OBJECTIVES: To explore the correlation of hypertension with postoperative cognitive dysfunction and its possible mechanism. METHODS: Twelve-week-old spontaneously hypertensive rats (SHRs) and Wistar-Kyoto (WKY) rats were both randomized into control group and surgical group (n=8). In the latter group, the rats received carotid artery exposure surgery under sevoflurane anesthesia to establish models of postoperative learning and memory impairment. Postoperative cognitive function changes of the rats were evaluated using behavioral tests. The hippocampus of the rats were collected for determining ATP level and mitochondrial membrane potential (MMP) and for detecting expressions of UCP2 and astrocyte markers (GFAP and NOX4) using Western blotting and immunofluorescence staining. Serum levels of ROS, IL-6, IL-1β and TNF‑α were detected using ELISA. Nissl staining was used to examine hippocampal neuronal loss in the CA1 region. RESULTS: The SHRs exhibited exacerbated learning and memory deficits following the surgery as shown by significantly reduced performance in novel object recognition tests and context-related and tone-related fear conditioning experiments. Compared with WKY rats, the SHRs had significantly decreased mitochondrial UCP2 expression and MMP in the hippocampus, increased hippocampal ATP level, and markedly increased serum levels of ROS and inflammatory factors, showing also increased activation of hippocampal astrocytes and microglia and reduced number of neurons positive for Nissl staining. CONCLUSIONS Hypertension can exacerbate major postoperative learning and memory impairment in rats possibly as a result of UCP2-mediated mitochondrial dysfunction and oxidative stress damage, which further leads to astrocyte overactivation and neuronal damage.
Animals ; Rats, Inbred SHR ; Rats ; Uncoupling Protein 2 ; Rats, Inbred WKY ; Hypertension/physiopathology* ; Hippocampus/metabolism* ; Mitochondria/metabolism* ; Down-Regulation ; Male ; Memory Disorders/etiology* ; Mitochondrial Proteins/metabolism*

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Objective:To discuss the possibility of modifying nonfunctional distractors to improve the quality of multiple-choice questions in medical examination through analyzing the changes in the difficulty and discrimination of items and the selection rate of modified distractors.Methods:Thirty-two multiple-choice questions involving nonfunctional distractors from a medical examination were studied. According to the item-writing guidelines, experts modified nonfunctional distractors based on actual measurements. We analyzed the changes in the difficulty and discrimination of items and the selection rate of modified distractors before and after item modification using the paired Wilcoxon test, and investigated the correlation of item difficulty and discrimination before and after item modification by Spearman's rank correlation analysis.Results:Six questions were modified due to technical factors, and 26 questions were modified due to weak interference in knowledge content. Before and after nonfunctional distractor modification, the difficulty values of the questions were 0.676 (0.558, 0.893) and 0.637 (0.531, 0.839), respectively; the discrimination values (point-biserial correlation) were 0.261 (0.150, 0.316) and 0.262 (0.138, 0.358), respectively; and the discrimination index values were 0.215 (0.113, 0.352) and 0.259 (0.138, 0.346), respectively. There were significant differences in the difficulty and discrimination index of items before and after modification. The difficulty and discrimination of items before and after modification were both significantly correlated. The selection rates of modified distractors were 0.009 (0.003, 0.015) and 0.044 (0.021, 0.092) before and after modification, respectively, which were significantly different.Conclusions:Nonfunctional distractors in this study were mainly caused by reasons in the contents of the test questions, less in technical defects. Through the analysis and modification of nonfunctional distractors, the selection rate of nonfunctional distractors can be effectively increased, and item difficulty and discrimination can be improved.

Objective: To investigate the status of physical development, vitamin A and vitamin D among primary and middle school students in poor rural areas in Hubei, to evaluate the implementation effectiveness of the Nutrition Improvement Program for Rural Compulsory Education Students (abbreviated to the program) from 2012 to 2021. Methods: In Enshi City, a pilot monitoring county of the program in Hubei, and a total of 2 554 students from one primary school and one junior middle school were randomly selected. During September to October in 2012-2021, height was measured, and fasting venous blood was collected from students, and serum vitamin A and vitamin D were detected. Results: From 2012 to 2021, height, serum vitamin A and serum vitamin D concentration increased by 2.7 cm, 96.7 μg/L and 8.6 ng/mL. Growth retardation rate decreased by 1.0%. The subclinical and clinical deficiency of serum vitamin A decreased by 37.3% and 6.2%. The subclinical and clinical deficiency of serum vitamin D decreased by 45.7% and 8.5%. Height was positively correlated with serum vitamin A status and negatively correlated with serum vitamin D status ( r =0.08,-0.08, P <0.01). Conclusion The pilot counties of the program in Enshi, has witnessed improvement in height, serum vitamin A and vitamin D status among primary and secondary students. However, future efforts remains essential as subclinical deficiency of vitamin A and vitamin D are noted in some students. Serum vitamin A is positively associated with height, and vitamin D is negatively associated with height.Considering the correlation between serum vitamin A and vitamin D status with height, continued efforts should be implemented in poor rural areasto strengthen targeted nutrition intervention for students in Hubei.

Objective To investigate the therapeutic effect of anteromedial ankle approach for talus fracture.Methods From January 2012 to October 2018,the data of 28 cases of talus fracture treated by anteromedial ankle approach were retrospectively analyzed,including 26 males and 2 females,aged 24-61 years with an average of 38.6 years.All 25 cases of closed injuries and 3 cases of open injuries were fresh injuries.There were 16 cases of traffic injuries,8 falling injuries,2 heavy object injuries and 2 sprains.Among the 28 patients,17 were talus neck fractures,and according to Hawkins talus neck fracture classification,there were 1 case of type Ⅰ,12 type Ⅱ,and 4 type Ⅲ.There were 11 cases of talus fracture,which were classified according to Sneppen talus fracture types:2 cases of type Ⅰ,8 cases of type Ⅱ and 1 case of type Ⅴ.Among them,2 cases of talus neck fracture complicated with T12 vertebral body fractures and 2 cases complicated with calcaneal fractures.The time from injury to operation for 3 patients with open fracture was 3-6 hours.25 cases of closed fracture injuries took 2-10 hours to operate,with an average time of 5.6 hours.All patients were fixed with cannulated screws through the anteromedial ankle approach.The weight-bearing time and strength of lower limbs were determined according to fracture healing after surgery.The ankle function was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) Score.Results All 28 patients were followed up for 23 to 82 months,with an average of 37.5 months.All fractures healed.The healing time of talus neck fracture was 3.5-8 months,with an average of 5 months.The healing time of talus fracture was 3-7 months,averaging 4.5 months.At the latest follow-up,AOFAS score ranged from 68 to 100,with an average of 82.5 points,including excellent in 15 cases,good in 8 cases,fair in 4 cases and poor in 1 case,with the excellent and good rate of 82.1％ (23/28).There were no signs of fracture displacement,malunion,loosening and prolapse of internal fixation,fracture and ischemic necrosis of talus after operation.Traumatic arthritis occurred in 9 patients,with an incidence rate of 32.1％ (9/28).Tibial joint was involved in 5 cases,talus joint in 3 cases,tibialis in 1 case and talus joint in 1 case.Among them,traumatic arthritis occurred in 2 cases of open injury.Nine patients (32.1％) suffered from traumatic arthritis 6-10 months after operation,with an average of 8 months.According to conservative treatments such as weight control,ankle immobilization,physiotherapy,anti-inflammatory and analgesic,nutrition of articular cartilage drugs,joint traction and plasty were given.The patients' conditions improved to different degrees and could tolerate walking and normal life and work.Conclusion The anteromedial ankle approach has the advantages of minimal vessel injuries,clear exposure for direct reduction,low rate of necrosis of talus and satisfactory curative effect.

Objective To investigate the clinical efficacy of the procedure for prolapse and hemorrhoids (PPH) plus external dissection and internal ligation in small incisions in the treatment of circumferential mixed hemorrhoids.Methods From January 2015 to January 2017,168 patients with annular mixed hemorrhoids in the People's Hospital of Qingzhou were selected.All cases were treated with PPH combined with small incision exfoliation and internal ligation.The clinical data of 168 patients were analyzed.Results Average operation time was 25 minutes;average hospital stay time was 6 days;168 cases were all cured,2 cases suffered from anal margin edema,7 cases urinary retention.There was no complications such as anal stricture,fecal incontinence etc.Conclusion PPH plus external dissection and internal ligation in small incisions in the treatment of circumferential mixed hemorrhoids has such multiple advantages as small incision,minor trauma,exact efficacy,less complications after operation and shorter hospital stay.

OBJECTIVETo evaluate the current feeding status of infants and young children under 2 years old in rural areas of Hubei province.

METHODSThe study was conducted by cluster random sampling from September 2009 to march 2010. The data on breastfeeding and complementary food supplement of the 1 197 infants and young children aged 0-23 months in 8 counties of Hubei province were collected through questionnaires. The feeding status was analyzed according to the WHO 2008 edition of Indicators for assessing infant and young child feeding practices.

RESULTSA total of 1 197 children aged 0-23 months were investigated. The rate of ever breastfeeding of children aged 0-23 months reached up to 93.9% (1 124/1 197), while the percentage of early initiation of breastfeeding was only 22.0% (263/1 197). The rates of exclusive breastfeeding under 6 months, continued breastfeeding for 1 year, and continued breastfeeding for 2 years were 72.1% (277/384), 17.0% (26/153) and 4.9% (7/144), respectively. The median time of giving complementary food was the 6th month and the weaning time was the 9th month. The rate of complementary food supplemented from 6th-8th month in time was 61.8% (444/718) . The rates of minimum dietary diversity, minimum meal frequency, minimum acceptable diet, and consumption of iron-rich or iron-fortified foods among children aged 6-23 months were 61.7% (502/813), 81.5% (663/813), 54.4% (442/813) and 50.1% (407/813), respectively.

CONCLUSIONLate initiation of breastfeeding, non-continued breastfeeding, giving complementary food too early or too late, inadequate category and frequency of complementary food, and the low rate of consumption of iron-rich or iron-fortified foods were the main issues to be concerned on infant feeding in rural areas of Hubei province.

Breast Feeding ; statistics & numerical data ; Child, Preschool ; China ; Diet Surveys ; statistics & numerical data ; Feeding Behavior ; Humans ; Infant ; Infant Food ; statistics & numerical data ; Rural Population ; Surveys and Questionnaires ; Weaning

Objective Benign childhood epilepsy with centrotemporal spikes (BECT) is the most common partial epilepsy syndrome in children, and responds well to carbamazepine (CBZ), oxcarbazepine (OXC), and valproic acid (VPA). The aim of this study is to investigate the therapeutic effect of OXC on BECT. Methods We retrospectively discussed a case of partial epilepsy in a 6-year-old boy with no abnormality on neuroradiologic examination. Results The patient′s seizures were easily controlled by administration of OXC, but electroencephalography (EEG) identified deterioration of the EEG features following the introduction of OXC monotherapy. Then OXC was gradually decreased in dose and substituted with VPA. When VPA was increased to the dose of 0.5g/d, the boy had no more seizures and exhibited normal EEG in the conscious state. Conclusion OXC may induce new types of seizure and aggravate EEG features although it is considered to be the first-line anti-epileptic drug (AED) and much better tolerated than either phenytoin or CBZ.