OBJECTIVE: To explore effectiveness of TiRobot-assisted screw implantation in the treatment of coracoid process fractures of the scapula. METHODS: A retrospective analysis was conducted on the clinical data from 24 patients with coracoid process fractures of the scapula admitted between September 2019 and January 2024 and met selection criteria. Among them, 12 patients underwent TiRobot-assisted screw implantation (robot group) and 12 underwent manual screw implantation (control group) during internal fixation. There was no significant difference ( P>0.05) in baseline data such as gender, age, body mass index, disease duration, cause of injury, coracoid process fracture classification, and proportion of patients with associated injuries between the two groups. The incision length, operation time, intraoperative blood loss, hospital stay, accuracy of screw placement, coracoid process fracture healing time, and complications were recorded and compared, as well as pain visual analogue scale (VAS) score, and Constant-Murley score at last follow-up. RESULTS: The intraoperative blood loss and incision length in the robot group were significantly lower than those in the control group ( P<0.05); however, there was no significant difference in operation time and hospital stay between the two groups ( P>0.05). All patients were followed up 8-27 months (mean, 17.5 months), and the difference in follow-up time between the two groups was not significant ( P>0.05). At last follow-up, the VAS score for shoulder pain in the robot group was signifncatly lower compared to the control group, and the Constant-Murley score was significantly higher ( P<0.05). In the robot group, 16 screws were implanted intraoperatively, while 13 screws were implanted in the control group. Radiographic re-evaluation showed that the excellent and good rate of screw implantation was higher in the robot group (93.8%, 15/16) than in the control group (61.5%, 8/13), but the difference in the precision of screw implantation between the two groups was not significant ( P>0.05). Four patients in the robot group and 1 in the control group achieved double screws fixation; however, the difference in achieving double screws fixation between the two groups was not significant ( P>0.05). All fractures healed in both groups with 1 case of malunion in the control group. There was no significant difference in healing time between the two groups ( P>0.05). During follow-up, 1 patient in the control group experienced screw loosening and displacement. There was no significant difference in the incidence of screw loosening and fracture malunion between the two groups ( P>0.05). CONCLUSION Compared with manual screw implantation, TiRobot-assisted minimally invasive treatment of coracoid process fractures of the scapula can reduce intraoperative blood loss, shorten incision length, alleviate pain, and obtain better promote shoulder joint functional recovery.
Humans ; Male ; Female ; Retrospective Studies ; Fracture Fixation, Internal/instrumentation* ; Minimally Invasive Surgical Procedures/instrumentation* ; Adult ; Middle Aged ; Fractures, Bone/surgery* ; Bone Screws ; Coracoid Process/surgery* ; Robotic Surgical Procedures/methods* ; Scapula/surgery* ; Treatment Outcome ; Operative Time ; Young Adult ; Length of Stay ; Blood Loss, Surgical

Objective:To explore the feasibility and clinical effect of surgical treatment for patients with malignant tumor complicated with coronary heart disease.Methods:The medical records of 12 patients with malignant solid tumor complicated with coronary heart disease who were treated by the same surgical team in the Department of Cardiac Surgery, the First Hospital of Tsinghua University from January 2018 to May 2025 were collected retrospectively, including 8 cases of digestive system tumors, 3 cases of lung tumors and 1 case of urinary system tumor. All patients underwent simultaneous (4 cases) or staged (8 cases) coronary artery bypass grafting and tumor resection. Coronary artery bypass grafting under cardiopulmonary bypass was performed in 2 cases, and off-pump coronary artery bypass grafting was performed in the remaining 10 cases. Postoperative follow-up was conducted.Results:None of the 12 patients died during hospitalization, and all were cured and discharged. No perioperative myocardial ischemia or infarction occurred during hospitalization, and no postoperative surgical bleeding occurred. The 12 patients were followed up for 1 month to 7 years and 5 months. One patient with rectal cancer complicated with coronary heart disease had liver and lung metastases 13 months after surgery and died suddenly during the second cycle of chemotherapy 16 months after surgery. The remaining 11 patients survived.Conclusions:It is feasible to perform coronary artery bypass grafting and tumor resection in patients with coronary heart disease complicated with malignant tumor, and the short-term and medium-term effects are satisfactory.

Objective To track and evaluate the implementation and application of the occupational health standard Radiation shielding requirements for radiotherapy room—Part 4: Radiotherapy room of ²⁵²Cf neutron afterloading (GBZ/T 201.4-2015) by radiation health technical service agencies, medical institutions, health supervision agencies, and radiotherapy facility design units, and to provide a scientific basis for the further revision and implementation of this standard. Methods Following the Guideline for health standards tracking evaluation (WS/T 536-2017) and the project implementation plan, relevant practitioners were randomly selected for a questionnaire survey. The survey primarily focused on their awareness, standard training, application, and revision suggestions of GBZ/T 201.4-2015. The results were summarized and analyzed. Results A total of 168 evaluation questionnaires were collected from relevant practitioners in 28 provinces. Only 31.6% of the respondents reported being “well familiar” or “ familiar” with the standard, 27.4% of the respondents believed that the standard was widely used, and 45.2% of the respondents believed that the standard could meet the needs of their work. Only 14.9% of the respondents had received relevant training on the standard, more than half of the respondents had not applied the standard within the past 10 years, and 45.2% of the respondents believed that the standard "needs to be revised". Conclusion Due to the small number of californium-252 neutron afterloading radiotherapy devices in operation on the market, the overall awareness of the standard is low, suggesting that relevant authorities need to strengthen training and publicity of the standard, and that certain sections of the standard need to be revised or merged.

Objective To examine the association between sleep and depressive symptoms among community-dwelling older adults and whether loneliness mediates this association.Methods Using a multistage sampling approach,we enrolled participants aged 60 years or older from two communities in Chengdu,China.A questionnaire was used to collect basic information,including age,sex,etc.,from the participants.In addition,loneliness,depressive symptoms,and sleep quality were assessed using a short-form University of California Los Angeles Loneliness Scale(ULS-8),the 10-item version of Center of Epidemiologic Studies Depression Scale(CESD-10),and the Pittsburgh Sleep Quality Index(PSQI),respectively.The Spearman rank correlation coefficient was employed to assess the correlations among social sleep,loneliness,and depression symptoms.Generalized structural equation modeling was used to assess the mediating effect of loneliness between sleep and depressive symptoms.Results Of the 1377 participants,32.03％(441)experienced loneliness and 30.57％(421)had depressive symptoms,with the median and interquartile range of their sleep quality being 6(3,9).Correlation analysis revealed statistically significant associations between sleep quality,loneliness,and depressive symptoms(P＜0.001).Generalized structural equation modeling analysis revealed that loneliness had a partial mediation effect on the association between sleep quality and depressive symptoms(b=0.075;95％CI,0.025-0.125;P＜0.05),accounting for 44.38％of the total effect(95％CI,0.258-0.630;P＜0.001).Conclusion Poor sleep quality is associated with a higher risk of depressive symptoms in community-dwelling older adults,with loneliness mediating the association.Further research on improving the sleep quality to mitigate depressive symptoms in older adults is warranted.Special attention should be given to older adults experiencing both poor sleep and loneliness.

Objective:To explore the feasibility and clinical effect of surgical treatment for patients with malignant tumor complicated with coronary heart disease.Methods:The medical records of 12 patients with malignant solid tumor complicated with coronary heart disease who were treated by the same surgical team in the Department of Cardiac Surgery, the First Hospital of Tsinghua University from January 2018 to May 2025 were collected retrospectively, including 8 cases of digestive system tumors, 3 cases of lung tumors and 1 case of urinary system tumor. All patients underwent simultaneous (4 cases) or staged (8 cases) coronary artery bypass grafting and tumor resection. Coronary artery bypass grafting under cardiopulmonary bypass was performed in 2 cases, and off-pump coronary artery bypass grafting was performed in the remaining 10 cases. Postoperative follow-up was conducted.Results:None of the 12 patients died during hospitalization, and all were cured and discharged. No perioperative myocardial ischemia or infarction occurred during hospitalization, and no postoperative surgical bleeding occurred. The 12 patients were followed up for 1 month to 7 years and 5 months. One patient with rectal cancer complicated with coronary heart disease had liver and lung metastases 13 months after surgery and died suddenly during the second cycle of chemotherapy 16 months after surgery. The remaining 11 patients survived.Conclusions:It is feasible to perform coronary artery bypass grafting and tumor resection in patients with coronary heart disease complicated with malignant tumor, and the short-term and medium-term effects are satisfactory.

Objective To investigate the current status of physical activity and depressive symptoms a-mong middle-aged and older adults in Chengdu,Sichuan and explore the relationship between physical activity and depressive symptoms.Methods Multi-stage proportional stratified random sampling was employed to select middle-aged and older adults aged ≥45 years as the participants,and face-to-face interviews were carried out to collect data.Logistic regression was adopted to explore the relationship between physical activity and depressive symptoms in middle-aged and older adults.The trend test was performed for the relationship between different lev-els of physical activity and depressive symptoms.The subgroup analysis and the test for multiplicative interactions were conducted for the relationship between physical activity and depressive symptoms.Results A total of 4376 middle-aged and older adults were included.Among them,14.58％(638/4376),25.98％(1137/4376),and 27.83％(1218/4376)had depressive symptoms,failed to reach the guideline-recommended standards of physical activity,and were at low levels of physical activity,respectively.There was a negative association be-tween reaching guideline-recommended physical activity standard and depressive symptoms in middle-aged and ol-der adults(OR=0.713,95％CI=0.589-0.861,P＜0.001).In addition,moderate levels(OR=0.714,95％CI=0.586-0.871,P=0.001)and high levels of physical activity(OR=0.705,95％CI=0.548-0.906,P=0.006)had negative associations with the presence of depressive symptoms.The trend test revealed that the negative association between physical activity and depressive symptoms in middle-aged and older adults enhanced as the level of physical activity increased(Pfor trend=0.001).The subgroup analysis and the test for multiplicative interactions revealed that neither reaching guideline-recommended physical activity standards or not nor the physi-cal activity level had an interaction with each of the subgroups(all Pfor interaction＞0.05).Conclusions The current status of depressive symptoms among middle-aged and older adults in Chengdu,Sichuan needs to be ameliora-ted.A negative association existed between reaching the guideline-recommended physical activity standard and pres-ence of depressive symptoms,and the negative association enhanced as the physical activity level elevated.

Objective:To investigate the short-term efficacy of the intelligent robot-assisted fracture reduction system (RAFR) in the treatment of Tile-type C1-2 pelvic fractures.Methods:A retrospective study was conducted to analyze the clinical data of the 15 patients who had been treated for Tile-type C pelvic fractures at Department of Orthopedic Trauma, Foshan Hospital of Traditional Chinese Medicine between June 2022 and November 2023. The cohort were 7 males and 8 females, with an age of (51.6±22.1) years and a body mass index of (22.35±2.14) kg/m 2. According to the Tile classification, there were 9 cases of type C1 and 6 cases of type C2. The interval from injury to surgery was (11.3±3.9) days. Minimally invasive closed reduction and internal fixation of pelvic fractures were performed with the assistance of RAFR system. The anterior pelvic ring was fixed with percutaneous hollow screws from the pubic branch, and the posterior pelvic ring fixed with percutaneous hollow screws from the sacroiliac joint. If necessary, external fixation brackets and internal stent fixation technique for the anterior pelvic ring were used to enhance the stability of the pelvic ring. The frequency and time of intraoperative fluoroscopy, reduction time, surgical time, intraoperative bleeding volume, fracture reduction quality, follow-up time, fracture healing time, pelvic function recovery at the last follow-up, and incidence of complications were recorded. Results:With the assistance of RAFR system, 15 patients were all successfully treated with minimally invasive closed reduction and internal fixation for pelvic fractures. For this cohort, intraoperative fluoroscopy frequency was 31 (20, 55) times, fluoroscopy time 25.8 (18.0, 33.0) seconds, reduction time (57.7±3.5) minutes, surgical time 205 (200, 210) minutes, intraoperative bleeding volume 100 (100, 200) mL, and residual displacement (7.55±3.51) mm. According to the Matta scoring, the postoperative quality of fracture reduction was evaluated as excellent in 4 cases, as good in 8 cases, and as fair in 3 cases. Fourteen patients were followed up for 15.0 (10.8, 18.0) months after surgery, and 1 patient was lost to the follow-up. The fracture healing time for the 14 patients was 3.6 (3.2, 4.7) months. The Majeed functional score at the last follow-up was (83.4±6.4) points, giving 4 excellent and 10 good cases.Conclusion:The RAFR system can facilitate precise and minimally invasive closed reduction for the majority of patients with Tile-type C1-2 pelvic fracture, achieving satisfactory fracture reduction quality and short-term efficacy.

Objective:To explore the osteogenic activity of in vitro cultured preosteoblasts treated by magnesium loaded hydrogel core-shell microspheres.Methods:A microfluidics chip device was designed and made to fabricate magnesium loaded hydrogel core-shell microspheres to precisely control the stable release of magnesium ions in vitro,the mechanism of controllable magnesium ion release in the promotion of osteogenic activity of MC3T3-E1 preosteoblasts was systematically investigated.Results:The magnesium loaded hydro-gel microspheres(PLGA/MgO-alginate microspheres)prepared by the microfluidics chip exhibited to be monodisperse with special core-shell structure and could control the stable release of magnesium ions at a concentration of 50 ppm in vitro.The in vitro study showed that it significantly enhanced the activity and proliferation ability of MC3T3-E1 preosteoblasts,promoted their osteogenic differ-entiation and mineralization ability,and increased ALP activity.Conclusion:Magnesium loaded hydrogel core-shell microspheres can promote the osteogenic activity of MC3T3-E1 osteoblasts in vitro.

Objective To understand the current situation and explore the influencing factors of delay in seeking medical treatment for common symptoms of residents in the rural areas of Sichuan province. Methods In July 2019,multi-stage random sampling was carried out in Zigong city,Sichuan province,and the data were collected by face-to-face questionnaire interview.The residents who had lived at hometown for more than half a year in the past year and had seen a doctor in the most recent month were surveyed.Logistic regression was adopted to predict the influencing factors of delay in seeking medical treatment. Results A total of 342 subjects were enrolled,and the incidence of delay in seeking medical treatment was 13.45%(46/342).Compared with the young and middle-aged(<65 years)people,the elderly(≥65 years)people were more likely to have delay in seeking medical treatment (OR=2.187,95%CI=1.074-4.457,P=0.031).The rural residents who gave higher score of the overall quality of township health centers were less likely to have delay in seeking medical treatment (OR=0.854,95%CI=0.735-0.992,P=0.039). Conclusions The occurrence of delay in seeking medical treatment for common symptoms of rural residents in Sichuan province is low.Age and the overall quality evaluation of township health centers affect the occurrence of delay in medical treatment among the rural residents in Sichuan province.Efforts should be made to improve the awareness of disease prevention among the elderly in rural areas.The investment in health resources in township health centers should be increased to strengthen the introduction and training of talents.These measures can improve the health services in township health centers,guide residents to make timely use of health resources,and reduce the occurrence of delay in seeking medical treatment.
Middle Aged ; Aged ; Humans ; Surveys and Questionnaires ; Logistic Models ; Rural Population ; China/epidemiology*

Objective: To establish a standard operation procedure (SOP) for ribosome genotyping (ribotyping) on Clostridioides (C.) difficile, supplement and verify ribotyping typing library, so as to improve the comparability of data between different laboratories and to develop surveillance network of C. difficil in China. Methods: Molecular typing of 54 reference strains from the United States and Europe of C. difficile were performed by using the SOP referencing correspondence from abroad and from our laboratory with a BioNumerics 7.6 software to estimate the reference library of types of C. difficile. Identification of 374 clinical and animal isolates of C. difficile from 13 cities in China between 2010 and 2018, to supplement the library information. Kappa test was used to evaluate the consistency. Results: Results of capillary electrophoresis of reference strains appeared clear and stable, which guaranteed the clustering results being fast and accurate. Results from the supplementary typing showed that there were 84 types of isolates, of which 25 RT types were consistent with reference strains from abroad, while 58 RT types were different from referenced types. In the 40 referenced types, 15 RT types were not found in this study. In the consistency evaluation, the Kappa value was 0.891 and (P<0.01), showing the two Molecular typing as consistent and with close resemblance. Conclusions The result of capillary electrophoresis by applying SOP for ribotyping on C. difficile base on QIAxcel capillary electrophoresis system, appeared clear and stable. The standardized library seemed more easily used for comparability and data sharing between the laboratories.