Objective:To investigate the clinical efficiency of induced membrane technique combined with structural bone grafting for treatment of segmental defects of the metacarpus and phalanges.Methods:A retrospective study was conducted to analyze the clinical data of 26 patients with segmental defects of the metacarpus and phalanges who had been treated by induced membrane technique combined with structural bone grafting from January 2021 to January 2023 at Department of Hand Surgery, Xuzhou Renci Hospital. There were 22 males and 4 females, aged 37.5 (31.5, 54.0) years. Ten left sides and 16 right sides were affected. Acute traumatic bone defects were observed in 22 cases and bone defects after post-trauma debridement of chronic osteomyelitis in 4 cases. Metacarpal bone defects occurred in 12 cases and phalangeal bone defects in 14 cases. The sizes of the defects ranged from 0.8 cm×0.6 cm×0.6 cm to 4.2 cm×1.2 cm×1.0 cm, and the sizes of the bone grafts from 1.0 cm×0.6 cm×0.6 cm to 4.5 cm×1.2 cm×1.0 cm. All patients were treated by bone cement filling into the bone defects to induce formation of a membrane in the first stage and structural grafting with autologous iliac bone in the second stage. Regular X-ray follow-ups were conducted after surgery. Wound healing, complications, bone union time, bone union rate, and total active movement (TAM) of the finger affected at the last follow-up were observed.Results:Stage I wound healing was achieved in all the 26 patients after surgery, without such complications as infection or delayed healing. All the 4 patients with chronic post-traumatic osteomyelitis healed after a single filling treatment with bone cement containing sensitive antibiotics. All patients were followed up for 12.0 (8.7, 15.0) months. Their fracture union time averaged (8.5±1.5) weeks, ranging from 6 to 12 weeks. The bone union rate was 100% (26/26). At the last follow-up, the TAM of the finger affected was 170°± 45° in all patients, ranging from 60° to 240°, and the affected side recovered 73.0% (69.0%, 89.2%) of the hand function of the healthy side.Conclusion:In the treatment of segmental defects of the metacarpus and phalanges, induced membrane technique combined with structural bone grafting can lead to a high fracture union rate, effectively reduced infection and good recovery of the finger mobility.

Objective:To investigate the clinical efficiency of induced membrane technique combined with structural bone grafting for treatment of segmental defects of the metacarpus and phalanges.Methods:A retrospective study was conducted to analyze the clinical data of 26 patients with segmental defects of the metacarpus and phalanges who had been treated by induced membrane technique combined with structural bone grafting from January 2021 to January 2023 at Department of Hand Surgery, Xuzhou Renci Hospital. There were 22 males and 4 females, aged 37.5 (31.5, 54.0) years. Ten left sides and 16 right sides were affected. Acute traumatic bone defects were observed in 22 cases and bone defects after post-trauma debridement of chronic osteomyelitis in 4 cases. Metacarpal bone defects occurred in 12 cases and phalangeal bone defects in 14 cases. The sizes of the defects ranged from 0.8 cm×0.6 cm×0.6 cm to 4.2 cm×1.2 cm×1.0 cm, and the sizes of the bone grafts from 1.0 cm×0.6 cm×0.6 cm to 4.5 cm×1.2 cm×1.0 cm. All patients were treated by bone cement filling into the bone defects to induce formation of a membrane in the first stage and structural grafting with autologous iliac bone in the second stage. Regular X-ray follow-ups were conducted after surgery. Wound healing, complications, bone union time, bone union rate, and total active movement (TAM) of the finger affected at the last follow-up were observed.Results:Stage I wound healing was achieved in all the 26 patients after surgery, without such complications as infection or delayed healing. All the 4 patients with chronic post-traumatic osteomyelitis healed after a single filling treatment with bone cement containing sensitive antibiotics. All patients were followed up for 12.0 (8.7, 15.0) months. Their fracture union time averaged (8.5±1.5) weeks, ranging from 6 to 12 weeks. The bone union rate was 100% (26/26). At the last follow-up, the TAM of the finger affected was 170°± 45° in all patients, ranging from 60° to 240°, and the affected side recovered 73.0% (69.0%, 89.2%) of the hand function of the healthy side.Conclusion:In the treatment of segmental defects of the metacarpus and phalanges, induced membrane technique combined with structural bone grafting can lead to a high fracture union rate, effectively reduced infection and good recovery of the finger mobility.

As a non-atherosclerotic disease in the extracranial segment of the carotid artery, carotid web is a ridge-like intraluminal protrusion beyond the bifurcation of the posterior wall of the carotid artery bulb. Carotid web also has been referred to as an atypical variant of fibromuscular dysplasia. In recent years, more and more studies indicate that carotid web is a rare but important risk factor for ischemic stroke. In order to accurately diagnose carotid artery web, implement targeted intervention and treatment for ischemic stroke caused by carotid web, the authors summarized the recent advances in carotid web and ischemic stroke.

Objective: To investigate the effect of biofeedback therapy on metabolic syndrome (MS) and the effect of different levels of job stress on the outcome. Methods: The physicians in tertiary hospitals who were diagnosed with MS from January to December, 2016 were divided into biofeedback group and health education group according to different intervention methods, and moderate group, medium group, and high group according to different levels of job stress. A 6-month intervention was implemented from May to October, 2017. A two-way factorial design was used to analyze the main effect of biofeedback on physical and biochemical parameters and the interaction of biofeedback and job stress. Results: After 6 months of intervention, the patients in both the biofeedback group and the moderate group had significantly decreased waist circumference, body mass index, systolic blood pressure (SBP) , diastolic blood pressure (DBP) , and levels of triglyceride (TG) , total cholesterol, low-density lipoprotein cholesterol (LDL-C) , and fasting plasma glucose (FPG) and a significantly increased level of high-density lipoprotein cholesterol (HDL-C) (all P<0.05) ; the patients in both the health education group and the moderate group had significantly decreased SBP, DBP, and levels of TG, LDL-C, and FPG (P<0.05) . The factorial analysis of variance showed that there was a synergistic interaction between the intervention method and job stress level in SBP, DBP, TG, HDL-C, LDL-C, and FPG among MS patients (P<0.05) . The high group had significantly more improvements in all indices compared with the medium group and the moderate group (P<0.05) . Conclusion Biofeedback therapy can effectively improve blood pressure, blood lipids, and blood glucose in MS patients, and is more effective for patients with high job stress level.

Objective To explore the predictive value of obesity-related index for metabolic syndrome(MS)among Tianjin adults. Methods A total of 522 adults who participated in a physical examination were included in this cross-sectional study. Participants 'gender and age were record-ed,height,weight,waist circumference(WC)and hip circumference were measured,and TC,TG,HDL-C and FPG were tested. The receiver op-erating characteristic(ROC)curves were generated to identify the optimal measurement of obesity for the prediction of metabolic risk in this popu-lation. Results The area under the ROC curve(AUC)value for waist-to-height ratio(WHtR)predicted the maximum value of MS,followed by WC and BMI,and WHR was the lowest. The optimal cut off value of WHtR was 0.509. There was significant difference in the ability of BMI be-tween different age groups and WC to predict MS. In the groups of<40 years old and≥60 years old,BMI had higher predictive value for MS than WC. Conclusion WHtR has the best predictive value for evaluating the MS risk compared to BMI ,WC or WHR alone among Tianjin adults. The predictive value of BMI and WC for evaluating the MS risk can be improved by the method of age stratification.

Recent researches revealed that intestinal flora contribute to the development of metabolic syndrome, espe?cially to the disorder of their targeted cardiovascular system. Blood cholesterol level is affected by the metabolism of intesti?nal flora in cholesterol and bile acid. At the same time, the blood cholesterol level is the key player in development of athero?sclerosis. This review mainly discussed the relationship between the intestinal flora dependent metabolite trimethylamine ox?ide (Trimetlylamine oxide, TMAO) and atherosclerosis.

Objective To explore the outcomes of endoscopic minimally invasive surgery as a new technique for the treatment of glossopharyngeal neuralgia.Methods From January 2000 to May 2008,16 cases of primary glossopharyngeal neuralgia were treated by endoscopic minimally invasive surgery through suboccipital retrosigmoid approach in our hospital.We made a 6-to 8-cm vertical incision within the inner hairline to drain the cerebrospinal fluid from the cerebellopotine angle cistern(CPA) so that to form an operational path.And then,the adherent arachnoid membrane was freed and the structure of the glossopharyngeal nerve and local arteries were detected.Results After the endoscopic surgery,pharyngeal pain disappeared in all of the 16 cases.Follow-up was available for 3 months to 8 years in the patients(1-3 years in 4 cases,and 3-8 years in 2 cases).Two patients had hoarse voice after the operation.No one had dysphagia or recurrence during the follow-up.Conclusion Endoscopic surgery through suboccipital retrosigmoid approach is a minimally invasive method for primary glossopharyngeal neuralgia with good outcomes,mild surgery-related complications,and quick post-operative recovery.

The relationship of cause-result between low selenium (Se) and Kashin-Beck disease (KBD) was probed by the prospective study of epidemiological method with regarding low-Se as an exposure factor in this paper. 597 healthy children lived in KBD areas with low, middle and high prevalence were divided into the low-Se exposed group and the non-low-Se exposed group according to their Se content in hair. The low-Se exposed group was divided into three subgroups, such as Se content in hair≤110 ng/g, 110 ng/g＜Se content in hair≤150 ng/g and 150 ng/g＜Se content in hair≤200 ng/g, respectively. Six new cases of the total with KBD (incidence was 0.574% person-year) were found in the low-Se exposed group during three years period of the investigation. No new case was found in the non low-Se exposed group . KBD incidence was not significantly different between those two groups. Two new cases were found in children with Se content in hair kept below 110 ng/g during three years (incidence: 1.21% person-year). SMR in each group indicated that the new cases observed in the low-Se exposed group was remarkable lower than the new cases expected. It was not observed that the dose-response relationship between low-Se and KBD, and was not supported that the low-Se was a predominant factor to cause KBD.