Objective:To study the minimally invasive fixation with virtual self-designed screws between the iliac plates for acetabular posterior column fractures and compare the differences between genders.Methods:The CT data were collected from the 80 patients with normal pelvis who had undergone pelvic CT scan due to physical examination or trauma at Department of Orthopaedics, The Third Hospital of Xiamen from June 2021 to June 2022. There were 40 males and 40 females with an age of (45.0±12.4) years. The virtual screws between the minimally invasive iliac plates were designed with design software after 3D modeling. The insertion point, screw length, screw diameter, angle between the screw and the coronal plane of the pelvis, angle between the screw and the sagittal plane of the pelvis, angle ε between the screw and the anterior edge bone crest line of the greater sciatic notch, and bone channel volume were measured. Comparisons of the above data were made between genders. Results:The insertion point of the screw between the minimally invasive iliac plates was located between the anterior superior iliac spine and the iliac tubercle nodule, going toward the area between the ischial spine and the small ischial notch. The screw length was (139.64±8.46) mm, the screw diameter (8.95±1.16) mm, and the bone channel volume (51.91±10.77) cm 3. The screw length [144.34±7.58) mm], screw diameter [9.50±0.98) mm], angle between the screw and the sagittal plane of the pelvis (31.14°±2.74°), and bone channel volume [(57.82±8.82) cm 3] for males were significantly larger than those for females [(134.95±6.48) mm, (8.40±1.07) mm, 26.72°±2.74°, and (46.01±9.22) cm 3], while the angle between the screw and the sagittal plane of the pelvis [(35.74°±3.85°) mm] and angle ε between the screw and the anterior edge bone crest line of the greater sciatic notch (11.96°±4.57°) for males were significantly smaller than those for females (36.89°±2.96° and 14.17°±5.15°) (all P < 0.05). Conclusions:Fixation with screws between the iliac plates provides a new treatment for acetabular posterior column fractures, because the screws can be placed percutaneously in a minimally invasive manner or antegradely. The screw length, screw diameter, angle between the screw and the sagittal plane of the pelvis, and bone channel volume for males are significantly larger than those for females, while the angle between the screw and the sagittal plane of the pelvis and the angle between the screw and the anterior edge bone crest line of the greater sciatic notch for males are significantly smaller than those for females. Therefore, the angles between the iliac plate screw and the sagittal and coronal planes of the pelvis should be adjusted according to gender in screw placement.

Objective:To explore the speech features of female patients with anhedonic depression and their recognition of pleasure deficient symptoms.Methods:A total of 102 female depression patients who were hospitalized at Nanjing Brain Hospital from September 2020 to October 2021 were selected, including 62 anhedonic depression patients (anhedonic group) and 40 non-anhedonic depression patients (non-anhedonic group). A total of 50 female healthy controls were recruited during the same period.All participants were evaluated by the 17-item Hamilton depression scale (HAMD-17), Snaith-Hamilton pleasure scale (SHAPS), and the temporal experience of pleasure scale (TEPS), as well as voice acquisition.SPSS 23.0 software was used for data processing.Statistical analysis was conducted using one-way ANOVA, non-parametric tests, Logistic regression, and receiver operating characteristic curve.Results:Compared with the non-anhedonic group, the anhedonic group showed significant changes in 15 voice features(all P<0.05), including Mel-frequency cepstral coefficients, formant frequencies, intensity, and energy features.Among these features, Mel-frequency cepstral coefficients exhibited the highest accuracy in identifying anhedonic depression, with sensitivity of 47.5%, specificity of 91.9%, area under curve (AUC) of 0.751, 95% CI=0.686-0.866.Formant frequencies could identify female anhedonic depression, with a sensitivity of 90.0%, a specificity of 40.3%, an AUC of 0.647, and 95% CI=0.605-0.824.Energy features could identify anhedonic deficient depression, with a sensitivity of 60.0%, a specificity of 74.2%, an AUC of 0.679, and 95% CI=0.587-0.804.Intensity features could identify female anhedonic depression, with a sensitivity of 70.0%, a specificity of 58.1%, an AUC of 0.640, and 95% CI=0.554-0.769. Conclusion:Mel-frequency cepstral coefficients, formant frequencies, intensity features, and energy features may have specific changes in female patients with anhedonic depression.The Mel-frequency cepstral coefficients has the highest recognition accuracy for anhedonic symptoms in female depression patients, and is expected to become an objective evaluation index for female anhedonic depression.

OBJECTIVE：To explo re the potential molecular mechanism of ursolic acid in the treatment of osteoporosis （OP）. METHODS：TCMSP，PubMed database and UniProt database were used to screen potential targets of monomer compound ursolic acid. OP related target genes were searched with GeneCards database. The common target genes of component-disease were obtained by Venny 2.1 online mapping tool. The protein-protein interaction （PPI）network of component-disease common target genes was constructed by using STRING database ，and topological analysis was carried out ；the core target genes ，whose degree value was greater than the average degree value ，were screened. GO functional annotation and KEGG pathway enrichment analysis of component-disease common target genes were carried out by DAVID database. AutoDock Vina 1.1.2 software was used for molecular docking ，using protein encoded by the core target gene as receptor and ursolic acid as ligand. RESULTS ：A total of 55 ursolic acid related target genes and 4 273 OP related target genes were excavated ，with a total of 44 common target genes. PPI network with above common target genes included 44 nodes and 513 edges，with an average node degree of 23.3. There were 24 core target genes ，including VEGFA，TP53，IL6，CASP3. There were 340 GO functional items were enriched （corrected P＜ 0.05），including 263 biological processes （negative regulation of apoptosis ，etc.），25 molecular functions （protein binding ，etc.） and 52 cell components （cytosol，etc.）. There were 90 KEGG signaling pathways （corrected P＜0.05），such as tumor pathway ， hepatitis B pathway ，TNF signaling pathway ，viral carcinogenesis and phosphatidylinositol 3 kinase/protein kinase B （PI3K-Akt） signaling pathway. The binding energy between ursolic acid and 6 proteins encoded by core target genes such as TP53 was lower than －5 kcal/mol，which had strong binding activity. CONCLUSIONS ：The therapeutic effect of ursolic acid on OP may be achieved by regulating VEGFA，TP53，IL6，CASP3，JUN and other core target genes and acting on multiple key pathways such as cancer pathway ， hepatitis B and TNF signaling

Since December 2019, novel coronavirus pneumonia (NCP) has been reported in Wuhan, Hubei Province, and spreads rapidly to all through Hubei Province and even to the whole country. The virus is 2019 novel coronavirus (2019-nCoV), never been seen previously in human, but all the population is generally susceptible. The virus spreads through many ways and is highly infectious, which brings great difficulties to the prevention and control of NCP. Based on the needs of orthopedic trauma patients for emergency surgery and review of the latest NCP diagnosis and treatment strategy and the latest principles and principles of evidence-based medicine in traumatic orthopedics, the authors put forward this expert consensus to systematically standardize the clinical pathway and protective measures of emergency surgery for orthopedic trauma patients during prevention and control of NCP and provide reference for the emergency surgical treatment of orthopedic trauma patients in hospitals at all levels.

Objective: To evaluate left ventricular myocardial systolic function in patients with type 2 diabetes mellitus (T2DM) combined with abdominal obesity with three-dimensional speckle tracking imaging (3D-STI). Methods:A total of 56 T2DM patients were enrolled, including 26 patients with abdominal obesity (abdominal obesity group) and 30 without abdominal obesity (non-abdominal obesity group), while 30 healthy volunteers were selected as the control group. Conventional ultrasound parameters and strain parameters, including left ventricular end-diastolic diameter (LVDd), two-dimensional ejection fraction (2D-EF), relative wall thickness (RWT), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), three-dimensional ejection fraction (3D-EF), as well as left ventricular global longitudinal strain (LVGLS), left ventricular global circumferential strain (LVGCS), left ventricular global area strain (LVGAS) and left ventricular global radial strain (LVGRS) were compared among 3 groups. Results :Among the three groups, LVDd, RWT, LVEDV and LVESV in abdominal obesity group were higher than those in control group and non-abdominal obesity group (all P<0.05), while 2D-EF and 3D-EF were lower than those in control group (both P<0.05). LVGLS, LVGCS, LVGAS and LVGRS in abdominal obesity group and non-abdominal obesity group were lower than those in control group (all P<0.05), while in abdominal obesity group were lower than in non-abdominal obesity group (all P<0.05). Conclusion: 3D-STI can be used to evaluate left ventricular myocardial systolic function in patients with T2DM combined with abdominal obesity.

Objective To compare cable tension band fixation with other 3 fixations in terms of biomechanical stability for tibial avulsion fractures of the anterior cruciate ligament (ACL).Methods Eighty fresh porcine knees were randomized into 4 equal groups (n =20).For each knee,all the soft tissues were removed only to keep the femur-ACL-tibia complex.The knee complexes were used to create fracture models of standard Meyers-Mc Keever type Ⅲ at the ACL attachment region using a swing saw.The fracture fragments in the 4 groups were subjected to fixation respectively with intramedullary lag screws,high-strength suture,tension band wire and cable tension band.All the specimens were subsequently tested on a Material Testing Machine at a load rate of 60 mm/mm.The 4 groups were compared in terms of ultimate failure load,yield load,and fragmental displacement under single-cycle loading and multi-cyclic loadings.Results Cable tension band fixation displayed significantly higher ultimate failure,higher yield load and lower fragmental displacement than all the other 3 fixations (P ＜ 0.05).Conclusion As cable tension band fixation,which is convenient and economical,provides better biomechanical stability than other 3 fixations for tibial avulsion fractures of the ACL,it may allow earlier functional and weight-bearing exercise after operation.

Objective To investigate the significance of circulating tumor cells in tumor reflux venous blood in colorectal cancer patients with liver metastasis.Methods Seventy-four patients with colorectal cancer treated in Liaoning Cancer Hospital & Institute from January 2015 to January 2017 were enrolled in this study.The circulating tumor cells were detected by CellSearch system in patients with tumor reflux venous blood to analyze the results of circulating tumor cells and their clinical significance.Results Among the 74 patients with colorectal cancer,there were 24 patients with synchronous liver metastasis and 9 patients with metachronous liver metastasis.The sensitivity of CEA and CA19-9 positive in the detection of colorectal cancer synchronous liver metastasis was 67.9% and 58.6%,respectively.The sensitivity of circulating tumor cells positive detection in tumor reflux venous blood in the diagnosis of synchronous liver metastasis was 60.6%.n patients with metachronous liver metastases,CEA and CA19-9 positive patients were 33.3% and 55.6%,respectively,while CTCs positive patients were 77.8%.Conclusion The detection of circulating tumor cells in tumor reflux venous blood of colorectal cancer not only improves the detection rate,but also may become a predictive factor for metachronous liver metastasis.

Objective Meta-analysis the efficacy and safety of Exenatide and insulin therapy oral hypoglycemic drugs effect of obesity with type 2 diabetes .Methods According to the research purpose to set up the screening of related literature and exclusion criteria; formulatethe searching strategy, through PubMed、the Chinese Biological Medicine Datebase(CBM)、 CNKI、Wanfang Data Knowledge Service Platform, VIP to retrieve all theliterature selection of efficacy and safety by Exenatide oral hypoglycemic drugs and insulin therapy of obese type 2 diabetes mellitus.Choose met inclusion exclusion criteria, the complete data information randomized controlled trial (RCT) as the research object; Apply to the international commonly used Jadad score method to evaluate quality included in the test; To process the relevant data in the test ; Apply the ReviewManager 5.1 software to analysis the extracted research data.Analysis the results and put forward conclusions.Results Participants included 11 RCT , meta analysis results showed that compared with the Exenatide, in terms of reducing fasting glucose ,insulin effect more apparent [MD = 0.35, 95％CI: (0.11, 0.59), P = 0.004)]. In control effect of glycosylated hemoglobin, there was no statistically significant difference[MD=-0.04 ,95％CI:(-0.20,0.11), P=0.58],between Exenatide and insulin. Compared with the insulin, Exenatide reduce BMI more apparent[MD=-2.77,(95％CI: -3.34,-2.20),P<0.00001]; Compared with the insulin, Exenatide reduce insulin resistance index, the effect is more obvious[MD=-1.67,95％CI:(-1.93,-1.41), P<0.00001]; Adverse reaction in the process of treatment, the insulin is more likely to lead to hypoglycemia, [OR = 0.32, 95％ CI: 0.19, 0.54), P<0.0001]; While Exenatide are more likely to lead to gastrointestinal adverse reaction [OR = 4.04, 95％ CI: 2.35, 6.93), P<0.00001).Conclusion According to the Meta-analysis: Exenatide can be used in the treatment of oral hypoglycemic drugs of adult obesity with type 2 diabetes, and obvious effects of treatment of insulin resistance, long-term results still needs a large number of samples of high quality RCT to verify.

OBJECTIVE:To investigate the effect of Wuzhi soft capsule on the pharmacokinetics of sirolimus in rats. METH-ODS:Wistar rats were randomly divided into 5 groups,with 6 rats in each group. They were given very low-dose,low-dose,me-dium-dose and high-dose of Wuzhi soft capsule(67,134,268 and 536 mg/kg)ig or blank solvent,respectively;and then given si-rolimus 0.4 mg/kg. The blood 100 μl was sampled by capillary eyes before giving sirolimus(0 h)and 0.5,0.75,1,1.5,2,2.5, 3,4,6,8,12,24 and 36 h after giving sirolimus and put into edetic acid anticoagulation tube. Blood concentration of sirolimus was assayed by LC-MS/MS. The pharmacokinetic parameter was calculated by DAS 2.0 software using non-compartment model. RESULTS:The pharmacokinetic parameters of sirolimus in very low-dose,low-dose,medium-dose and high-dose groups and blank solvent group were cmax of(6.79±1.15),(17.40±3.13),(21.24±3.14),(22.06±4.82),(2.80±0.72)ng/ml;t1/2 of(11.01± 0.82),(12.20±2.02),(12.28±2.38),(12.36±0.73),(10.59±0.69)h;AUC0-∞ of(85.79±15.26),(162.18±41.75),(273.12± 73.69),(268.79±28.46),(36.72±3.01)ng·h/ml,respectively. Compared with blank solvent group,cmax and AUC0-∞ of sirolimus were all increased in very low-dose,low-dose,medium-dose and high-dose groups,but t1/2 changed slightly. CONCLUSIONS:Wu-zhi soft capsule can substantially enhance the absorption of sirolimus in rats.

Capillary Leak Syndrome ; complications ; Cholestasis, Intrahepatic ; complications ; Humans ; Mucocutaneous Lymph Node Syndrome ; complications