BACKGROUND:Ilizarov bone transport is very effective in the treatment of open large tibial bone defects,but there are still complications,among which the difficulty of junction healing is one of the difficult points in treatment. OBJECTIVE:To investigate the effect of Ilizarov bone transport combined with antibiotic bone cement on junction healing after operation of open large tibial bone defect. METHODS:Totally 51 patients with open large tibial bone defect(bone defect>4 cm)admitted to Binzhou Medical University Hospital from August 2010 to January 2022 were selected,of which 28 received Ilizarov bone transport alone(control group)and 23 received Ilizarov bone transport combined with antibiotic bone cement treatment(trial group).External fixation time,bone healing time,bone healing index,visual analog scale score during bone removal,bone defect limb function,junction healing and complications at the final follow-up were statistically compared between the two groups. RESULTS AND CONCLUSION:(1)All the 51 patients were followed up for a mean of(22.53±5.77)months.External fixation time,bone healing time,bone healing index,postoperative infection rate,and non-healing rate of junction were less in the trial group than those in the control group(P<0.05).There was no significant difference between the two groups in visual analog scale scores at 6 months after the second surgery and in the functional excellence and good rate of limb with bone defect at the final follow-up(P>0.05).(2)These findings indicate that compared with the Ilizarov bone transport alone,Ilizarov bone transport combined with antibiotic bone cement treatment can promote the healing of open tibial fracture junction and increase the rate of bone healing.

Objective:To explore the clinical efficacy of free superficial circumflex iliac artery perforator flap (SCIAPF) in reconstruction of soft tissue defects of hand and foot in children.Methods:From August 2021 to August 2023, free SCIAPFs were used to reconstruct soft tissue defects of hands and feet in 8 children at the Department of Hand and Foot Surgery, Zhoukou Huaihai Hospital. There were 6 boys and 2 girls aged between 2 and 7 years old. The sites of soft tissue defect were: 1 of metacarpophalangeal joint in the functional area of left thumb, 2 of dorsal right hand, 1 of dorsal left foot, 2 of medial malleolus of right foot, and 2 of right forefoot, and all were accompanied with tendon and bone exposure. The size of soft tissue defects ranged from 2.5 cm×3.0 cm to 6.0 cm×3.5 cm. After emergency debridement, the children received flap transfers, the flaps sized from 3.0 cm×3.5 cm to 7.0 cm×4.0 cm. Donor sites were closed by running intradermal suture. All children were included in the scheduled postoperative follow-up by visit of outpatient clinic, WeChat interviews and home visits to observe the appearance, colour, texture and sensation of the flaps, the functional recovery of the affected hands and feet, as well as the healing of donor sites.Results:After surgery, all 8 flaps survived beside 1 had a partial necrosis at the edge and healed with a scab after dressing change. Flap donor sites healed in one stage. Scheduled postoperative follow-up lasted from 7 to 22 months, with an average of 10 months. The flaps presented a slightly bloated appearance, soft texture with a restored protective sensation and satisfactory functional recovery of hands and feet. Linear scars were left at the donor sites. According to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association, 1 child was of excellent and 2 children of good in hand function of the 3 children with hand injury. The Maryland Foot Score revealed 3 children were of excellent and 2 of good in foot function of the 5 children with foot injury.Conclusion:Free SCIAPF is an ideal option for reconstruction of soft tissue defects of hand and foot in children, with concealed donor site, convenient flap harvesting, fewer complications and satisfactory reconstructive effect.

Objective To investigate the therapeutic effect of segmental decompression combined with corrective short-segment fusion surgery for the treatment of degenerative lumbar scoliosis.Methods In total,124 patients with degenerative lumbar scoliosis were selected and divided into short-and long-segment fusion groups using the random number table method,with 62 patients in each group.Posterior short-segment decompression,fixation,and fusion were performed in the short-segment fusion group;the fusion segment was the adjacent lumbar vertebra.Posterior long-segment decompression,fixation,and fusion were performed in the long-segment fusion group;the fusion segments included multiple adjacent lumbar vertebrae.At the 6th month after surgery,the coronal Cobb angle of lumbar convexity,sagittal Cobb angle of lumbar lordosis,intervertebral foramen height,intervertebral space height,intervertebral foramen area,spinal canal area,spinal canal diameter,Japanese Orthopedic Association(JOA)score,Oswestry Disability Index(ODI),degree of pain in the lower back and lower limbs,and postoperative complications were compared between the groups.Results The Cobb angle of the coronal lumbar scoliosis in the short-and long-segment fusion groups was significantly higher than that before surgery(P<0.05).At the 6th month after surgery,the intervertebral foramen height,intervertebral space height,intervertebral foramen area,spinal canal area,and spinal canal diameter in both groups increased,and those in the short-segment fusion group were higher than those in the long-segment fusion group(P<0.05);at the 6th month after the operation,the JOA scores of the short-segment and long-segment fusion groups were higher than those before surgery,and the JOA score of the short-segment fusion group was higher than that of the long-segment fusion group(P<0.05).The ODI score was lower than that before surgery in the short-and long-segment fusion groups,and the ODI score in the short-segment fusion group was lower than that in the long-segment fusion group(P<0.05).At the 6th month after surgery,the pain scores of the lower back and lower limbs in the short-and long-segment fusion groups were significantly higher than those before surgery(P<0.05).There were two cases of dural tears during decompression caused by lamina dura adhesion in the long-segment fusion group,and no serious complications were observed in the short-segment fusion group.Conclusions Both short-and long-segment decompression fixation fusion using a posterior approach can achieve good therapeutic effects for treating degenerative lumbar scoliosis.However,compared to the long-segment fusion group,the short-segment fusion group undergoing short-segment decompression fixation fusion through a posterior approach had a shorter surgical period,lower intraoperative blood loss,better recovery of lumbar function,and a lower risk of postoperative complications.

Objective:To explore the clinical effect of using great toe fibular flaps of both feet on reconstruction of pulp defects of two neighbouring digits.Methods:A total of 14 digit pulp defects in 7 cases were repaired in Zhoukou Huaihai Hospital using great toe fibular flaps of both feet from August 2020 to January 2023. Of the 7 cases, there were 4 males and 3 females, with an average of 28 years old, ranging from 19 to 45 years old. Meanwhile, there were 4 cases in left hand and 3 cases in right hand. There were 3 cases of digit pulp defects in index and middle fingers, 2 in middle and ring fingers, and 2 in thumb and index fingers. The area of soft tissue defect in 1.2 cm×1.5 cm-3.0 cm×2.5 cm, and flap was 1.5 cm ×1.8 cm-3.2 cm×2.8 cm. Furthermore, 1 case underwent emergency surgery and 5 were repaired in elective surgery. The donor site of the flap was closed directly, and an intermediate-thickness skin graft was prepared from the medial plantar area for transfer in the case of high suture tension at the wound edge. After surgery, patients received postoperative by outpatient clinic and WeChat to observe the appearance, sensation, functional recovery and flap contracture of digits, as well as the movement of the great toes of both feet.Results:After the surgery, all flaps in the 7 cases survived smoothly and the donor sites healed. All patients entered scheduled follow-ups postoperatively for 6 months to 2 years, with an average of 9 months. The flap showed an aesthetic appearance and excellent sensation, with a TPD of 3-6 mm, and satisfactory digit function. The donor site of the great toe fibular flap left linear scars only, without abnormality in range of motion and gait in walking. In addition, there were 5 in excellent and 2 in good according to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association.Conclusion:Application of great toe fibular flaps of both feet is an ideal option for the simultaneous repair of pulp defects of two neighbouring digits, which can achieve good reconstructive results.

Promoting the modernization of TCM can facilitates the modernization of nation,the development of national social economy,and the construction of a"healthy"China;industrially,it improves of the quality and efficiency,achieving qualitative innovation and development;for the general public,it ameliorates the lifestyle and the perception of the people on being healthy.This article focuses on TCM industry,whilst executing the policies of the State Council.Based on the current stage of development,the modernization of TCM and its essential philosophy,strategic background and pathway,basic principles,this article strives to explore the most appropriate methods to modernize TCM in terms of healthcare,technology,education,industry,culture and management system.

Parkinson's disease (PD) is a chronic neurodegenerative disease commonly seen in middle-aged and elderly people, and aging is the largest risk factor for PD. With acceleration of the aging process in China, the wellbeing and life quality of the elderly are expected to be disturbed by increasing prevalence of PD. The Community-based Cohort Study on Nervous System Diseases (CCSNSD) has established community population-based cohorts of epilepsy, Alzheimer's disease, and PD, respectively; baseline survey and one round of follow-up have finished so far. The CCSNSD collected data on demographics, community environment, diet, lifestyle, cognition, history of chronic diseases, and PD-related risk factors and facilitated exploration of the relationship between dietary nutrition and PD-related outcomes. This special column described status on prodromal Parkinson's disease (pPD) risk and its demographic & economic differences among people aged 55 and above in four provinces of China, and investigated the associations of red meat and processed meat products intake , dairy products intake, and cognitive function with pPD risk, respectively. Furthermore, one paper reviewed previous studies on dietary nutrition, lifestyle, and PD risks. However, the follow-up time of CCSNSD was relatively short as of the publishing of this column, longer follow-ups are required to allow studying potential factors and risk of incident PD combined with clinical examination and diagnosis of PD.

OBJECTIVE: To compare the effectiveness of lower extremity axial distractor (LEAD) and traction table assisted closed reduction and intramedullary nail fixation in treatment of femoral subtrochanteric fracture. METHODS: The clinical data of 117 patients with subtrochanteric fracture of femur treated by closed reduction and intramedullary nail fixation between May 2012 and May 2022 who met the selection criteria were retrospectively analyzed. According to the auxiliary reduction tools used during operation, the patients were divided into LEAD group (62 cases with LEAD reduction) and traction table group (55 cases with traction table reduction). There was no significant difference in baseline data, such as gender, age, injured side, cause of injury, fracture Seinsheimer classification, time from injury to operation, and preoperative visual analogue scale (VAS) score, between the two groups ( P>0.05). Total incision length, operation time, intraoperative blood loss, fluoroscopy frequency, closed reduction rate, fracture reduction quality, fracture healing time, weight-bearing activity time, and incidence of complications, as well as hip flexion and extension range of motion (ROM), Harris score, and VAS score at 1 month and 6 months after operation and last follow-up were recorded and compared between the two groups. RESULTS: There were 14 cases in the LEAD group from closed reduction to limited open reduction, and 43 cases in the traction table group. The incisions in the LEAD group healed by first intention, and no complication such as nerve and vascular injury occurred during operation. In the traction table group, 3 cases had perineal crush injury, which recovered spontaneously in 1 week. The total incision length, operation time, intraoperative blood loss, fluoroscopy frequency, and closed reduction rate in the LEAD group were significantly better than those in the traction table group ( P<0.05). There was no significant difference in the quality of fracture reduction between the two groups ( P>0.05). Patients in both groups were followed up 12-44 months, with an average of 15.8 months. In the LEAD group, 1 patient had delayed fracture union at 6 months after operation, 1 patient had nonunion at 3 years after operation, and 1 patient had incision sinus pus flow at 10 months after operation. In the traction table group, there was 1 patient with fracture nonunion at 15 months after operation. X-ray films of the other patients in the two groups showed that the internal fixator was fixed firmly without loosening and the fractures healed. There was no significant difference in fracture healing time, weight bearing activity time, incidence of complications, and postoperative hip flexion and extension ROM, Harris score, and VAS score at different time points between the two groups ( P>0.05). CONCLUSION For femoral subtrochanteric fracture treated by close reduction and intramedullary nail fixation, compared with traction table, LEAD assisted fracture reduction can significantly shorten the operation time, reduce intraoperative blood loss and fluoroscopy frequency, reduce incision length, effectively improve the success rate of closed reduction, and avoid complications related to traction table reduction. It provides a new method for good reduction of femoral subtrochanteric fracture.
Humans ; Fracture Fixation, Intramedullary ; Bone Nails ; Traction ; Blood Loss, Surgical/prevention & control* ; Retrospective Studies ; Treatment Outcome ; Femoral Fractures ; Hip Fractures/surgery* ; Lower Extremity ; Surgical Wound ; Fracture Fixation, Internal

Chinese medicinal materials are the basis for the inheritance and development of traditional Chinese medicine,as well as strategic resources related to the national economy and people's livelihood.In 2015,12 departments,including the Ministry of Industry and Information Technology,and the State Administration of Traditional Chinese Medicine,jointly formulated the Plan for the Protection and Development of Traditional Chinese Medicine(2015-2020)(hereinafter referred to as the Plan),focusing on seven major construction tasks for the protection and development of traditional Chinese medicine.Through the summary and evaluation of the Plan,it can be seen that the overall development goals and 7 specific indicators have been achieved by 2020.It has been focused on solving the problems of the loss and depletion of some wild Chinese medicinal materials resources and the shortage of Chinese medicinal materials supply.Promoting to alleviate the problems,including the abuse of chemical fertilizers,pesticides,and growth regulators.The extensive production and management of Chinese medicinal materials,as well as the poor exchange of supply and demand information were effectively improved.On the whole,the development and protection of Chinese medicinal materials were promoted.Moreover,the dependence on wild Chinese medicinal materials was reduced through scientific development of Chinese medicinal materials production.And the sustainable development of the Chinese medicinal materials industry was coordinated with the protection of the ecological environment.However,there were still some problems and deficiencies,such as a lack of accurate information guidance,an incomplete price formation mechanism,and an incomplete whole-process traceability system of Chinese medicinal materials.It is suggested that during the 14th Five-Year Plan period,we should continuously strengthen the protection and sustainable development of traditional Chinese medicine resources,and build a new development pattern for traditional Chinese medicine industry based on the new development concept and requirement.

Background Global dietary magnesium insufficiency is widespread and seriously harmful to human health. There are few studies on dietary magnesium intake in China, and associated dietary intervention lacks scientific support. Objective To explore the dietary magnesium intake level and food sources of Chinese adults aged 18-64 in 2018, and to identify the problems of dietary magnesium intake. Methods A total of 9181 residents in the 2018 "China Health and Nutrition Survey" were selected as the study subjects. Types and intake of food collected from consecutive 3-day 24-hour dietary recalls and by household condiment weighing and counting method. The average daily dietary magnesium intake and the composition of main food sources were calculated using the food composition table. Multiple logistic regression was used to analyze the relationship between socioeconomic factors and insufficient dietary magnesium intake. Results In 2018, the daily intake of magnesium in P₅₀ (P₂₅, P₇₅) of adults aged 18-64 in 15 provinces (autonomous regions and municipalities) of China was 252.28 (196.25, 326.27) mg. The proportion of residents with insufficient dietary magnesium intake was 60.9%. The proportions of women, adults aged 18-49, urban residents, southern region residents, and western regions residents with insufficient dietary magnesium intake were 66.4%, 63.4%, 62.4%, 65.2%, and 68.3%, respectively. The results of multiple logistic regression analysis showed that the risks of insufficient dietary magnesium intake were 64.6%, 24.6%, and 43.6% higher in women, urban residents, and southern region residents than those in men, rural residents, and northern region residents, respectively (OR=1.646, 95%CI: 1.509-1.794; OR=1.246, 95%CI: 1.126-1.379; OR=1.436, 95%CI: 1.311-1.573); the risk of insufficient dietary magnesium intake in residents aged 50-64 was 15.7% lower than that in residents aged 18-49 (OR=0.843, 95%CI: 0.771-0.921); the risks of insufficient magnesium intake in residents in middle and western areas were 1.202 times and 1.590 times of that in residents in eastern area (OR=1.202, 95%CI: 1.079-1.340; OR=1.590, 95%CI: 1.424-1.776). The effect of education level and income level on magnesium intake insufficiency was not observed (P>0.05). In addition, 41.4% of dietary magnesium of the subjects came from cereals and products (ranking first in food sources), and only 2.4% from dark vegetables with rich magnesium content (ranking sixth place). The top six dietary magnesium sources of men and women were the same. The proportion of dietary magnesium from cereals and products was 6.3% higher in rural residents than in urban residents, and 9.3% higher in residents living in northern regions than those in southern regions. The proportion of dietary magnesium from livestock meat and products was 1.3% higher in the 18-49 age group than in the 50-64 age group, 0.9% higher in urban residents than in rural residents, and 1.6% higher in western region residents than in eastern region residents. Conclusion The dietary magnesium intake of Chinese residents is generally insufficient, and the source of dietary magnesium is irrational. Women, residents aged 18-49, residents in southern, middle, and western areas are high-risk populations of dietary magnesium insufficiency. Chinese residents are encouraged to eat more dark vegetables and whole grain food; women should improve their dietary quality and intake diverse magnesium-rich food; southern region residents and urban residents should increase the intake of whole grains and avoid over refining food; residents aged 18-49, urban residents, and those in western regions should adjust their dietary structure and reduce meat intake.

Background Magnesium is an important nutrient, and participates in most metabolic processes. Many studies show an association between dietary magnesium intakes and nutrition-related diseases such as diabetes. However, the data of dietary magnesium intakes and secular trends among the whole life cycle of Chinese residents are not available. Objective To investigate the dietary magnesium intakes and associated secular trends over the past three decades in residents of all ages and China, to identify the high-risk residents of magnesium deficiency and plan nutritional interventions, and provide basic data support for the revision of dietary magnesium reference intake. Method The data came from the 10 rounds of the "China Health and Nutrition Survey" from 1991 to 2018, and the participants with complete sociodemographic and dietary data wereselected. The median intakes, insufficient rates, and secular trends of dietary magnesium intakes were analyzed in different survey years. Analysis of multiple linear regression was used to analyze the annual change characteristics of dietary magnesium intakes controlling gender, age, education, urban-rural stratum, and north-south region. Wilcoxon trend test was used to analyze the secular trends of dietary magnesium intakes in different characteristic groups. The trends of insufficient rate were analyzed by Cochran-Armitage trend test among different characteristic groups. Results A total of 127169 residents were included in the present study. The medians of dietary magnesium intakes in 1991, 1993, 1997, 2000, 2004, 2006, 2009, 2011, 2015, and 2018 were 283.70, 283.38, 304.26, 285.50, 283.64, 275.49, 267.92, 242.93, 240.51, and 238.89 mg·d⁻¹, respectively, showing a significant downward trend (F=2931.81, P<0.001). Dietary magnesium intakes showed significant differences in gender, age, education level, income level, urban-rural stratum, and north-south region in almost all survey years, except that there was no significant difference among different income groups in 1991. Insufficient rate of dietary magnesium intake showed a significant upward trend (Z=62.62, P<0.001), approximate 60% of Chinese residents consumed insufficient magnesium. The insufficient rate was 53.94% for male and 65.35% for female, and the insufficient rate in the 14-17 age group was as high as 71.29%. Conclusion The dietary magnesium intake shows a significant downward trend and insufficient intake of dietary magnesium is prevalent among Chinese population. It is necessary to observe the high-risk population and conduct relevant nutritional interventions, as well as to further assess the recommended intake of magnesium.