51 (43.6%) patients,aggravated in 26 (22.2%),alleviated in 21 (18.0%) and regressed in 19 (16.2%) at the endpoint.Meanwhile 185(36.5 %) out of 507 normal subjects developed NAFLD at the endpoint.The standard prevalence of NAFLD increased from 10.5% (2005) to 22.6% (2009,P<0.05).The standard incidence was 4.9% per year with male (5.1%) being higher than female (4.7%,P<0.05).The cumulative incidence was significantly higher in urban cities (43.1%) than in rural areas (27.4%,P<0.05).Cox proportional hazards regression showed that the age (OR= 1.893),waist circumference (OR=2.512),waist-to-hip ratio (WHR,OR= 1.400),body mass index (BMI,OR=2.581) and serum cholesterol levels (OR = 1.587) were associated with the development of NAFLD (P < 0.05).Multivariate regression logistic analysis revealed that age and BMI were associated factors for NAFLD.Decreased waist circumference was prone to remission.Conclusions The higher prevalence and incidence of NAFLD were noted in population of Guangdong province.The NAFLD patients mainly died of cardiovascular/cerebrovascular diseases,but not liver disease.Obesity,aging and dyslipidemia are high risk factors for NAFLD development.

Objective To investigate the relationship between the genetic polymorphisms, which played roles in the pathogenesis of metabolic syndrome (MS), and susceptibility of non-alcoholic fatty liver disease (NAFLD) in Han people in Guangdong province. Methods The subjects were selected from an epidemiologie survey in Guangdong province. Fifty to 117 adult NAFLD patients, who met the criteria of Chinese guideline for diagnosis of NAFLD and had typically clinical, biochemical signs and abdominal ultrasonography, were recruited in the study. By using 1 : 1 matched method of nested case-control study, same numbers of people without NAFLD were included as controls. The genetic analyses was performed by using genomic DNA extracted from peripheral blood. Polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) was applied to detect the single nucleotide polymorphisms (SNPs) at 9 sites in 7 candidate genes. Results Most SNPs of the genes were related to the susceptibility of NAFLD. Some of them had positive relation (increasing the risk) such as tumor necrosis factor (TNF)-α-238, adiponectin-45, leptin-2548, peroxisome proliferator-activated receptors (PPAR) γ-161 and phosphatidylethanolamine N-methyltransferase (PEMT)-175. Some had negative relation (decreasing the risk) including adiponectin-276 and hepatic lipase-514. And some had no relation (TNF-α-380 and PPAR g coactivator-1α-482). Conclusion Most cytokines' SNPs of candidate genes discovered in MS patients are related to the susceptibility of NAFLD.

Parkinson′s disease is a degenerative disease, in which cognitive impairment is main non-motor symptom. It can develop to dementia and seriously affect the quality of life and life expectancy of patients. Therefore, a correct understanding of the etiology and mechanism of cognitive impairment in Parkinson′s disease is helpful for the disease diagnosis and treatment. In recent years, the correlation between vascular factors and the development of Parkinson′s disease has become a research hot topic. This article reviewed the research progress of the correlation between vascular related factors and cognitive impairment in Parkinson′s disease.

Objective:To perform principal component analysis on the status quo of nurses' research ability, and explore the status quo of their relevant research needs.Methods:In this cross-sectional study, totally 588 clinical nurses working in a children's hospital in Hunan Province from July to December 2019 were selected by stratified random sampling and investigated with the self-designed questionnaire. The survey content included three parts: the first part was general information; the second part was the survey of the status quo of nurses' research ability; the third part was the survey of the status quo of nurses' research needs. A total of 588 questionnaires were distributed, and 577 questionnaires were collected, accounting for an effective recovery rate of 98.13%.Results:The three items with the higher scores in the survey of research ability status were frequently search for professional materials through the Internet (3.255±0.491) scores, able to perform statistical description (2.931±0.572) scores and able to use Chinese database (2.894±0.429) scores. The three items with the higher need for research ability were project application 80.94% (467/577) , paper writing 76.95% (444/577) and special lecture 71.92% (415/577) , whereas the three items with the lower need for research ability were continuing learning 46.10% (266/577) , retrieving documents 40.90% (236/577) and group symposium 38.30% (211/577) .Conclusions:Nursing staff has relatively good ability in information retrieval and basic statistics, but relatively poor ability in paper writing. The research ability of nurses can be summarized as statistical analysis ability, information retrieval/document reading ability, research topic selection ability and paper writing ability. Attention should be paid to whether there are high research needs in the weak links of research ability, and nursing research guidance and education should be provided purposively.

Alzheimer′s disease (AD) is the most common neurodegenerative disease. Its etiology and pathogenesis remain unclear. Since its inception, the amyloid-β (Aβ) cascade hypothesis has dominated the field of AD research and has provided the intellectual framework for disease-modifying therapies. Nowadays, many Aβ-targeted therapies have been accelerated approval or received Food and Drug Administration′s breakthrough therapy designation which offers a new dawn for disease-modifying treating AD. This article reviews the research progress of clinical trials of Aβ-targeting modification therapies, and summarizes the lessons learned from the clinical failure with several classes of anti-Aβ drugs. Although many challenges remain, anti-Aβ therapies have become a promising treatment strategy for AD.

Objective To summarize the characteristic of muscle MRI of lower limbs in patients with GNE myopathy and to explore the correlation between the fatty degenerative score of muscle MRI and clinical phenotype.Methods This was a prospective study. Seventeen patients with genetically confirmed GNE myopathy,having lower limb muscle MRI test and completed clinical and laboratory data.The degree of fatty degeneration in 18 muscles of lower limbs in each patient was grading.According to the GM-W score, these patients were divided into two groups.GM-W score≤3 were divided into mild group(n=8)and GM-W score≥ 4 were divided into severe group(n=9). Kruskal-Wallis test was used to compare the fatty degenerative score in different muscles of the thigh and the calf level;Mann-Whitney U test was used to compare score of the same muscle between mild and severe group;Spearman rank correlation test was used to analysis the relationship between fatty degenerative score and the course of disease (year), GM-W score, creatinine kinase (IU/L), respectively.Results At the thigh level, the most severely involved muscle of GNE myopathy was semi-tendinosusand adductor, followed by semi-membranous, biceps femoris and gracilis. There was no statistically significant difference in the fatty degenerative score of the above-mentioned muscles (P=0.058). At the calf level, the most severely involved muscle was medial of soleus which score was 4.0(3.0, 4.0), followed by tibialis anterior,extensor digitorum longus and lateral of soleus. There was no significant difference of the above (P=0.259).The fatty degenerative score showed difference between the mild and severe group at sartorius and adductor(P<0.05).At the calf level,the fatty degenerative score in peroneus longus, medial of soleus, lateral of soleus, medial of gastrocnemius and lateral of gastrocnemius showed difference between groups(P<0.05).The total score of fatty degenerative of Lower limb muscles was positively correlated with GM-W score(r=0.730, P<0.05). There were positive correlations between the score of fatty degenerative of the sartorius,peroneal longus,lateral of soleus,medial of gastrocnemius, lateral of gastrocnemius and the GM-W scores( r=0.630,0.845,0.569,0.591,0.640, 0.659,P<0.05).The total score of fatty degenerative of Lower limb muscles was not correlated with the level of creatine kinase(P=0.582), course of disease(P=0.601) and age of onset(P=0.850). Conclusions GNE myopathy in the thigh level within the adductor muscle and posterior muscle involvement, calf level to the tibial anterior muscle early involvement. The total score of fatty degenerative of lower limb muscles is positively correlated with GM-W score,but not correlated with the level of creatine kinase,course of disease and age of onset.

Septic shock is one of the leading causes of death in children，especially infants，both domestically and internationally.Research has found that patients with septic shock often have abnormal thyroid function，which affects their prognosis.This article reviewed the changes in thyroid hormone and thyroid-stimulating hormone levels，the reasons for these changes，and the mechanisms by which thyroid function affects the immune system in patients with septic shock,aiming to provide new ideas for clinical treatment.

Objective:To investigate the neuropsychological and imaging features of patients with posterior cortical atrophy (PCA).Methods:Patients of PCA, dementia with Lewy bodies (DLB), typical Alzheimer′s disease (t-AD) who were diagnosed in the Department of Neurology, Huashan Hospital, Fudan University from September 27, 2019, to September 24, 2021 were enrolled, and the normal controls who visited the Outpatient and Physical Examination Centers of Huashan Hospital, Fudan University and Rizhao People′s Hospital at the same time were enrolled, too. Neuropsychological assessments, magnetic resonance imaging (MRI), and positron emission tomography (PET)/CT data of the 4-group subjects were collected. Variance analysis was used to compare the differences in neuropsychological performance among the 4 groups, and the imaging features of PCA patients were summarized.Results:Eleven PCA patients, 17 DLB patients, 31 t-AD patients, and 11 normal controls were included in the study. The cognitive function of patients in the PCA group [Mini-Mental State Examination (MMSE) score 13.52±1.81; Montreal Cognitive Assessment (MoCA) score 7.06±1.72] was significantly impaired compared to the normal control group (MMSE score 27.85±1.75, t=-6.561, P<0.001; MoCA score 23.60±1.59, t=-7.968, P<0.001]. However, there was no statistically significant difference compared to the DLB group and the t-AD group. Patients in the PCA group exhibited more severe impairments in attention, executive function, and language compared to the DLB group (Trail Making Test A score: 298.86±16.16 vs 110.07±18.62, t=9.980, P<0.001; Trail Making Test B score: 305.51±18.89 vs 230.34±23.59, t=2.865, P=0.024; Boston Naming Test score: 8.67±1.53 vs 15.66±1.56, t=-2.682, P=0.013) and the t-AD group (148.91±12.77, t=7.071, P<0.001; 200.78±19.34, t=3.789, P=0.004; 15.15±1.05, t=-2.544, P=0.016). Scores for visuospatial function [PCA group: 1(0, 1), normal control group: 3(3, 3), Z=-4.023, P<0.001] and visual perception [PCA group: 0(0, 1), normal control group: 35(34, 36), Z=-3.704, P<0.001] were significantly lower in the PCA group compared to the normal control group. The cranial MRI findings of PCA patients showed atrophy of the parietal and occipital lobes, with less obvious atrophy of the medial temporal lobe, which can be distinguished from t-AD. 18F-fluorodeoxyglucose PET/CT of the PCA patients showed a relative reduced glucose metabolism in the bilateral parietal lobe, occipital lobe and posterior cingulate gyrus, while the 18F-florbetapir PET/CT showed deposition of amyloid protein in the bilateral frontal lobe, parietal lobe, temporal lobe, and cingulate gyrus. Conclusions:PCA patients exhibit neuropsychological characteristics of visuospatial dysfunction, along with impairments in various cognitive domains such as memory, attention, and executive functions. The typical MRI feature is parietal occipital lobe atrophy, and the PET/CT findings are consistent with metabolic changes in AD.