Objective:To compare the efficacy between Kirschner wire and clavicular hook plate in the fixation of distal clavicle fractures in older children.Methods:A retrospective analysis was conducted of the 28 pediatric patients with distal clavicle fracture who had undergone surgical treatment at Department of Pediatric Orthopedics, The Second General Hospital of Fuzhou from December 2014 to December 2023. There were 20 boys and 8 girls. Age: 10.0 (9.0, 12.8) years old; 22 left sides and 6 right sides; by the Craig modified Neer classification: 22 cases of type Ⅱ, 5 cases of type Ⅳ, and 1 case of type Ⅴ. The patients were divided into 2 groups based on their internal fixation methods. The Kirschner wire group of 12 cases were treated with open reduction and Kirschner wire fixation; the hook plate group of 16 cases were treated with open reduction and clavicular hook plate fixation. Operation time, hospital stay, fracture healing time, incidence of complications, and scores at the final follow-up (the Constant-Murley shoulder function score, quick disabilities of the arm, shoulder, and hand (quickDASH) score, and visual analog scale (VAS) for aesthetic satisfaction) were recorded and compared between the 2 groups.Results:There were no statistically significant differences in the baseline data between the 2 groups, indicating comparability ( P>0.05). The postoperative follow-up period for the 28 patients was (14.8±6.5) months. The operation time in the Kirschner wire group [(34.3±12.1) min] was significantly shorter than that in the hook plate group [(49.4±16.8) min] ( P<0.05), and the VAS score for aesthetic satisfaction at the final follow-up in the Kirschner wire group [(8.2±1.1) points] was significantly higher than that in the hook plate group [(6.2±2.6) points] ( P<0.05). There were no statistically significant differences between the 2 groups in terms of fracture healing time, hospital stay, incidence of complications, or Constant-Murley score and quickDASH score at the final follow-up ( P>0.05). Conclusions:For pediatric patients with distal clavicle fracture, both Kirschner wire fixation and clavicular hook plate fixation can achieve good functional outcomes. However, Kirschner wire fixation has advantages of shorter operation time, higher postoperative aesthetic satisfaction, and no need of a secondary surgery for implant removal.

This case report presents a patients with stable schizophrenia who abruptly vomited for three days during long-term treatment of clozapine. Laboratory tests revealed a blood clozapine concentration of 2 826.54 ng/ml (three times higher than the warning threshold). The intoxication of clozapine was cured after a week of intensive psychiatric emergency care, including promoting metabolism-promotion infusion and symptomatic and supportive treatment. A comprehensive review of the patient′ medical history, laboratory results, and symptoms led to the identification of the concurrent use of Roukou Sishen Wan, a traditional Chinese herbal medicine that modulated Bowel problems and diarrhea. Several components of Roukou Sishen Wan could interact with cytochrome P450 (CYP450), potentially disturbing clozapine metabolism and causing the elevated blood clozapine concentration. Based on these findings, clinicians are strongly recommended to exercise caution when prescribing combination therapies. The drug interaction should be considered when encountering unexpectedly high blood clozapine levels during routine clozapine treatment with stable doses.

This case report presents a patients with stable schizophrenia who abruptly vomited for three days during long-term treatment of clozapine. Laboratory tests revealed a blood clozapine concentration of 2 826.54 ng/ml (three times higher than the warning threshold). The intoxication of clozapine was cured after a week of intensive psychiatric emergency care, including promoting metabolism-promotion infusion and symptomatic and supportive treatment. A comprehensive review of the patient′ medical history, laboratory results, and symptoms led to the identification of the concurrent use of Roukou Sishen Wan, a traditional Chinese herbal medicine that modulated Bowel problems and diarrhea. Several components of Roukou Sishen Wan could interact with cytochrome P450 (CYP450), potentially disturbing clozapine metabolism and causing the elevated blood clozapine concentration. Based on these findings, clinicians are strongly recommended to exercise caution when prescribing combination therapies. The drug interaction should be considered when encountering unexpectedly high blood clozapine levels during routine clozapine treatment with stable doses.

From November 2014 to July 2017,637 patients with acute coronary syndrome (ACS) were included in the analysis,among whom there were 48 cases with prior ischemic stroke (7.5％).The risk factors,history,severity of coronary artery disease,medication status,and incidence of adverse cardiovascular and cerebrovascular events (cardiac death,re-infarction,heart failure,stroke) were analyzed.Compare with patients without prior ischemic stroke (control group) patients with prior ischemic stroke (study group) had lower rates in administration of beta blockers [50.00％(24/28) vs.69.78％(411/589),x2=8.02,P＜0.05]and interventional therapy[56.67％(17/30) vs.81.86％(334/408),x2=11.15,P＜0.05].However,there were no significant differences in medication of dual antiplatelet,statins and angiotensin converting enzyme inhibitors or angiotensin receptor blocker between two groups (P＞0.05);and there was no significant difference in major adverse cardiovascular events between two groups (P＞0.05).In the future,more studies are needed for clinical management of this group of patients.

Objective To probe into the characteristics of men who have sex with men living in small-medium sized cities and provide scientific foundation for the formulation of strategy for AIDS prevention and control.Methods A qualitative survey was carried out by convenience sampling for thirty one selected MSM.Results Interviewees had a large age gap,widely different occupations and various degrees of education;they depended mainly on internet and friends' contacts to find their sex partners;their knowledge about HIV/STDs was poor and they were indifferent to the risk of AIDs,but were faced with enormous psychological pressure.Multiple sex partners,unprotected anal intercourse were their main high risk behaviors,and they hoped to have access to free condoms,free HIV detection and hot line consultation.Conclusion To implement prevention in an effective manner,close attention should be paid to the role of key persons within the MSM group,to increasing knowledge of the target population,to protecting their mental health and to creating a friendly social environment for their existence and effective use of internet.