Objective To explore the relationship between peripheral blood levels of phosphoryla-ted Tau181(p-Tau181)and β-amyloid(Aβ)42 and microstructure of white matter in elderly pa-tients with different types of dementia.Methods A total of 64 elderly dementia patients admitted to our department between January 2022 and December 2023 were enrolled and according to dif-ferent types of dementia,they were divided into Alzheimer's disease(AD)group(38 cases)and vascular dementia(VaD)group(26 cases).Another 30 healthy individual taking physical examina-tion during the same period were subjected and served as control group.All participants under-went MRI examination and detection of peripheral blood indicators.The cognitive level[mini-mental state examination(MMSE),Montreal cognitive assessment(MoCA)],diffusion tensor imaging parameters in different white matter areas[fractional anisotropy(FA),mean diffusion coefficient(MD)[,and peripheral blood indicators(p-Tau181,Aβ42)were compared among the three groups.Spearman correlation analysis was applied to analyze the relationship between peripheral blood Tau181 and Aβ42 levels and microstructure of white matter in AD group and VaD group.Results The scores of MMSE and MoCA were significantly higher in the control group than the AD group and the VaD group(28.13±0.72 vs 11.25±2.37 and 10.98±2.59,27.84±0.62 vs 10.37±2.64 and 10.58±2.87,P＜0.05).In the VaD group,the MD values of anterior and pos-terior horns of left and right lateral ventricles were obviously greater than the AD group and the control group,while the FA values were notably lower than the two groups(P＜0.05).The levels of p-Tau181 and Aβ42 were remarkably higher in the AD group and the VaD group than the con-trol group,and the level of p-Tau181 was significantly higher and that of Aβ42 was significantly lower in the AD group than the VaD group(P＜0.05).Spearman correlation analysis showed that in the VaD group,the peripheral blood level of p-Tau181 was positively correlated with the FA value and negatively with the MD value of brain white matter,while that of Aβ42 was negatively with the FA value and positively correlated with the MD value of brain white matter(P＜0.01).Conclusion There are significant differences in microstructure damage of white matter and pe-ripheral blood levels of p-Tau181 and Aβ42 among elderly patients with different types of dementi-a,and the levels of the two indicators are correlated with the microstructure damage.Clinically,peripheral blood indicators can be applied to evaluate microstructure damage of white matter.

Objective To explore the relationship between peripheral blood levels of phosphoryla-ted Tau181(p-Tau181)and β-amyloid(Aβ)42 and microstructure of white matter in elderly pa-tients with different types of dementia.Methods A total of 64 elderly dementia patients admitted to our department between January 2022 and December 2023 were enrolled and according to dif-ferent types of dementia,they were divided into Alzheimer's disease(AD)group(38 cases)and vascular dementia(VaD)group(26 cases).Another 30 healthy individual taking physical examina-tion during the same period were subjected and served as control group.All participants under-went MRI examination and detection of peripheral blood indicators.The cognitive level[mini-mental state examination(MMSE),Montreal cognitive assessment(MoCA)],diffusion tensor imaging parameters in different white matter areas[fractional anisotropy(FA),mean diffusion coefficient(MD)[,and peripheral blood indicators(p-Tau181,Aβ42)were compared among the three groups.Spearman correlation analysis was applied to analyze the relationship between peripheral blood Tau181 and Aβ42 levels and microstructure of white matter in AD group and VaD group.Results The scores of MMSE and MoCA were significantly higher in the control group than the AD group and the VaD group(28.13±0.72 vs 11.25±2.37 and 10.98±2.59,27.84±0.62 vs 10.37±2.64 and 10.58±2.87,P＜0.05).In the VaD group,the MD values of anterior and pos-terior horns of left and right lateral ventricles were obviously greater than the AD group and the control group,while the FA values were notably lower than the two groups(P＜0.05).The levels of p-Tau181 and Aβ42 were remarkably higher in the AD group and the VaD group than the con-trol group,and the level of p-Tau181 was significantly higher and that of Aβ42 was significantly lower in the AD group than the VaD group(P＜0.05).Spearman correlation analysis showed that in the VaD group,the peripheral blood level of p-Tau181 was positively correlated with the FA value and negatively with the MD value of brain white matter,while that of Aβ42 was negatively with the FA value and positively correlated with the MD value of brain white matter(P＜0.01).Conclusion There are significant differences in microstructure damage of white matter and pe-ripheral blood levels of p-Tau181 and Aβ42 among elderly patients with different types of dementi-a,and the levels of the two indicators are correlated with the microstructure damage.Clinically,peripheral blood indicators can be applied to evaluate microstructure damage of white matter.

OBJECTIVE: To summarize the characteristics of posterior coronal banana-shaped fragments and its research progress in treatment of intertrochanteric femoral fracture with cephalomedullary nail, provide valuable reference for clinical practice. METHODS: Relevant domestic and foreign literature was extensively reviewed to summarize the history, anatomical structure of posterior coronal banana-shaped fragments, and the need for reduction and fixation, the influence on the stability of cephalomedullary nail, and the remedies. RESULTS: The posterior coronal banana-shaped fragments refers to the second level fracture line of the intertrochanteric femoral fracture, involving four anatomical structures, namely, the posterior part of the greater trochanter, the intertrochanteric crest, the lesser trochanter, and the posteromedial cortex. With the wide application of three-dimensional-CT in clinical practice, the posterior coronal banana-shaped fragments were more comprehensively understood. According to whether the anterior extension of the fracture line affects the integrity of the lateral entry of the head and neck implant, the posterior coronal banana-shaped fragments can be divided into small and large ones, of which the large single banana-shaped fragment account for about 20% of the AO/Orthopaedic Trauma Association (AO/OTA) type A2 fractures. If the large fragment involving the posteromedial wall (lesser trochanter) will increase the difficulty of the medial cortical contact reduction; or involving the posterolateral wall and resulting in rupture of the entry portal (type A2.4), which will cause sagittal swing of the nail in the femoral marrow cavity, thereby affecting the stability of the nail. There is no effective technique for reduction and fixation of the banana-shaped fragment nowadays. However, the adverse effects of posterior coronal banana-shaped fragment can be compensated by improving the quality of fracture reduction and choosing high filling cephalomedullary nail. CONCLUSION The posterior coronal banana-shaped fragments can easily lead to the rupture of the entry portal of head-neck implants, cause the sagittal swing of the cephalomedulis nail, and then lead to the loss of fracture reduction and affect the treatment effect. Whether the entry portal rupture or not and its risk factors still need further clinical and basic research.
Humans ; Bone Nails ; Fracture Fixation, Intramedullary/methods* ; Hip Fractures/surgery* ; Tomography, X-Ray Computed

Objective: To evaluate the running status of Qinghai provincial measles laboratory network during 2012—2017. Methods: To analyze serological and virological surveillance database developed in Qinghai provincial measles laboratory network in 2012—2017, and evaluate the indicators for the running status of measles laboratory network in Qinghai Province. Results: It was shown that 5 763 suspected measles cases were reported in Qinghai Province during 2012—2017, and 4 167 serum samples were collected from suspected measles cases, the collection rate is 72.31%; among them, 3 697 were IgM positive for measles and the positive rate was 88.72%; 68 were IgM positive for rubella and the positive rate was 1.63%. And 515 throat swab specimens were collected from suspected measles cases, 82 measles virus isolates were obtained and the positive rate was 15.92%. The result of sequencing and analysis showed that all the measles viruses belonged to genotype H1 and subgenotype H1a, which were predominant genotype circulated in China in recent years. In addition, Qinghai provincial measles network labs passed all the serological confirmatory test and proficiency test, and on-site review held by national or provincial measles laboratory and WHO during 2012—2017, respectively. Conclusions Qinghai provincial measles laboratory network has been established and running well. It provided important scientific basis for measles elimination in Qinghai province.