Objective To evaluate the clinical efficacy of tendon-regulating and bone-setting manipulation combined with subtalar joint arthroereisis in the treatment of adolescent flexible flatfoot.Methods A retrospective analysis was conducted on the clinical data of 86 children with flexible flatfoot treated at Dongguan Hospital of Guangzhou University of Chinese Medicine(Dongguan Traditional Chinese Medicine Hospital)between December 2022 and February 2024.Based on pre-treatment physician-patient communication,the children were divided into an trial group(44 cases)and a control group(42 cases).The control group received subtalar joint arthroereisis alone,while the trial group received additional tendon-regulating and bone-setting manipulation just once one day before surgery and once weekly postoperatively for one month,with a follow-up period of no less than 6 months.The Visual Analogue Scale(VAS)pain score,American Orthopaedic Foot & Ankle Society(AOFAS)ankle-hindfoot score,Tegner activity score,radiographic parameters,and static plantar pressure parameters of the two groups were observed before and after surgery.Results(1)Regarding clinical data,all surgeries were successfully completed in both groups.There were no statistically significant differences in perioperative general data,including operative time,hospital stays,and complication rates(P＞0.05).All children were followed up for no less than 6 months.The results showed that at the final follow-up,the VAS pain score,AOFAS ankle-hindfoot score,and Tegner activity score were significantly improved in both groups compared to preoperative values(P＜0.05),and the improvement in the trial group was significantly greater than that in the control group(P＜0.05 or P＜0.01).(2)Regarding radiographic parameters,at the final follow-up,the talonavicular coverage angle(TNCA),talus-first metatarsal angle(T1MT),talus-second metatarsal angle(T2MT)on weight-bearing anteroposterior radiographs,and the Meary angle between the talus and the first metatarsal as well as calcaneal Pitch angle(Pitch angle)on weight-bearing lateral radiographs were significantly improved in both groups compared to preoperative values(P＜0.05).The improvement in Meary angle,T1MT angle,and T2MT angle in the trial group was significantly greater than that in the control group(P＜0.01).However,there were no statistically significant differences in TNCA and Pitch angle between the two groups at the final follow-up(P＞0.05).(3)Regarding plantar pressure testing,at the 1-month postoperative follow-up,the forefoot load increased significantly in both groups compared to preoperative values(P＜0.05),while the midfoot load significantly decreased(P＜0.05).The increase in forefoot load and decrease in midfoot load in the trial group were significantly greater than those in the control group(P＜0.05 or P＜0.01).However,there were no statistically significant differences in hindfoot load between preoperative and postoperative values or between the two groups at the 1-month follow-up(P＞0.05).Conclusion For adolescent flexible flatfoot,tendon-regulating and bone-setting manipulation combined with subtalar joint arthroereisis can effectively restore the arch,improve foot mechanical imbalance,thereby correcting flatfoot deformity and enhancing joint motor function.

Objective: To explore the relationship between serum complement 1q (C1q) and C1q/tumor necrosis factor-related protein 1 (CTRP1) levels in patients with coronary atherosclerotic heart disease (CHD) and their clinical value. Methods: Case-control study.115 patients with CHD who were hospitalized in the Department of Cardiology of Ningxia Medical University General Hospital from January 2018 to November 2018 were selected as the case group, including 72 males and 43 females, aged 35-82 years, average (59.96±9.49) years old. There were three subgroups: stable angina group (SAP, n=12), unstable angina group (UA, n=69), and acute myocardial infarction group (AMI, n=34). The control group was selected from 43 healthy subjects in the same period, including 21 males and 22 females, aged 23-71 years, with an average of (45.00±10.66) years old. Serum C1q and CTRP1 levels were tested by immunoturbidimetry and ELISA, and other biochemical indicators such as triglyceride (TG) and total cholesterol (CHOL) were detected.Multiple linear regression was used to analyze the influence of various factors on C1q level. ROC curve and area under the curve (AUC) to explore the diagnostic value of C1q and CTRP1. Results: The C1q level in the CHD group (184.06±31.05) mg/L was higher than that in the control group (122.22±28.18) mg/L (t=-11.405, P<0.001). The AMI group (192.80±34.08) mg/L was significantly higher than the SAP group (169.17±27.13) mg/L (t=-2.328, P=0.021).The CTRP1 level in the CHD group [241.85(79.38)] ng/ml was lower than that in healthy control group [292.7(67.64)] ng/ml (Z=-3.64, P<0.001). Group B with higher Gensini score (t=3.672, P<0.001) and group C (t=2.529, P=0.013) had higher C1q levels than group A.After adjusting for the effects of age, sex and other indicators, C1q levels were correlated with HDL-C (β=-0.582, P<0.001),CHOL (β=0.384,P<0.001) and systolic blood pressure (β=0.142,P=0.038). The ROC curve shows that when the CHD is diagnosed, the sensitivity of C1q level >150.82 mg/L is 87%,the specificity is 88.4%, and the AUC is 0.942. The corresponding sensitivity and specificity of CTRP1 <281.80 ng/ml are 76.5% and 60.5% respectively, and the AUC is 0.688. The AUC obtained by combined predictors was 0.944, and the sensitivity and specificity were 89.6% and 86.0% respectively. When AMI is diagnosed, C1q level >178.3 mg/L, corresponding sensitivity and specificity are 70.6% and 66.1%, the AUC is 0.726, CTRP1 has no diagnostic value. Conclusions Serum C1q levels in patients with CHD are elevated, and AMI patients are higher than SAP patients; C1q may be a potential marker reflecting the severity of coronary artery disease; there is no significant correlation between serum C1q and CTRP1 in CHD patients.

Objective To investigate the professional attitudes and occupational values of undergraduate students and to compare the differences between the first-year and fourth-year students? Method A scale concerning the professional attitude and a questionnaire concerning the occupational values were used to investigate the occpational values in 196 first-year and fourth year college nursing students? Results The professional attitude score of the first-year students was(6?7±1?3),which was significantly higher than that of the fourth students(5?3±1?1,P = 0?027)? The occupational value on the hygiene factor of the first-year students was significantly higher than that of the fourth-year students(P < 0?001)? The occupational value of reputation and social status,development between the students of the two grades achieved no significant difference? Conclusions The professional attitude and occupational value of students from different grades are different? The professional attitude and occupational value of the senior students tend to be rational?