As the National Health Commission changes the management of novel corona virus infection, the situation and preventive policies for controlling the epidemic have also entered a new stage in China. Perioperative care strategies for orthopedic trauma such as designated isolation and nucleic acid test screening have also been adjusted in the new stage. Based on the perioperative work experiences in the new stage of epidemic from the frontline anti-epidemic staff of orthopedics in domestic hospitals and combined with the literature and relevant evidence-based medical data in perioperative care of orthopedic trauma patients under the current anti-epidemic policies at home and abroad, Chinese Orthopedic Association and Chinese Society of Traumatology organized relevant experts to formulate the Guideline for clinical perioperative care of orthopedic trauma patients in the new stage of novel corona virus infection ( version 2023). The guideline summarized 16 recommendations from the aspects of preoperative diagnosis and treatment, infection prevention, emergency operation and postoperative management to systematically standardize the perioperative clinical pathways, diagnosis and treatment processes of orthopedic trauma in the new stage of novel corona virus infection, so as to provide a guidance and reference for hospitals at all levels to carry out relevant work in current epidemic control policies.

Fatty acids(FAs),which were initially recognized as energy sources and essential building blocks of biomembranes,serve as the precursors of important signaling molecules.Tracing FA metabolism is essential to understanding the biochemical activity and role of FAs in physiological and pathological events.Inspired by the advances in click chemistry for protein enrichment,we herein established a click chemistry-based enrichment(CCBE)strategy for tracing the cellular metabolism of eicosapentaenoic acid(EPA,20:5 n-3)in neural cells.Terminal alkyne-labeled EPA(EPAA)used as a surrogate was incubated with N2a,mouse neuroblastoma cells,and alkyne-labeled metabolites(ALMs)were selectively captured by an azide-modified resin via a Cu(I)-catalyzed azide-alkyne cycloaddition reaction for enrichment.After removing unlabeled metabolites,ALMs containing a triazole moiety were cleaved from solid-phase resins and subjected to liquid chromatography mass spectrometry(LC-MS)analysis.The proposed CCBE strategy is highly selective for capturing and enriching alkyne-labeled metabolites from the complicated matrices.In addition,this method can overcome current detection limits by enhancing MS sensitivity of targets,improving the chromatographic separation of sn-position glycerophospholipid regioisomers,facilitating structural characterization of ALMs by a specific MS/MS fragmentation signature,and providing versatile fluorescence detection of ALMs for cellular distribution.This CCBE strategy might be expanded to trace the metabolism of other FAs,small molecules,or drugs.

OBJECTIVE: To confirm the therapeutic effect of recombinant human thrombopoietin (rhTPO) on rhesus monkeys irradiated with 5.0 Gy ⁶⁰Co γ-ray, and provide experimental basis for clinical treatment of similar patients. METHODS: Fourteen adult rhesus monkeys were irradiated with ⁶⁰Co γ-ray on both sides at the dose of 5.0 Gy (dose rate 69.2 cGy/min) to establish the acute radiation sickness model. The monkeys were divided into irradiation group (n=5), rhTPO 5 μg/kg group (n=4) and rhTPO 10 μg/kg group (n=5). Two hours after irradiation, the three groups of monkeys were injected with saline 0.1 ml/kg, rhTPO 5 μg/kg（0.1 ml/kg） and rhTPO 10 μg/kg(0.2 ml/kg), respectively. The general signs, survival, peripheral hemogram and serum biochemistry of rhesus monkeys were observed before and after irradiation, and the differences between rhTPO group and irradiation control group were compared. RESULTS: After total body irradiation with 5.0 Gy⁶⁰Co γ-ray, rhesus monkeys successively showed fever, hemorrhage, sharp decrease of whole blood cell counts in peripheral blood and disorder of serum biochemical indexes. Compared with the irradiated control group, a single intramuscular injection of rhTPO 5 μg/kg or 10 μg/kg 2 hours after irradiation could improve the symptoms of fever and bleeding, increase the nadir of peripheral red blood cells and platelets counts, shorten the duration of hemocytopenia, and advance the time for blood cells to return to the pre-irradiation level. The serum biochemical results showed that rhTPO could improve the abnormality of serum biochemical indexes in rhesus monkeys induced by 5.0 Gy total body irradiation to some extent. Compared with the two administration groups, the therapeutic effect of rhTPO 10 μg/ kg was better. CONCLUSION A single injection of rhTPO 5 μg/ kg or 10 μg/ kg 2 hours after irradiation can alleviate the injury of multilineage hematopoiesis and promote the recovery in monkeys irradiated by 5.0 Gy γ-ray. It also improves animal signs and has obvious therapeutic effect on acute radiation sickness.
Humans ; Animals ; Macaca mulatta ; Radiation Injuries

Objective: To examine the safety and effectiveness of a new stent graft system for endovascular repair of abdominal aortic aneurysm(AAA). Methods: This is a prospective,multi-center,single-arm clinical trial. The patients with AAA treated with a new stent graft system were enrolled at 21 centers from September 2018 to September 2019 in China. Follow-up was performed before discharge, and at 30, 180, 360 days after operation, respectively. The primary safety endpoint was the incidence of major adverse events(MAE) within 30 days. The primary efficacy endpoint was the success rate of AAA treatment at 360 days. Secondary safety endpoints were the incidence of perioperative access complications and acute lower limb ischemia,all-cause mortality, AAA related mortality and incidence of serious adverse events (SAE) at 180 and 360 days. Secondary efficacy endpoints were the incidence of type Ⅰ or Ⅲ endoleak,stent displacement,and conversion to open surgery or re-intervention at 180 and 360 days. Results: One hundred and fifty-six patients were enrolled,including 137 males and 19 females. The age was (68.9±6.9) years (range:48.2 to 84.6 years).Maximum aneurysm diameter was (50.8±11.2) mm (range:25.0 to 85.0 mm),diameter of proximal landing zone was (21.2±2.5) mm (range:17.0 to 29.5 mm),and length of proximal landing zone was (31.4±13.0) mm (range:11.0 to 75.0 mm).The incidence of MAE was 1.3% (2/156) at 30 days,both were all-cause death cases. The success rate of AAA treatment was 88.5% (138/156) at 360 days. No perioperative access complication and acute lower limb ischemia occurred. All-cause mortality was 2.0% (3/154) at 180 days and 2.6% (4/153) at 360 days,and there was no AAA related death. The incidence of SAE was 23.0%(35/152) at 180 days and 30.5%(46/151) at 360 days, and no device-related SAE occurred. The incidence of type Ⅰor Ⅲ endoleak was 3.4% (5/147) at 180 days and 3.5% (5/144) at 360 days. Conclusion: The new stent graft system is easy to operate,and early-term safety and effectiveness results are expected.
Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Prospective Studies ; China ; Ischemia ; Aortic Aneurysm, Abdominal/surgery*

Objective: To analyze and compare the distribution of the high-risk population of upper gastrointestinal (UGI) cancer and the factors influencing the compliance rate of endoscopic screening in urban China and rural China. Methods: From 2015 to 2017, an epidemiological survey was conducted on residents aged 40-69 in two rural areas (Luoshan county of Henan province, Sheyang county of Jiangsu province) and two urban areas (Changsha city of Hunan province, Harbin city of Heilongjiang province). As a result, high-risk individuals were recommended for endoscopic screening. Chi-square χ(2) test was used to compare the high-risk rate of UGI cancer between urban and rural residents. In addition, the multivariate logistic regression model was used to analyze the factors influencing the compliance rate of endoscopic screening. Results: A total of 48, 310 residents aged 40-69 were enrolled in this study, including 22 870 (47.34%) residents from rural areas and 25 440 (52.66%) residents from urban areas. A total of 23 532 individuals were assessed with a high risk of UGI cancer, with an overall risk rate of 48.71%. A higher proportion of participants with high risk was observed in rural China (56.17%, 12 845/22 870) than in urban China (42.01%, 10 687/25 440). A total of 10 971 high-risk individuals with UGI cancer participated in endoscopic screening, with an overall compliance rate of 46.62% (10 971/23 532), 45.15% (5 799/12 845) in rural China, and 48.40% (5 172/10 687) in urban China. In rural population, the compliance rate of endoscopic screening was higher in those of females, aged 50-69 years, primary school education or above, high income, a family history of UGI cancer, history of gastric and duodenal ulcer, history of reflux esophagitis, and history of superficial gastritis, but lower in smokers (P<0.05). Among the urban population, the compliance rate of endoscopic screening was higher in those aged 40-49 years, uneducated, low income, family history of UGI cancer, history of reflux esophagitis, history of superficial gastritis, but lower in smokers (P<0.05). Conclusions: The proportion of participants with high risk of UGI cancer in rural areas is higher than that of urban areas. The compliance rates of endoscopic screening in urban and rural areas are low, and influencing factors of endoscopic screening exhibit some differences in rural China and urban China.
China/epidemiology* ; Early Detection of Cancer ; Esophagitis, Peptic ; Female ; Gastritis ; Gastrointestinal Neoplasms/epidemiology* ; Humans ; Rural Population ; Urban Population

Objective To explore the spatio-temporal characteristics of Oncomelania hupensis snails along the Danyang section of the Beijing-Hangzhou Grand Canal and the Danyang-Jintan-Liyang Canal, so as to provide scientific evidence for the dynamic assessment of the risk of snail spread in this region. Methods O. hupensis snail status was collected in the plain regions with waterway networks in the study area from 2012 to 2017. The spatio-temporal variations of snail distribution were investigated along the Danyang section of the Beijing-Hangzhou Grand Canal and the Danyang-Jintan-Liyang Canal using buffer zone analysis, spatial autocorrelation, hotspot analysis and standard deviational ellipse with the geographical information system (GIS) tools. Results The number of snail habitats showed a tendency towards a rise in the study area from 2012 to 2017, and snail habitats were predominantly distributed in the 1 000 m long buffer zone of the Danyang-Jintan-Liyang Canal, notably along the Jiuqu River at the junction between the Beijing-Hangzhou Grand Canal and the Danyang-Jintan-Liyang Canal. The distribution of snail habitats appeared spatial autocorrelations in 2014, 2016 and 2017, and the hotspot areas were mainly identified at the junction between the Danyang-Jintan-Liyang Canal and the Beijing-Hangzhou Grand Canal. In addition, the overall distribution of snail habitats was located in the northeastern-southwestern part of the study aera, and gradually shifted to the southern and northern parts with the time. Conclusions The spatial distribution of O. hupensis snails is complex along the Danyang section of the Beijing-Hangzhou Grand Canal and the Danyang-Jintan-Liyang Canal, and there is a risk of snail spread from the upper reaches to the lower reaches, where snail control needs to be intensified.

Objective:To explore the influencing factors of job burnout of medical staff and provide reference for the formulation of intervention measures.Methods:From November to December, 2018, a questionnaire survey was conducted among medical staff in a general hospital by using the research design of the current situation survey. A total of 1193 questionnaires were distributed and 939 questionnaires were returned, with a recovery rate of 78.7%, including 891 valid questionnaires and an effective recovery rate of 94.9%. Social support rating scale (SSRs) was used to evaluate social support, and Maslach Burnout Scale (MBI-GS) was used to evaluate job burnout. Single factor analysis was performed by chi square test and Fisher exact probability method. To explore the influencing factors of job burnout by using disordered multi classification logistic.Results:The average age was (27.47 ± 4.22) years old, female accounted for 71.5% (637/891) . The total physical examination rate of job burnout was 46.6%. The scores of emotional exhaustion, cynicism and decreased sense of achievement were (10.10±3.75) , (6.14±3.43) , (17.91±4.13) respectively. Multiple logistic regression analysis showed that, compared with the non detected job burnout, the young, working for 1-3 years, average sleep ≤6 hours, and poor social support were more likely to have mild job burnout ( OR=0.91, 0.40, 2.25, 2.38, P<0.05) ; female, high night shift frequency in the past year, average sleep ≤6 h. Those with poor social support were more likely to have moderate to severe job burnout ( OR=1.59, 2.94, 4.01, 2.40, 3.66, P<0.05) . Conclusion:Corresponding measures should be taken to reduce job burnout and improve work efficiency.

Objective:To explore the influencing factors of job burnout of medical staff and provide reference for the formulation of intervention measures.Methods:From November to December, 2018, a questionnaire survey was conducted among medical staff in a general hospital by using the research design of the current situation survey. A total of 1193 questionnaires were distributed and 939 questionnaires were returned, with a recovery rate of 78.7%, including 891 valid questionnaires and an effective recovery rate of 94.9%. Social support rating scale (SSRs) was used to evaluate social support, and Maslach Burnout Scale (MBI-GS) was used to evaluate job burnout. Single factor analysis was performed by chi square test and Fisher exact probability method. To explore the influencing factors of job burnout by using disordered multi classification logistic.Results:The average age was (27.47 ± 4.22) years old, female accounted for 71.5% (637/891) . The total physical examination rate of job burnout was 46.6%. The scores of emotional exhaustion, cynicism and decreased sense of achievement were (10.10±3.75) , (6.14±3.43) , (17.91±4.13) respectively. Multiple logistic regression analysis showed that, compared with the non detected job burnout, the young, working for 1-3 years, average sleep ≤6 hours, and poor social support were more likely to have mild job burnout ( OR=0.91, 0.40, 2.25, 2.38, P<0.05) ; female, high night shift frequency in the past year, average sleep ≤6 h. Those with poor social support were more likely to have moderate to severe job burnout ( OR=1.59, 2.94, 4.01, 2.40, 3.66, P<0.05) . Conclusion:Corresponding measures should be taken to reduce job burnout and improve work efficiency.

Objective: To investigate the incidence of post-bronchiolitis recurrent wheezing and its risk factors in children. Methods: This study was conducted on patients with bronchiolitis admitted to the Department of Respiratory Disease, Children′s Hospital of Soochow University between November 2016 and March 2017.Nasopharyngeal secretions were taken from all patients and assessed for respiratory pathogens.After discharge, the patients were followed up every 3 months by outpatient visit or telephone call for 1 year. Results: Eighty-nine patients with bronchiolitis were enrolled in this study.Among those 89 patients, respiratory syncytial virus(RSV) infection accounted for 46.1%(41/89 cases), Mycoplasma pneumonia(MP) for 5.6%(5/89 cases), rhinovirus(RV) for 4.5%(4/89 cases), and human bocavirus(hBoV) for 2.2%(2/89 cases). Eighty-three patients were successfully followed up.At the 3, 6, 9, and 12 months of follow-up, the occurrence of wheezing episodes for only once happened in 20 cases(24.1%), 27 cases(32.5%), 35 cases (42.2%), and 38 cases(45.8%), respectively.At 12 months after initial bronchiolitis, the occurrence of wheezing episodes for only once happened in 21 cases(25.3%), 2 episodes of wheezing in 10 cases(12.0%), and 7 cases (8.4%) had more than 3 episodes of wheezing, and 6 cases lost follow-up.The proportion of eczema and milk-protein allergy in post-bronchiolitis recurrent wheezing group was significantly higher than that of the group with not post-bronchiolitis recurrent wheezing patients (χ²=6.219, 4.855, all P<0.05). Logistic regression analysis showed eczema was the independent risk factor for post-bronchiolitis recurrent wheezing(OR=0.189, 95%CI: 0.047-0.765). There were no significant difference in gender, age, premature birth, birth weight, feeding pa-tterns, family history of asthma, pet contact history, severity of disease, course of disease, total immunoglobulin E of serum and the species of virus infected between 2 groups(all P>0.05). Conclusions The incidence of recurrent wheezing among post-bronchiolitis patients is higher during one-year follow-up period.Eczema is the independent risk factor for post-bronchiolitis recurrent wheezing.The specific pathogens and severity of disease have no correlation with post-bronchiolitis wheezing.

Objective To investigate the clinical efficacy and safety of wedge osteotomy combined with internal fixation for ulnar olecranon fracture of Mayo type ⅡB.Methods From July 2014 to December 2017,8 patients with ulnar olecranon fracture of Mayo type ⅡB were treated with wedge osteotomy of the ulnar olecranon combined with internal fixation.They were 6 men and 2 women,from 28 to 45 years of age (mean,31.4 years).The wedge osteotomy was planned preoperatively according to the literature data and the osteotomy lengths were measured postoperatively to confirm the safe range for the surgery.Fracture healing was evaluated by regular X-ray follow-up and therapeutic effects were assessed by the range of elbow motion and the Broberg-Morry scoring system.Results On average in this group,the olecranon osteotomy was 6.2 mm in length on the articular sudace and 14.5 mm at the basal part.The olecranon was shortened by 4.6 cm on average after operation.All the 8 patients were followed up for 14 to 20 months (average,16.4 months).The clinical fracture healing time ranged from 12 to 16 weeks,with an average of 14.3 weeks.Follow-ups revealed no fracture displacement,pain or internal fixation failure.No significant differences were found between the affected and the contralateral sides in the flexion,extension or range of motion of the elbow joint at 3 months or at one year after surgery (P ＞ 0.05).According to the Broberg-Morry scoring system,5 cases were rated as excellent,2 as good and one as fair at 3 months after surgery.The final follow-ups found no traumatic arthritis or joint instability.Conclusions As a new treatment alternative,wedge osteotomy combined with internal fixation can obtain satisfactory curative outcomes for ulnar olecranon fractures of Mayo type ⅡB.The wedge osteotomy was performed in a safe range for this group.