As a fundamental aspect of bone fracture treatment, fracture reduction plays a decisive role in restoring the structural integrity and function of bones. At present, fracture reduction techniques mostly rely on semi-automatic interaction methods or healthy-side bone templates for registration, which have many limitations in clinical practice. In order to enhance treatment efficiency and accuracy, an automatic fracture reduction algorithm is proposed. This algorithm utilizes the similarity of fracture cross-sections for registration, thereby reducing the workload of physicians and eliminating the need for a healthy-side bone template. Initially, the closed edge is identified and extracted by analyzing the differences in the fracture surface and the calorific value diagram of the roughness distribution. Next, the fracture section is determined by using the identified closed edge as a guideline for regional expansion and similarity matching. During the registration phase, the iterative closest point (ICP) algorithm is highly sensitive to distance. Therefore, the geometric features of point clouds are incorporated into the objective function of the registration algorithm to mitigate the influence of noise, and fracture section registration is implemented one by one. Finally, the algorithm is tested and compared on 180 simulated datasets and 16 publicly available datasets. The results show that the proposed algorithm significantly improves the registration accuracy, and the registration error of clinical bone fracture cases is controlled within 1.7 mm.
Algorithms ; Fractures, Bone/therapy* ; Humans

Objective: To understand the prevalence of school bullying and the comorbidity of anxiety and depressive symptoms among middle school students and their association, so as to provide a basis for developing related intervention strategies. Methods: From September to December 2023, a multistage random cluster sampling was employed to select 107 851 middle school students across 104 counties in Anhui Province. The Center for Epidemiological Studies Depression Scale (CES-D) and the Generalized Anxiety Disorder-7 (GAD-7) Scale were used to assess depressive and anxiety symptoms. Logistic regression analysis was utilized to examine the correlations between experiences of school bullying and the comorbidity of anxiety and depressive symptoms. Results: The findings revealed that 2.80% of middle school students had experienced school bullying in the past 30 days. Additionally, 27.03% exhibited potential symptoms of depression, 8.94% showed signs of anxiety symptom, and the comorbidity rate of anxiety and depressive symptoms was 8.04%. Logistic regression analysis showed that statistically significant correlations were identified between experiences of school bullying and increased risks of depressive symptoms (OR=6.42, 95%CI=5.93-6.94, P<0.01), anxiety symptoms (OR=5.94, 95%CI=5.47-6.44, P<0.01), and their comorbidity (OR=6.38, 95%CI=5.88-6.93, P<0.01). Compared with those who did not suffer from school bullying, junior high school students, ordinary senior high school students, vocational senior high school students, boys and girls who suffered from school bullying all had increased risks of comorbidity of anxiety and depressive symptoms (OR=7.25, 5.55, 4.80, 6.42, 6.27, P＜0.01). Conclusions The study underscores the significant impact of school bullying on increasing the risk of comorbidity of anxiety and depressive symptoms among middle school students. It is important to pay attention to the psychological health of bullied students and implement timely psychological intervention measures.

Objective:To analyze the performance characteristics of the energy output of defibrillation device at different lifecycle stages of the equipment,and to improve the level of management,so as to ensure the safety and effectiveness of using the device.Methods:A total of 90 defibrillation devices of using 10 types included 861290 and CardioServ(included scrapped devices)during the period of 2015-2022 were retrospectively analyzed.The detected data of energy output of defibrillation device were analyzed as statistical method,and the error of releasing energy was calculated.A total of 36 defibrillation devices that were in the early stages of use(at the first three years of device use)were divided into the first year,the second year and the third year,and the data of energy outputs of devices among three years were compared.The data of the type A and type B defibrillation devices,which were the largest number of devices in the normal stage of use(the middle stage of use),were calibrated according to the energy release in the three years between 2018 and 2000.The difference of releasing energy at the preseted value of 100J between the two types of devices was analyzed.Finally,the errors of energy releases of 8 devices,which energy outputs exceeded the deadline,in the scrap period between 2015 and 2022 were summarized.Results:In the data of three groups of devices in the early stages of use,the differences at the first and second year of device use among 100J,150J and 200J of the energy releases of the preseted values were significant(t=-0.17,-0.17,-0.58,P>0.05).The difference of the measured values between the first and third years of device use was not significant(Z=-0.70,-0.38,-0.86,P>0.05).The results of variance analysis of repeated measurement of the energy releases of the devices in normal stage indicated that the difference of the energy release at 100J preseted point among different types of 41 devices was significant(F=4.40,P<0.05).The energy release of type X defibrillator appeared constantly high,and the relative error increased with the increasing of preseted values.The repeatability of the device was better,and the relationship between preseted energy(x)and release energy(y)conformed to linear relationship(R2=0.9985).In these defibrillation devices that were using,the qualified rate of energy output of>100J preseted point was 97.68%.Conclusion:There is slight difference in the mean value of energy release between different type of defibrillation devices within the qualified range,and the energy release still is a performance indicator that should be highly focused for defibrillation devices.We should combine with the maintenance and repair data of device to conduct in-depth analysis,so as to grasp the operating status of the device,and optimize the strategy of quality control,and ensure the safety of defibrillator in clinical use.

The acute combination fractures of the atlas and axis in adults have a higher rate of neurological injury and early death compared with atlas or axial fractures alone. Currently, the diagnosis and treatment choices of acute combination fractures of the atlas and axis in adults are controversial because of the lack of standards for implementation. Non-operative treatments have a high incidence of bone nonunion and complications, while surgeries may easily lead to the injury of the vertebral artery, spinal cord and nerve root. At present, there are no evidence-based Chinese guidelines for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults. To provide orthopedic surgeons with the most up-to-date and effective information in treating acute combination fractures of the atlas and axis in adults, the Spinal Trauma Group of Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field of spinal trauma to develop the Evidence-based guideline for clinical diagnosis and treatment of acute combination fractures of the atlas and axis in adults ( version 2023) by referring to the "Management of acute combination fractures of the atlas and axis in adults" published by American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) in 2013 and the relevant Chinese and English literatures. Ten recommendations were made concerning the radiological diagnosis, stability judgment, treatment rules, treatment options and complications based on medical evidence, aiming to provide a reference for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults.

Objective To compare the diagnostic index which used to evaluate the balance of covariates between groups in real world study(RWS).Methods Simulate RWS simulation data scenarios such as different inter group equilibrium degree,different covariate and exposure,outcome relationship,etc.by constructing the correlation model between each diagnostic index and estimation deviation,evaluate the accuracy and robustness of different single covariate and global covariate diagnostic indexes.Results In addition to L1 measure,standardized difference,overlap coefficient,K-S distance,Lévy distance,Mahalanobis distance and general weighted difference can distinguish different degrees of inter group covariate equilibrium.The R2 of the correlation models estimated by the C-statistic based on propensity score and the general weighted difference diagnostic index is greater than 0.8,and the intercept value approaches the origin,which is the most accurate and stable for the diagnosis of inter group equilibrium.Conclusion The single covariate diagnosis index can evaluate the balance of covariates between groups of RWS data,but the accuracy,sensitivity and robustness of the global diagnosis index are better.Among them,the diagnosis effect of L1 measure is poor,while of the C-statistic based on propensity score is the best.

OBJECTIVE：To study the relationship of polymorphism of clopidogrel absorption and metabolism related genes CYP2C19（* 2，* 3，* 17），ABCB1 C3435T and PON1 Q192R in patients with coronary heart disease in Xinjiang Uygur Autonomous Region ，and to explore the characteristics of population and combined diseases. METHODS ：A total of 1 126 patients with coronary heart disease who underwent clopidogrel absorption and metabolism related gene testing during hospitalization in the First Affiliated Hospital of Xinjiang Medical University from January 2016 to June 2020 were included as the study subjects. The gender，age，body mass index （BMI），nationality and the proportion of combined with hypertension and diabetes were compared among different CYP2C19 metabolic phenotypes and ABCB1 C3435T and PON1 Q192R genotypes. RESULTS ：Among 1 126 patients，1 126 had CYP2C19 * 2，* 3 and * 17 genotypes，1 109 had ABCB1 C3435T genotype and 1 123 had PON1 Q192R genotype. The distribution of each genotype was in line with Hardy-Weinberg balance （P＞0.05）. There were 66（5.86％）， com 459（40.76％），476（42.27％） and 125（11.10％）patients with CYP2C19 ultra-rapid metabolizer （UM）， extensive metabolizer（EM），intermediate metabolizer （IM）and poor metabolizer（PM），respectively. The proportion of patients with UM metabolism phenotype with BMI ＞24 was significantly higher than those of patients with IM and PM metabolism phenotypes （P＜0.05）. The proportion of Han nationality patients with UM metabolic phenotype was significantly lower than those of patients with EM ，IM and PM metabolic phenotypes （P＜0.05）；the proportion of Uygur nationality was significantly higher than that of patients with EM ，IM and PM metabolic phenotypes （P＜ 0.05）. There were 355，538 and 216 patients with ABCB1 C3435T wild-type（CC），heterozygous（CT）and mutant homozygous （TT）genotypes，respectively；the proportion of Han nationality in TT genotype patients was significantly lower than that in CC and CT genotype patients （P＜0.05），and the proportion of Uygur nationality was significantly higher than that in CC and CT genotype patients （P＜0.05）；the proportion of TT genotype patients with diabetes was significantly higher than that of patients with CT genotype （P＜0.05）. There were 365，519 and 239 patients with PON1 Q192R wild-type（GG），heterozygous（GA）and mutant homozygous （AA），respectively；the proportion of Han nationality in AA genotype patients was significantly lower than that in GG and GA genotype patients （P＜0.05），and the proportion of Uygur nationality was significantly higher than that of GG and GA genotype patients （P＜0.05）；the proportion of Han nationality and BMI ≤24 in patients with AA genotype were significantly lower than those with GA genotype （P＜0.05），and the proportion of Uygur nationality ，BMI＞24 and hypertension were significantly higher than those in GA genotype patients （P＜0.05）. CONCLUSIONS ：There are significant nationality differences among patients with different CYP2C19 metabolic phenotypes and ABCB1 C3435T and PON1 Q192R genotypes. In addition，patients with BMI ＞24 account for high proportion among CYP2C19 UM metabolism genotype ；patients with diabetes account for high proportion among ABCB1 C3435T TT genotype ；patients with BMI ＞24 and hypertension account for high proportion among PON1 Q192R AA genotype.

Objective:To explore the clinical effects of hair transplantation combined with SVF GEL assisted fat transplantation in treating cicatricial alopecia.Methods:Eleven patients (5 males and 6 females, ranging from 22 to 41 years old) with cicatricial alopecia caused by burn or tumor excision in Shanghai Mylike Cosmetic Hospital from October 2017 to August 2019. All patients were treated with hair transplantation combined with SVF GEL assisted fat transplantation according to their scar areas.Results:Patients were followed up for 11 months on average, their hair grew well, with significantly improved appearances and no obvious complications. Hair follicle detection system was used to analyze the hair density after transplantation. The average survival rate reached 90.26% in accompany with desirable patients＇ satisfactory rates.Conclusions:Excellent results can be achieved by conducting hair transplantation combined with SVF GEL assisted fat transplantation in treating cicatricial alopecia, which is worth clinical application.

Objective:To examine the effect of“lesion removal plus whole breast exploration and washing plus micro-plastic surgery”in granulomatous lobular mastitis.Methods:A single-center prospective randomized controlled study method was used to enroll patients diagnosed with granulomatous lobular mastitis for whom surgical procedures were projected from March 2017 to September 2019 at Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University. The sample size is determined by the superiority test. Based on the literatures and the previous work, the two groups require 97 cases. Fifty-two patients underwent“lesion removal+whole breast exploration and washing plus micro-plastic surgery”(observation group). Forty-five cases underwent“empirical breast lesion resection plus fascia tissue flap plasty plus nipple and areola correction”(control group). The primary study endpoint is the recurrence rate, and the secondary study endpoints include surgical complications, incision healing time, and postoperative patient satisfaction. Independent sample t test, Wilcoxon rank-sum test, χ2 test and Fisher exact test were used for comparison between groups. Results:All procedures were completed successful, with no severe complications. All patients were followed up for (15.2±1.9) months (range: 12 to 24 months). There were no significant differences in incidence of postoperative complications (7.7% (4/52) vs. 6.7%(3/45), P=1), drainage time ((8.6±0.6) days vs. (8.4±0.8) days, t=1.921, P=0.053) and hospital stay ((7.7±0.6) days vs. (7.6±0.5) days, t=1.633, P=0.102) between the two groups. The recurrence rate of the observation group was lower significantly than that of the control group (3.8% (2/52) vs. 24.4%(11/45), χ2=8.819, P=0.003). The observation group had better cosmetic effects ( Z=-2.657, P=0.008) and patient satisfaction than control group ( Z=-5.730, P=0.000). Conclusion:The “lesion removal plus whole breast exploration and flushing plus micro-plastic surgery” has a good therapeutic effect and cosmetic value for patients with refractory granulomatous lobular mastitis.

Objective:To examine the effect of“lesion removal plus whole breast exploration and washing plus micro-plastic surgery”in granulomatous lobular mastitis.Methods:A single-center prospective randomized controlled study method was used to enroll patients diagnosed with granulomatous lobular mastitis for whom surgical procedures were projected from March 2017 to September 2019 at Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University. The sample size is determined by the superiority test. Based on the literatures and the previous work, the two groups require 97 cases. Fifty-two patients underwent“lesion removal+whole breast exploration and washing plus micro-plastic surgery”(observation group). Forty-five cases underwent“empirical breast lesion resection plus fascia tissue flap plasty plus nipple and areola correction”(control group). The primary study endpoint is the recurrence rate, and the secondary study endpoints include surgical complications, incision healing time, and postoperative patient satisfaction. Independent sample t test, Wilcoxon rank-sum test, χ2 test and Fisher exact test were used for comparison between groups. Results:All procedures were completed successful, with no severe complications. All patients were followed up for (15.2±1.9) months (range: 12 to 24 months). There were no significant differences in incidence of postoperative complications (7.7% (4/52) vs. 6.7%(3/45), P=1), drainage time ((8.6±0.6) days vs. (8.4±0.8) days, t=1.921, P=0.053) and hospital stay ((7.7±0.6) days vs. (7.6±0.5) days, t=1.633, P=0.102) between the two groups. The recurrence rate of the observation group was lower significantly than that of the control group (3.8% (2/52) vs. 24.4%(11/45), χ2=8.819, P=0.003). The observation group had better cosmetic effects ( Z=-2.657, P=0.008) and patient satisfaction than control group ( Z=-5.730, P=0.000). Conclusion:The “lesion removal plus whole breast exploration and flushing plus micro-plastic surgery” has a good therapeutic effect and cosmetic value for patients with refractory granulomatous lobular mastitis.

OBJECTIVE：To investigate the effects of Buyang huanwu decoction on lipid metabolism and hepatic tissue in hyperlipemia model rats. METHODS ：Male SD rats were randomly divided into blank control group ，model group ，positive control group （simvastatin 0.004 g/kg），Buyang huanwu decoction low-dose and high-dose groups （3.5，14.0 g/kg，by crude drugs），with 10 rats in each group. Except that blank control group was given water intragastrically ，hyperlipidemia mode of other groups was established by intragastric administration of fat emulsion according to the body weight. From the 21st day after modeling，the rats in each group were given water or fat emulsion in the morning and water or corresponding drugs in the afternoon for consecutive 20 days. After last medication ，the contents of TG ，TC，LDL-C，ALT，AST，LCAT，PLTP and HL in plasma were determined in each group ；the contents of LPL ，MTP and HMG-CoA redutase in liver tissue were also determined. The pathological changes of liver tissue were observed in each group. RESULTS ：Compared with blank control group ，the contents of TG ，TC，LDL-C，ALT and HMG-CoA reductase were increased significantly in model group （P＜0.05 or P＜0.01），while the contents of HL ，LPL and MTP were decreased significantly （P＜0.01）. Compared with model group ，the contents of TG ，TC， LDL-C and HMG-CoA reductase in administration groups as well as the contents of ALT ，AST in Buyang huanwu decoction low-dose and high-dose groups were decreased significantly （P＜0.05 or P＜0.01）；the contents of HL and MTP in administration groups as well as the content of LPL in positive control group were increased significantly （P＜0.05 or P＜0.01）. Pathological sections showed that the hepatocytes of model group were arranged irregularly ，and there was obvious cell steatosis. The hepatocytes in positive control group and Buyang Huanwu decoction high-dose group had almost no abnormal change compared with blank control gr oup，and there was a small amount of slight cell steatosis in Buyang Huanwu decoction low-dose group. CONCLUSIONS ： Buyang huanwu decoction has a 础。E-mail：zhang520-888@163.com significant lipid-lowering effect on hyperlipemia model rats ，which may be related to the regulation of lipid absorptiontransport and metabolism by regulating the expression of lipid 126.com metabolism related enzymes and transporter.