Objective To investigate the efficacy of antibiotic cement column combined with iliac bone graft in the treat-ment of open fracture with bone defect of distal femur.Methods From October 2014 to March 2021,16 patients of open frac-ture bone defect of distal femur were treated with antibiotic bone cement column and iliac bone graft,including 12 males and 4 females.The age ranged from 28 to 68 years old.There were 11 cases of traffic accident injury,5 cases of falling injury,3 cases as Gustilo type Ⅰ,5 cases as type Ⅱ and 8 cases as type Ⅲ A.AO classification was used:9 cases of C2 type and 7 cases of C3 type.The time from injury to final bone grafting ranged from 4 to 119 days.The length of bone defect ranged from 2 tol0 cm.Fractures healing time,complications and knee function Merchan score were recorded.Results All the 16 patients were fol-lowed up from 9 to 29 months.The incisions of 16 patients healed in one stage without postoperative infection,plate fracture,limb shortening and valgus and varus deformity.The healing time randed from 4 to 10 months.Knee joint function according to the Merchant scoring standard,showed that 8 cases were excellent,4 cases were good,3 cases were fair,and 1 case was poor.Conclusion The use of antibiotic bone cement column combined with iliac bone graft in the treatment of open and complex bone defects of distal femur is an effective surgical method to prevent infection,assist fracture reduction,increase fixation strength and significantly reduce the amount of bone grafting.

Objective To understand the disease acceptance status and related factors in human immunodeficiency virus(HIV)-infected/acquired immunodeficiency syndrom(AIDS)patients,so as to guide the clinical development of intervention measures,and to provide empirical evidence for improving clinical outcomes.Methods Convenience sampling method was used to select 555 HIV-infected/AIDS patients who received treatment in the designated AIDS treatment clinic of a hospital.General data,disease acceptance,disease self-management efficacy and clinical out-comes(such as quality of life,CD4+T lymphocyte count and HIV viral load)of the studied subjects were collected.Results The average disease acceptance of HIV-infected/AIDS patients was(26.08±5.34)points.Multiple linear regression analysis showed that religious belief and self-management efficacy were related factors affecting the di-sease acceptance of patients(both P＜0.05),which could explain the 30.4％variation in disease acceptance of HIV-infected/AIDS patients,and the disease acceptance of patients was closely related to their quality of life(P＜0.001).Conclusion HIV-infected/AIDS patients have a moderate level of disease acceptance.Medical staff should fully consider patients'religious beliefs and self-management efficacy,so as to formulate targeted intervention mea-sures to improve patients'acceptance of disease,and further promote patients'quality of life.

OBJECTIVE: To explore the characteristics of Shwachman-Diamond syndrome (SDS) in Chinese children in order to provide a reference for early diagnosis. METHODS: With Shwachman-Diamond syndrome, SDS, SBDS gene and inherited bone marrow failure as the keywords, the search period was set from January 2002 to October 2022. Relevant literature was retrieved from the Wanfang Database and China National Knowledge Infrastructure (CNKI) database. In addition, by using Shwachman-diamond syndrome as a keyword, the search period was also retrieved from the Web of Science, PubMed, and MEDLINE databases from January 2002 to October 2022. A child with SDS treated at the Tongji Hospital was also included. A total of 44 cases with complete clinical data were analyzed with reference to the International Standard for SDS Diagnosis. Chi-square test and t test were used for statistical analysis. Evidence-based research was carried out in the form of systematic review. The epidemiology, clinical characteristics and key points of early diagnosis of the Chinese SDS children were summarized and compared with the international data. RESULTS: The main characteristics of SDS in Chinese children were summarized as follows: The ratio of males to females was about 1.3 : 1, the median age of onset was 3 months, and the median age of diagnosis was 14 months. The first symptoms were often exocrine pancreatic insufficiency (31.8%) and granulocytopenia with infection (31.8%). According to the international consensus, the incidence rates of the three major diseases of SDS were hemocytopenia (95.4%), pancreatic disease (72.7%), and bone abnormality (40.9%). The common factors underlying SDS disease were variants of the SBDS gene (c.258+2T>C and c.183_184TA>CT), albeit there was no significant correlation between genotype and phenotype (P > 0.05). Compared with international reports, the clinical manifestations and genotypes of Chinese SDS children are different (P < 0.05). CONCLUSION The SDS children have an early age of onset and significant individual difference. It is necessary to analyze the case-related data to facilitate early recognition, diagnosis and clinical intervention.
Female ; Humans ; Male ; Bone Marrow Diseases/therapy* ; China ; East Asian People ; Exocrine Pancreatic Insufficiency/therapy* ; Shwachman-Diamond Syndrome/therapy*

ObjectiveTo identify causal factors of a case of severe Chlamydia psittaci pneumonia in Yangpu District and provide a scientific basis for effective prevention and control. MethodsBasic information and epidemiological data of the patient were collected through telephone interviews and field epidemiological surveys. Specimens from the patient， close contacts and the environment were collected for pathogen detection. Metagenomics next-generation sequencing （mNGS） was used to identify unknown pathogens. ResultsA 65-year-old male patient with a history of hypertension and diabetes was admitted to the hospital with symptoms of fatigue， poor appetite for a week， fever and cough for four days. A chest computer tomography （CT） scan showed scattered inflammation in the left lung with infiltration of multiple lobes. Blood gas analysis showed type I respiratory failure. The results of mNGS on the bronchoalveolar lavage fluid of the patient indicated that he was infected with Chlamydia psittaci. Epidemiological investigation showed a clear history of avian exposure， with an incubation period of 30 days. ConclusionThis serious pneumonia is a zoonotic disease caused by Chlamydia psittaci. A clear history of avian exposure and the use of mNGS technology can help in the timely diagnosis of this disease.

OBJECTIVE: To investigate the expression and clinical significance of soluble interleukin-2 receptor(sIL-2R) in patients with multiple myeloma(MM). METHODS: 54 newly diagnosed MM patients in the Second Affiliated Hospital of Fujian Medical University from February 2020 to December 2021 were selected as the observation group, and 60 healthy people in our hospital in the same period were selected as the control group. The expression levels of sIL-2R in the serum of the two groups were detected by enzyme-linked immunosorbent assay. The differences of sIL-2R expression level among different clinical parameter groups in MM patients were compared. The clinical parameters include:gender, age, ISS stage, hemoglobin, albumin, serum creatinine, lactate dehydrogenase and β₂-microglobulin, blood calcium, bone marrow plasma cell ratio and treatment response. The relationship between sIL-2R expression level and progression-free survival(PFS) and overall survival(OS) in MM patients were analyzed. RESULTS: The expression of serum SIL-2R in MM patients was significantly higher than that in healthy control group (P<0.05). The expression of sIL-2R in MM patients who did not achieve complete remission(CR) was significantly higher than those of CR patients (P=0.037). There was no significant difference in the expression of serum sIL-2R between the groups of different sex, age, ISS stage, hemoglobin concentration, albumin content, serum creatinine level, lactate dehydrogenase level, the content of β₂-microglobulin, the concentration of blood calcium, and the proportion of bone marrow plasma cells(P>0.05). The PFS of sIL-2R high expression group(15 months) was shorter than that of sIL-2R low expression group (22 months), which was significant difference (P=0.041). But there was no significant difference in OS between sIL-2R high expression group and sIL-2R low expression group (P=0.124). Univariate analysis results showed that the high expression of serum sIL-2R was associated with poor PFS in MM patients. Multivariate analysis results showed that the high expression of serum sIL-2R was still an independent adverse prognostic factor for PFS in MM patients, However, the expression of serum sIL-2R was not statistically significant in evaluating OS in MM patients by univariate and multivariate analysis. CONCLUSION The expression of serum sIL-2R in MM patients was significantly higher than that in healthy people. Serum sIL-2R is an independent prognostic factor of PFS in MM patients.
Humans ; Calcium ; Clinical Relevance ; Creatinine ; Lactate Dehydrogenases ; Multiple Myeloma ; Receptors, Interleukin-2

OBJECTIVE: To explore the risk grading method for benign thyroid nodules before microwave ablation and the clinical significance of risk grading. METHODS: This study was conducted among 527 patients undergoing ultrasound-guided microwave ablation of benign thyroid nodules between July, 2017 and December, 2020.Based on anatomic relationship of the thyroid nodules with the adjacent tissues, the ablation risk was classified into 4 levels: low, medium, high and extremely high risks.The incidence of severe complications and the rate of residual nodules following the ablation were recorded. RESULTS: In the patients graded to have low, medium, high and extremely high preoperative risks, the incidences of severe complications following the ablation were 0%, 0.88%, 2.41% and 6.78%, respectively, showing no significant differences among the different risk groups (P > 0.05).The rates of postoperative residual nodules in the 4 risk groups were 1.59%, 6.14%, 14.43% and 71.19%, respectively, showing a significant difference between the low and medium risk groups and the high and extremely high risk groups (P < 0.001). CONCLUSION Preoperative risk grading for thyroid nodular ablation can be helpful for prevention of severe complications during ablation and prediction of residual nodules after ablation.
Humans ; Thyroid Nodule/epidemiology* ; Microwaves/therapeutic use* ; Catheter Ablation/methods* ; Treatment Outcome ; Retrospective Studies

Objective:To analyze the incidence and epidemic characteristics of local cases infected with SARS-CoV-2 in Yangpu District of Shanghai， China， and provide scientific evidence for the prevention and control of coronavirus disease-19 （COVID-19）. Methods:Descriptive epidemiological methods were applied to analyze the epidemic data of all the patients tested positive for SARS-CoV-2 RNA in Yangpu District of Shanghai， China. Results:A total of 9 local cases （7 males and 2 females） were documented in Yangpu District from January 30， 2020 to February 29， 2020. The average age was （48.56±13.85） years old. According to the body mass index， the patients with overweight and obesity accounted for 44.44% of the total cases. All the patients had fever at the onset and radiological findings of pneumonia by CT examination. They were diagnosed during January 24 and February 8， 2020. The median incubation period of the COVID-19 was 9 days and the median course was 22 days. Six cases had travel history in the epidemic areas and the other 3 cases had history of contact with confirmed cases. There were two familial clusters， both of which were husband-wife relationships. One cluster had a clear temporal sequence of onset， while the other one might be co-exposed or mutually infected. No new local case infected with SARS-CoV-2 was evident since February 8， 2020. Conclusion:All the local COVID-19 cases in Yangpu District have clear epidemiological exposure history. It warrants further attention to the family clustering SARS-CoV-2 transmission. Currently， containment of imported cases is crucial for the prevention and control of COVID-19 epidemic.

Objective: Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear. Methods: A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( Results: Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks. Conclusion Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.
Adult ; Aged ; COVID-19/virology* ; China/epidemiology* ; Comorbidity ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome

A temperature-responsive hydrophilic block copolymer fluorescence sensor based on selective analysis of Al3+was designed and synthesized. The polymer fluorescent probe (L64-BTPA-SHMA) was synthesized by reversible addition-fragmentation chain transfer (RAFT) polymerization and characterized by 1 H NMR,and the recognition performance of the polymer probe was studied by fluorescence spectroscopy. It was found that the fluorescence response of Al3+detected by this polymer fluorescence probe was significantly affected by temperature. The higher the temperature, the lower the fluorescence intensity was observed. The results showed that 0.1 g/L polymer fluorescent probe had a good selectivity to Al3+in buffer solution at 25℃and pH 7.4,and was not affected by other metal ions. A fluorescence detection method based on this polymer probe for Al3+was developed. In this method,the fluorescence intensity was linear with Al3+concentration in the range of 2. 0 -18. 0 μmol/L, with a correlation coefficient of 0. 9977 and a detection limit of 1.43 μmol/L. The fluorescence response between the polymer fluorescence chemosensor and Al3+could be altered by controlling the temperature change. The successful application of the polymer fluorescence probe for detecting Al3+residues in agricultural products has practical application value.

Objective ] To analyze the incidence and mortality of liver cancer and survival situation among permanent residents in Yangpu District of Shanghai from January 2002 to December 2012, and compare these data with the statistics obtained from Qidong City of Jiangsu Province. [ Methods] The data on liver cancer among permanent residents in Yangpu District were collected from the database of cancer registration and management system in Shanghai.The temporal trend in the incidence and mortality of liver cancer was assessed and compared with the related statistical data from Qidong City of Jiangsu Province.Kaplan-Meier analysis with log-rank test was performed for survival analysis. [ Results] A total of 3 389 cases of liver cancer were diagnosed from January 2002 to December 2012 . The standardized incidence rate was 15.70/105 in males, significantly higher than 5.45/105 in females ( P<0.05) .A total of 3 026 cases died of liver cancer during this period.The standardized mortality rate was 13.38/105 in males and 4.66/105 in females ( P<0.05).The median survival time was 0.41 years in total, 1.40 years in those who received surgery, significantly higher than 0.35 years in those without surgery ( P <0.05 ) .The ratios between Yangpu District and Qidong City were around 1 ∶3 in both incidence and mortality rates, and about 2 ∶1 in survival rate. [ Conclusion] The mortality of liver cancer close to its incidence among permanent residents in Yangpu District of Shanghai during 2002-2012. Both the incidence and mortality of liver cancer were significantly higher in males than in females.Surgical resection significantly prolongs overall survival time and improves prognosis.Early diagnosis and prompt surgical resection can improve the overall survival rate of liver cancer patients.HBV infection may be the major risk factor of liver cancer in Yangpu District, while liver cancer in Qidong City is likely to be caused by the interaction among many factors including HBV infection, exposure to aflatoxin, genetic factors, drinking water pollution, and lack of microelement.