OBJECTIVE: To explore the integrated traditional Chinese and Western medicine treatment plan for ankylosing spondylitis complicated with lower cervical spine fracture and dislocation, adopt the treatment plan of preoperative continuous traction, intraoperative prizing reduction combined with anterior long-segment plate-screw and posterior short-segment pedicle screw-rod system internal fixation, and evaluate its surgical efficacy and clinical application value. METHODS: From June 2018 to September 2022, 7 male patients with ankylosing spondylitis complicated with lower cervical spine fractures were admitted, aged 43 to 65 years old. Among them, there was 1 case of C_3,4 fracture, 1 case of C_4,5 fracture, 1 case of C_6,7 fracture, and 4 cases of C_5,6 fracture, all of which were fracture and dislocation. All patients received preoperative continuous skull traction, and intraoperative prizing reduction combined with anterior long-segment plate-screw and posterior short-segment pedicle screw-rod system internal fixation. The Neck Disability Index (NDI), Japanese Orthopedic Association (JOA) score, and Frankel scale were used to evaluate the neurological function and quality of life before and after surgery. The visual analogue scale (VAS) was used to evaluate neck and limb pain. The operation time, blood loss, hospital stay, and surgery-related complications were recorded. RESULTS: All 7 patients were followed up for 6 to 24 months after surgery. The operation time of the 7 patients ranged from 300 to 480 minutes, the blood loss ranged from 300 to 1000 ml, and the hospital stay ranged from 8 to 25 days. The preoperative NDI of the 7 patients ranged from 25% to 42%, which decreased to 12% to 30% at 1 week after surgery and 5% to 25% at the last follow-up. The preoperative JOA score ranged from 8 to 13 points, which increased to 12 to 15 points at 1 week after surgery and 13 to 16 points at the last follow-up. The preoperative VAS ranged from 6 to 8 points, which decreased to 2 to 4 points at 1 week after surgery and 0 to 3 points at the last follow-up. Regarding the Frankel grade of neurological function, 2 patients were grade C before surgery and recovered to grade D at the last follow-up after surgery, and the remaining patients recovered to grade E at the last follow-up after surgery. There were 3 cases of pressure ulcers, including 1 case of intraoperative pressure ulcer, 1 case of cervical cerebrospinal fluid leakage, 1 case of screw loosening, and 1 case of aggravated fracture dislocation due to preoperative traction. CONCLUSION Preoperative cervical traction combined with intraoperative prizing reduction and anterior long-segment plate combined with posterior short-segment pedicle screw internal fixation provides a safe and effective surgical option for ankylosing spondylitis complicated with lower cervical spine fracture and dislocation, which can minimize surgical trauma and improve clinical efficacy. However, this study has a small sample size and a short follow-up time for some patients, so further verification with large-sample and long-term follow-up data is still needed.
Humans ; Male ; Adult ; Middle Aged ; Fracture Fixation, Internal/methods* ; Spondylitis, Ankylosing/surgery* ; Cervical Vertebrae/surgery* ; Spinal Fractures/surgery* ; Traction ; Aged ; Joint Dislocations/surgery*

"5+3" integrated training program is a new training model to cultivate doctors under the background of preclinical teaching and clinical training integration. Based on practice in Shantou University Medical College, the program design current progress and solution to the problem were elaborated. It adheres to principles of overall optimization and orienting to clinic, and to ensure the smooth implementation of the training model. Which will provide important reference for the reform of long-term medical training program in higher medical colleges and universities.

Objective: To investigate the influence of different feeding ways on the incidence rate of complication in patients with congenital cleft lip and their family satisfaction degree. Methods: A retrospective analysis were conducted from 90 cases underwent surgery of congenital cleft lip with clinical data, were randomly assigned to the control group and the observation group, 45 cases in each. The control group routinely take spoon feeding way after surgery, whereas patients in the observation group does not change the feeding way in the past, continuely taking the nipple feeding or breastfeeding. Wound infection rate, wound rupture rate, crying in the process of feeding and parents' satisfaction were compared between the two groups. Results: The wound infection rate and wound rate of the observation group were 2.2% and 0 respectively, the control group were 4.4% and 0 respectively. There was no significant difference between the 2 groups in the 2 index (P > 0.05). In the observation group, the crying children were less than the control group, In the observation group, the degree of coordination, parental satisfaction and acceptance of feeding were 84.4%, 88.9%, 93.3%, respectively, the control group were 55.6%, 60.0%, 66.7%. The observation group were better than the control group. The differences between groups was statistically significant (χ2coordination degree = 8.94, χ2satisfaction degree = 9.87, χ2recognition degree = 10.00, P < 0.05). Conclusion Children under the age of 1 with congenital grade Ⅰ and Ⅱ cleft lip do not change the way of feeding after surgery , who continue to take the bottle or breastfeeding can better meet the needs of children fed liquid diet, crying reduce, get parents' recogniton and reduce the burden on parents than the control group conventionally fed with a spoon.

PURPOSE: The aim of this study was to determine the relationship of hypoxia-inducible factor-2 (HIF-2α) and vascular endothelial growth factor (VEGF) with radiographic severity in primary osteoarthritis (OA) of the knee. Expression of these two factors in cartilage samples from OA knee joints was examined at mRNA and protein levels. MATERIALS AND METHODS: Knee joints were examined using plain radiographs, and OA severity was assessed using the Kellgren and Lawrence (KL) grading system. Specimens were collected from 29 patients (31 knees) who underwent total knee replacement because of severe medial OA of the knee (KL grades 3 and 4), 16 patients who underwent knee arthroscopy (KL grade 2), and 5 patients with traumatic knees (KL grade 0). HIF-2α and VEGF expression was quantified by real-time polymerase chain reaction and western blotting. RESULTS: Cartilage degeneration correlated with the radiographic severity grade. OA severity, determined using the Mankin scale, correlated positively with the KL grade (r=0.8790, p<0.01), and HIF-2α and VEGF levels with the radiographic severity of knee OA (r=0.7001, p<0.05; r=0.6647, p<0.05). CONCLUSION: In OA cartilage, HIF-2α and VEGF mRNA and protein levels were significantly and positively correlated. The expression of both factors correlated positively with the KL grade. HIF-2α and VEGF, therefore, may serve as biochemical markers as well as potential therapeutic targets in knee OA.
Adult ; Aged ; Arthroplasty, Replacement, Knee ; Arthroscopy ; Basic Helix-Loop-Helix Transcription Factors/*metabolism ; Biomarkers/*blood ; Cartilage/*metabolism ; Female ; Humans ; Knee Joint/*diagnostic imaging ; Male ; Middle Aged ; Osteoarthritis, Knee/*blood/diagnostic imaging/physiopathology ; RNA, Messenger ; Radiography ; Real-Time Polymerase Chain Reaction ; Severity of Illness Index ; Vascular Endothelial Growth Factor A/*metabolism

OBJECTIVETo study the effectiveness of waist circumference cut-off values in predicting the prevalence of metabolic syndrome (MetS) and risk factors in adults in China.

METHODSA cross-sectional survey was condcuted in 14 provinces (autonomous region, municipality) in China. A total of 47,325 adults aged⋝20 years were selected by multistage stratified sampling, and questionnaire survey and physical and clinical examination were conducted among them. MetS was defined according to the International Diabetes Federation (IDF) criteria and modified IDF criteria.

RESULTSThe age-standardized prevalence of MetS was 24.2% (22.1% in men and 25.8% in women) and 19.5% (22.1% in men and 18.0% in women) according to the IDF criteria and modified IDF criteria respectively. The age-standardized prevalence of pre-MetS was 8.1% (8.6% in men and 7.8% in women) according to the modified IDF criteria. The prevalence of MetS was higher in urban residents than rural residents and in northern China residents than in southern China residents. The prevalence of central obesity was about 30% in both men and women according to the ethnicity-specific cut-off values of waist circumference for central obesity (90 cm for men and 85 cm for women). Multivariate regression analysis revealed no significant difference in risk factors between the two MetS definitions.

CONCLUSIONUsing both the modified IDF criteria and ethnicity-specific cut-off values of waist circumference can provide more useful information about the prevalence of MetS in China. Conclusion Using both the modified IDF criteria and ethnicity-specific cut-off values of waist circumference can provide more useful information about the prevalence of MetS in China.

Adult ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Metabolic Syndrome ; diagnosis ; epidemiology ; Middle Aged ; Obesity ; epidemiology ; Prevalence ; Risk Assessment ; Risk Factors ; Waist Circumference

Objective To investigate the prevalence of high risk human papillomavirus (HPV) genital infection and cervical cancer in adult women from Shenzhen.Methods Cluster sampling was used to investigate the prevalence of HPV infection and cervical cancer from women aged 20-59 years old living in Luohu,Futian,Nanshan,Longgang and Baoan districts in Shenzhen from April 2006 to April 2010.All women were detected for liquid-based cytology test (LCT) or Thinprep cytologic test (TCT)and high-risk HPV-DNA test with hybrid capture Ⅱ (HC-Ⅱ ).All women with ≥ASC-US by cytology and/or a positive HC- Ⅱ test were asked to return for colposcopy and four-quadrant biopsy.Endocervical curettage was performed.Pathological finding were used as the gold standard of the diagnosis of cervical intraepithelial neoplasia.Results 10 210 women were involved in the study and 10 017 of them having completed data.The overall positive rate of high-risk HPV-DNA was 16.29％.HPV positive rates in 20-,30-,35-,40-,45-,50-59 age groups were 17.37％,15.59％,16.33％,14.74％,17.16％ and 17.98％,respectively.The curve of HPV infection rates in different age groups appeared a ‘W' shape.HPV infection rates in the 25-years-olds and 50-59 year-olds groups were significantly higher than the other age groups (x2=4.50,P=0.03 ).The overall prevalence rate of cervical intraepithelial lesions (CIN) was 7.52％,of which the prevalence rates of low-grade cervical intraepithelial lesions (CIN Ⅰ) was 5.32％ high-grade cervical intraepithelial lesions (CIN Ⅱ/Ⅲ ) was 2.21％,cervical cancer was 0.12％.The prevalence of CIN Ⅰ was significantly higher than the CIN Ⅱ/Ⅲ (x2=134.15,P＜0.001 ).The prevalence of cervical cancer in 45- age group was 0.12％,the highest.HPV infection rates increased with the grades of cervical lesions including women without CIN as 44.31％,in CIN Ⅰ as 70.73％,in CIN Ⅱ as 86.73％,and in CIN Ⅲ as 96.75％ and in cancer as 100.00％.The HPV infection rates were different in districts (x2=17.81,P=0.03 ),with Futian and Luohu higher than those of Nanshan,Longgang and Baoan district.The prevalence rate of CIN in Baoan was lower than other districts.The CIN prevalence rates were not significantly different among the other districts of Shenzhen (x2=4.84,P=0.18).Conclusion The prevalence of cervical cancer was low in adult women living in Shenzhen,with cervical lesions still in the early stage.Prevention of HPV infection and treatment of CIN were the key points for the prevention of cervical cancer.

Adult ; Aged ; Antigens, CD34 ; metabolism ; Chondrosarcoma, Mesenchymal ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Hemangiopericytoma ; metabolism ; pathology ; radiotherapy ; surgery ; Humans ; Male ; Meningeal Neoplasms ; metabolism ; pathology ; radiotherapy ; surgery ; Meningioma ; metabolism ; pathology ; Middle Aged ; Neoplasm Recurrence, Local ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Solitary Fibrous Tumors ; metabolism ; pathology ; Vimentin ; metabolism ; Young Adult

In order to analyze the molecular epidemiology of Hantavirus (HV) in Zhejiang Province, the complete M and S genome sequences of 12 HV strains from different hosts and locations in Zhejiang Province of China during the period of 1981-2007 were analyzed on genetic evolution by DNAstar and MEGA 4.0 software in this research. Phylogenetic analyses revealed that HTN and SEO strains were co-circulating in Zhejiang Province, and the difference in sequence similarity and the phylogeny was closely related to the isolated regions, but had no distinct relationship with the isolate year and the host, indicating a relationship between epidemiology of HFRS and the distribution region, especially in HTNV. The isolates in the same region could be assigned in same or near phylogenetic clade sharing high sequence similarity. Interestingly, the Gou3 strain and ZJ5 strain isolated from Jiande region in Zhejiang Province formed a distinct phylogenetic lineage in SEOV clade, and different from the other SEOV variants outside China. We believed that the special SEOV variants were distributed in Jiande region.
Animals ; China ; Disease Reservoirs ; virology ; Evolution, Molecular ; Hantavirus ; classification ; genetics ; isolation & purification ; Hantavirus Infections ; virology ; Humans ; Molecular Sequence Data ; Phylogeny ; Rodentia ; virology ; Viral Proteins ; genetics

Objective To evaluate the value of cervical cytology and hybrid capture Ⅱ (HC-Ⅱ) human papillomavarus (HPV) test for screening cervical lesion. Methods Conventional papanicolaou (Pap) smear by improved take-samples, liquid-based cytology test (LCT) and HC-Ⅱ human papillomavarus test were performed in 425 women in Shang Mei-lin community of Futian region in Shenzhen city, from December 2007 to March 2008 and the above methods were performed in 75 women in Shenzhen Hospital of Peking University at the same time. Age stratified sampling was used. Samples of Pap were taken a broom-type sampling device (take-samples used for LCT) with split-sampling method. Those women with HPV-positive, Pap≥atypical squamous cells of undetermined sign (ASCUS) or LCT≥ASCUS received multi-spot biopsy and endocervical curettage under colposcopy. Final diagnosis would depend on pathological findings as well, to evaluate the values of Pap, LCT, HC-Ⅱ HPV, Pap-HPV parallel test, LCT-HPV parallel test, Pap-HPV serial test and LCT-HPV serial test for the screening program on cervical cancer. Results (1) In this study, 7 women bad cervical intraepithelial neoplasia (CIN) Ⅱ, another 7 had CIN Ⅲ, 1 had cervical cancer in the community; 9 had CIN Ⅱ, 11 had CIN Ⅲ, 3 had cervical cancer in the hospital, respectively. (2) The sensitivity of HC-Ⅱ HPV and cytology-HPV parallel test for detecting≥CIN Ⅱ was >95.0% while negative pre-value were nearly 100.0%. (3) There were no significant differences of screening effectiveness and unsatisfactory rates between Pap of improved take-samples and LCT. (4) The cost-effectiveness ratio of Pap-HPV parallel test was higher than LCT-HPV parallel test. Conclusion It was suggested that the first choice for screening of cervical serious lesion were HC-Ⅱ HPV and cytology-HPV parallel test while Pap-HPV parallel test was the best method for screening purposes.

Objective This study assessed the effect of food preference and dietary behaviors on the risk of overweight or obesity in school children and adolescents aged 6-19 years.Methods A11 overweight or obeoe students,with age-and school-matched controls were recruited for this case-control study from 28 elementary and secondary schools in Guangzhou urban districts from October 2006 to April 2007.Weight and height were measured,and body nlass index was calculated for the classification of obesity.overweight and underweight.Their food preference and behaviors were asesbed using a structured questionnaire completed by their parents.Behavior and food preference were classified into four levels.and the relevant bottom levels were defined as control groups.Logistic regression wfs used to assess independent determinants of overweight and obesity.Results Among 7136 participants,1947 cases and 2136 normal weight controls from 5755 students with valid questionnaire data were included in the study.Results from univariate analysis showed that odds ratios for overweight or obesity were 0.60-0.69 in those with moat preference(top group)on vegetables,fruits,candy,evening snacks,0.50 in the students of less food partiality,1.84,1.30 and 1.26 in those of most preference for pork,beef and deep-fried foods.and 5.14 in students with fastest speed during eating,respectively(all P<0.05).Vegetable intake,evening snacks preference,speed during eating and food partiality remained with significant agsociation with overweight and obesity in multivariate analysis after adjusted for age,sex,family socio-economical status and their parents' body build. The adjusted odds ratios (OR) and 95% confidence intervals (95% CI) of the above items became 0.55 (0.42-0.73), 0.48 (0.35-0.65), 0.50(0.39-0.65),and 4.32(3.23-5.80) as compared to the relevant lowest categories, respecively. Conclusion Behaviors as eating more vegetable and slow-eating might be protective factos against overweight and obesity in school clildren.