Objective:To systematically analyze the risk factors for knee injury complicated with adolescent tibial tubercle fractures (ATTF).Methods:A retrospective study was conducted to analyze the clinical data of the 90 adolescent patients (the observation group) who had been treated and fully followed up for knee injury complicated with ATTF at Department of Pediatric Orthopedics, The Second General Hospital of Fuzhou from September 2017 to April 2024. There were 86 males and 4 females, with a mean age of 14.0 (13.0, 14.0) years. The injury was on the left side in 51 cases, on the right side in 34 ones, and on the bilateral sides in 5 ones. All their injuries resulted from sports activities. In addition, another contemporary 90 patients with knee injury but no exercise-induced ATTF were enrolled as the control group, including 54 males and 36 females with a mean age of 14.0 (13.0, 14.3) years. Their injury was on the left side in 45 cases, on the right side in 41 ones, and on the bilateral sides in 4 ones. Univariate analysis was conducted to compare gender, age, injury side, height, weight, body mass index, history of Osgood-Schlatter disease (OSD), and injury mechanism between the 2 groups. Variables with P<0.1 were included in a multivariate logistic regression analysis to screen independent risk factors for ATTF. The receiver operating characteristic (ROC) curve was used to evaluate their predictive values. The optimal cutoff value was determined by Youden index. Results:The univariate analysis showed that gender, height, weight, body mass index, and OSD history were significantly correlated with the occurrence of ATTF ( P<0.05). The multivariate logistic regression analysis further confirmed that male ( P=0.017), height ( P=0.021), weight ( P=0.014), body mass index ( P=0.032) and history of OSD ( P=0.003) were independent risk factors for ATTF. The ROC curve analysis showed that weight had the largest area under the curve (AUC) in prediction of the ATTF risk, suggesting that its predictive value was the most significant. Conclusion:Male, height, weight, body mass index, and prior OSD are independent risk factors for ATTF, with the highest predictive value in weight.

Objective:To systematically analyze the risk factors for knee injury complicated with adolescent tibial tubercle fractures (ATTF).Methods:A retrospective study was conducted to analyze the clinical data of the 90 adolescent patients (the observation group) who had been treated and fully followed up for knee injury complicated with ATTF at Department of Pediatric Orthopedics, The Second General Hospital of Fuzhou from September 2017 to April 2024. There were 86 males and 4 females, with a mean age of 14.0 (13.0, 14.0) years. The injury was on the left side in 51 cases, on the right side in 34 ones, and on the bilateral sides in 5 ones. All their injuries resulted from sports activities. In addition, another contemporary 90 patients with knee injury but no exercise-induced ATTF were enrolled as the control group, including 54 males and 36 females with a mean age of 14.0 (13.0, 14.3) years. Their injury was on the left side in 45 cases, on the right side in 41 ones, and on the bilateral sides in 4 ones. Univariate analysis was conducted to compare gender, age, injury side, height, weight, body mass index, history of Osgood-Schlatter disease (OSD), and injury mechanism between the 2 groups. Variables with P<0.1 were included in a multivariate logistic regression analysis to screen independent risk factors for ATTF. The receiver operating characteristic (ROC) curve was used to evaluate their predictive values. The optimal cutoff value was determined by Youden index. Results:The univariate analysis showed that gender, height, weight, body mass index, and OSD history were significantly correlated with the occurrence of ATTF ( P<0.05). The multivariate logistic regression analysis further confirmed that male ( P=0.017), height ( P=0.021), weight ( P=0.014), body mass index ( P=0.032) and history of OSD ( P=0.003) were independent risk factors for ATTF. The ROC curve analysis showed that weight had the largest area under the curve (AUC) in prediction of the ATTF risk, suggesting that its predictive value was the most significant. Conclusion:Male, height, weight, body mass index, and prior OSD are independent risk factors for ATTF, with the highest predictive value in weight.

[Objective]To treat cough after novel coronavirus infection based on clinical cases data mining.[Methods]Collect the clinical cases of cough treated in the Outpatient Department of Anhui University of Chinese Medicine from January to February 2023. Excel 2019,SPSS Statistics 25.0 and SPSS Clementine 12.0 software were used to establish databases,and the frequency analysis,cluster analysis and association rule analysis were used to explore the medication rules for the treatment of such cough.[Results]A total of 90 cases that met the inclusion criteria,involved the drug 162 flavors,Total frequency of medication was 2028 times,with a frequency of 30 times or more,mainly for clearing heat,phlegm cough,surface-clearing medicine;Cluster analysis yielded seven pairs of high-frequency drug combinations,trichosanthis skin,ephedra,bitter almond;Peucedanum root,Cynanchum glaucescens,the winter flower;Scutellaria baicalensis,platycodon grandiflorum;Houttuynia of houttuynia,arisaema with bile;Uncaria,cicada slough;Schisandra chinensis,hihiko;Scleromitrion diffusum,golden buckwheat,peach kernel;it mined 20 binomial associations. The results showed the highest correlation between baicalensis and platgrandiflorum,29 items of three associations The results showed that baicalensis had the most associated terms,baicalensis was most associated with hot ephedra and trichosanthis skin.[Conclusion]In the treatment of cough after novel coronavirus infection,it should usually clear heat and detoxify phlegm,treat from phlegm,combine classic medicine and use cough medicine with caution.

[Objective]To treat cough after novel coronavirus infection based on clinical cases data mining.[Methods]Collect the clinical cases of cough treated in the Outpatient Department of Anhui University of Chinese Medicine from January to February 2023. Excel 2019,SPSS Statistics 25.0 and SPSS Clementine 12.0 software were used to establish databases,and the frequency analysis,cluster analysis and association rule analysis were used to explore the medication rules for the treatment of such cough.[Results]A total of 90 cases that met the inclusion criteria,involved the drug 162 flavors,Total frequency of medication was 2028 times,with a frequency of 30 times or more,mainly for clearing heat,phlegm cough,surface-clearing medicine;Cluster analysis yielded seven pairs of high-frequency drug combinations,trichosanthis skin,ephedra,bitter almond;Peucedanum root,Cynanchum glaucescens,the winter flower;Scutellaria baicalensis,platycodon grandiflorum;Houttuynia of houttuynia,arisaema with bile;Uncaria,cicada slough;Schisandra chinensis,hihiko;Scleromitrion diffusum,golden buckwheat,peach kernel;it mined 20 binomial associations. The results showed the highest correlation between baicalensis and platgrandiflorum,29 items of three associations The results showed that baicalensis had the most associated terms,baicalensis was most associated with hot ephedra and trichosanthis skin.[Conclusion]In the treatment of cough after novel coronavirus infection,it should usually clear heat and detoxify phlegm,treat from phlegm,combine classic medicine and use cough medicine with caution.

Objective:To explore the effects of residual rotational deformity after supracondylar fractures of the humerus on the surgical efficacy in children.Methods:From January 2020 to December 2021, 453 patients with Gardland type Ⅲ supracondylar humeral fracture were treated with closed reduction and percutaneous pinning at Department of Pediatric Orthopedics, The Second Hospital of Fuzhou. They were assigned into 2 groups according to the quality of reduction. In the group of residual rotational deformity of 69 cases (group A), there were 44 boys and 25 girls, with an age of (6.3±2.9) years. The Baumann angle was maintained at 65° to 80° on the anteroposterior view of intraoperative fluoroscopy and the anterior humeral line passed through the anterior 1/3 of the capitellum on the lateral view with a normal carrying angle (from 4° to 23°). In the anatomical reduction group of 384 patients (group B), there were 242 boys and 142 girls, with an age of (5.9±2.7) years. The anteroposterior view and the lateral view of intraoperative fluoroscopy showed anatomical reduction of the fracture ends. The fluoroscopy frequency, operation time, intraoperative carrying angle, the carrying angle at 6 months after operation and the Flynn score at 6 months after operation were recorded and compared between the 2 groups.Results:There was no significant difference in gender, age, side or fixation time between the 2 groups before operation, showing they were comparable ( P>0.05). All patients were followed up for (6.3±2.9) months after operation. The median intraoperative fluoroscopy frequency was 6 (4, 6) times in group A, significantly lower than that in group B [8(6, 8)], and the median operation time was 20 (20, 25) min in group A, significantly shorter than that in group B [30(25, 30) min] ( P<0.05). There was no significant difference between group A and group B in the intraoperative rying angle (19.7°±2.7° versus 20.2°±2.8°) or in the carrying angle at 6 months after operation (17.4°±2.7° versus 17.6°±2.7°) ( P>0.05). By the Flynn scoring for the elbow joint at 6 months after operation, group A had 28 excellent cases, 30 good cases, 9 moderate cases, and 2 poor cases, yielding an excellent and good rate of 84.1%(58/69); group B had 241 excellent cases, 104 good cases, 34 moderate cases, and 5 poor cases, yielding an excellent and good rate of 89.8%(345/384). There was no statistically significant difference between the 2 groups ( P>0.05). No cubitus varus, delayed union, non-union, compartment syndrome, or iatrogenic ulnar nerve injury was observed in either group at postoperative 6-month follow-up. Conclusions:A certain degree of residual rotational deformity is acceptable after supracondylar fracture of the humerus in children, because it may have a little significant effect on the postoperative outcomes but may reduce fluoroscopy frequency and shorten operation time.

Objective:To explore the diagnosis and treatment of humeral medial epicondyle fracture combined with radial neck fracture in children and adolescents.Methods:The clinical data were retro-spectively analyzed of the 12 pediatric patients with fractures of the humeral medial epicondyle plus the radial neck who had been admitted from February 2015 to August 2021 to Department of Pediatric Orthopedics, The Second Hospital of Fuzhou. There were 6 males and 6 females, with an age of (11.1 ± 2.5) years. According to the Papavasiliou classification, the humeral medial epicondyle fractures were type Ⅱ in 7 cases, type Ⅲ in 2 cases and type Ⅳ in 3 cases; according to the Judet classification, the radial neck fractures were type Ⅰ in 3 cases, type Ⅱ in 4 cases and type Ⅲ in 5 cases. Two Judet-Ⅰ radial neck fractures were missed by X-ray exam-ination but diagnosed by CT examination. Of the humeral medial epicondylar fractures, 9 were treated by open reduction and hollow screwing and 3 by closed reduction and Kirschner wiring. Of the radial neck fractures, 8 were treated by closed reduction and elastic intramedullary nailing and 4 conservatively. Fracture healing was followed up by postoperative radiographs. At the last follow-up, the carrying angles were measured, Kim Elbow Function Score (KEPS) was used to evaluate the functional recovery of the injured limb, and related complications were recorded.Results:All the 12 patients were followed up for (40.0±25.6) months. Fractures headed after (6.3±1.2) weeks. At the last follow-up, the carrying angle was 15.5°±2.6° on the injured side and 14.7°±2.0° on the healthy side, showing no significant difference ( P>0.05); KEPS was (96.3±5.3) points on the injured side and (98.8±2.3) points on the healthy side, showing no significant difference either ( P>0.05). No incision infection, bone nonunion, elbow valgus, joint stiffness or other complications were found; the postoperative elbow stability recovered well. Conclusions:As the fracture of the humeral medial epicondyle combined with the radial neck fracture is a special type of injury of straightened elbow during valgus stress in children and adolescents, it is likely to be missed in diagnosis. The goal of treatment is good functional recovery by restoring the articular match and elbow stability.

Objective:To investigate the biomechanical properties of a new pediatric femoral neck system in the fixation of pediatric femoral neck fractures with a free fracture fragment.Methods:Ten Sawbones model bones were randomly divided into 2 even groups ( n=5), all of which were made into Delbet Type Ⅱ femoral neck fractures with a Pauwels angle of 70°. A free bone block was removed from the bottom at the proximal end of the fracture to simulate a femoral neck fracture with a free fragment. Group A were fixed with traditional inverted triangle cannulated screws, and group B with a new pediatric femoral neck system. After the 2 groups of specimens were placed on a biomechanical testing machine, each specimen was subjected to a static axial compression test, an anti-torsion test and a cyclic load test in turn. The biomechanical results were compared between groups A and B in aspects of axial compression stiffness, torsional stiffness and maximum displacement difference. Results:The axial compression stiffness [(321.718±5.770) N/mm] and torsional rigidity [(1.448±0.079) N·m/°] in group B were significantly higher than those in group A [(266.722±4.788) N/mm and (1.282±0.023) N·m/°] ( P<0.05). The maximum displacement difference in the cyclic load test in group B [(0.063±0.038) mm] was also significantly smaller than that in group A [(0.117±0.056) mm] ( P<0.05). Conclusion:In fixation of pediatric femoral neck fractures with a free fracture fragment, the new pediatric femoral neck system can lead to better biomechanical stability than the traditional inverted triangle cannulated screws.

Objective:To evaluate the ultrasonography-guided percutaneous leverage reduction in the treatment of pediatric radial neck fractures.Methods:From May 2016 to May 2018, 42 patients with Judet Ⅲ or Ⅳ radial neck fracture were treated at Department of Pediatric Orthopedics, The Second Hospital of Fuzhou. They were 15 boys and 27 girls, aged from 3 to 12 years. All of them were treated by percutaneous leverage reduction and Métaizeau technique. The operative procedures were guided by ultrasonography in 20 cases and by C-arm fluoroscopy in 22 cases. Postoperative evaluation was based on Métaizeau imaging criteria, Tibone and Stoltz functional criteria; complications such as radial nerve injury were recorded.Results:There were no statistically significant differences between the ultrasonography-guided group and the fluoroscopy-guided group in preoperative general data, showing comparability ( P>0.05). There were no significant differences between the 2 groups in terms of Métaizeau imaging, Tibone or Stoltz functional scores ( P>0.05). The frequency of fluoroscopy was (2.7±0.6) times for the ultrasonography group and (14.6±3.4) times for the fluoroscopy group while the operation time averaged (25.8±5.9) min for the former and (38.1±9.2) min for the latter, showing significant differences ( P<0.05). No postoperative complications were observed in the ultrasonography group while 4 cases of radial nerve injury in the fluoroscopy group, also showing significant difference between the 2 groups ( P< 0.05). Conclusion:Ultrasonography-guided percutaneous leverage reduction is a suitable surgical treatment of radial neck fracture in children, because it is simple, effective and safe.

Objective To investigate the relationship between the expression of Pin1 and Ki67 and the clinicopathologic features of gastrointestinal stromal tumors (GIST).Methods 40 paraffin-embeded specimens of surgical resected GIST from Jan.2013 to May.2015 in Pathology Department of Yuhuangding Hospital Affiliated to Qingdao University were retrieved and expressions of Pin1 and Ki67 were detected by immunohistochemical methods.Results The positivity rate of Pin1 and Ki67 in GIST was 80％ and 32.5％ respectively.The expression of Pin1 was associated with malignancy of GIST,tumor location,tumor size and mitotic counts.The expression of Ki67 is associated with malignancy of GIST,tumor location,tumor size,mitotic counts and tumour necrosis.Pin1 expression was positively related with Ki67 expression.Conclusion Pin1 and Ki67 is closely related with malignancy of GIST,which may be potential factors in predicting prognosis of GIST.

OBJECTIVETo investigate the methylation in promtor region of RASSF2 and sFRP1 in sporadic colorectal cancer patients in order to provide screening method for early colorectal cancer.

METHODSThe methylation in promoter region of RASSF2 and sFRP1 in serum samples of 59 sporadic colorectal cancer patients and 59 healthy volunteers was detected by methylation specific PCR. The association between clinicopathological features of sporadic colorectal cancer patients and methylation in promoter region of RASSF2 and sFRP1 was analyzed.

RESULTSThe methylation rates of RASSF2 and sFRP1 gene in serum of 59 sporadic colorectal cancer patients were 27.1% and 30.5%, significantly higher than those in healthy volunteers(0%, both P<0.01). The methylation of RASSF2 or sFRP1 occurred in 29(49.2%) patients, which was significantly higer than the methylation rate of single gene(P<0.05). No association was found between methylation ratio of RASSF2 and sFRP1 and clinicopathological features in sporadic colorectal cancer patients.

CONCLUSIONSMethylation in promoter region of RASSF2 and sFRP1 is often detected in serum of colorectal cancer patients. The combination detection of methylation for the two genes may provide information for early screening of colorectal cancer.

Colorectal Neoplasms ; diagnosis ; genetics ; DNA Methylation ; Female ; Humans ; Intercellular Signaling Peptides and Proteins ; blood ; genetics ; Male ; Membrane Proteins ; blood ; genetics ; Middle Aged ; Promoter Regions, Genetic ; Tumor Suppressor Proteins ; blood ; genetics