Osteoporotic fracture is the most major complication of osteoporosis. It is a significant global public health problem which continues to bring serious family and social burden. In order to improve the prevention and treatment of osteoporotic fractures， many countries have carried out new ways of fracture prevention and management， and achieved some results. Prevention mainly aims at those at high risk of fracture， and includes new health education on fracture and the promotion of fall prevention measures. For management， the "Fracture liaison services" mode is mainly applied to the fracture patients， with refined patient management to deal with the fractures that have occurred. This article summarizes the global prevalence of osteoporotic fractures， risk factors， and the current research progress in fracture prevention and management in China and the West.

Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.

【Objective】 To investigate the clinical features and gene analysis of one pedigree with multiple endocrine neoplasia type 2A （MEN2A） so as to clarify the diagnosis and classification of the disease， guide treatment and prevention， and improve prognosis. 【Methods】 The clinical data of a 36-member MEN2A family， including 6 probands， with medullary thyroid carcinoma， were investigated， and the peripheral blood genomic DNA of 28 family members （blood sample of one proband was not collected） was extracted. PCR amplification was performed on exons 8， 10， 11， 13， 14， 15 and 16 of the RET gene， and the products were directly sequenced. 【Results】 Review of the medical history showed that two probands with medullary thyroid carcinoma were accompanied with hyperparathyroidism， and one family member had pheochromocytoma. The RET gene mutation test confirmed that 13 family members， consisting of 5 probands and 8 family members， had the RET proto-oncogene exon 10 missense mutation. The heterozygous missense had mutation c.1852T>A， leading to the conversion of cysteine （TGC） at position 618 to serine （AGC） （Cys618Ser）. All subjects carrying RET gene Cys618Ser mutation had abnormal thyroid ultrasound change， accompanied with elevated calcitonin levels. Subjects carrying wild type of RET gene had normal calcitonin levels. The family was finally diagnosed with MEN2A by RET gene detection. 【Conclusion】 RET gene detection plays key role in the diagnosis and treatment of patients with MEN2A family and has guiding value in the follow-up and prognosis of asymptomatic carriers. There is a positive correlation between calcitonin level and the RET protooncogene mutation Cys618Ser. Patients suspected of MEN2A should be screened in time.

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

OBJECTIVETo introduce the clinical application of venous nutrition flap pedicled by medial plantar artery of the hallux on the medical aspect of the foot.

METHODSBased on the anastomoses between the medial plantar artery of the hallux and the nutritional vein, the flap was designed with the perforator of medial plantar artery adjacent to the first metatarsal bone as the rotation point. The flap axis was along the vein at the medial aspect of the foot between rotation point and medial malleolus.

RESULTS5 cases were treated with primary healing and complete survival flaps. The patients were followed up for 1-12 months with good match of texture and color.

CONCLUSIONSThe venous nutrition flap pedicled by medial plantar artery of the hallux on the medical aspect of the foot can be transpositioned to repair the defect at forefoot.

Arteries ; Forefoot, Human ; Hallux ; blood supply ; Humans ; Metatarsal Bones ; Surgical Flaps ; blood supply ; Veins ; Wound Healing

The study introduced the general evaluation indicator system for community health services in Shanghai and its characteristics,analyzing the results of the comprehensive evaluation from the aspects of regions and institutions.From six aspects of financial input,human resource construction, operation mechanism,family doctor system,information system construction and the application of the comprehensive evaluation results,the paper recommended on deepening the reform of community health services.

Objective To evaluate the effect of Diver CE aspiration thrombus catheter used in patients during the recovery of acute myocardial infarction (AMI) with percutaneous coronary intervention (PCI). Methods A total of 50 AMI patients were enrolled from January 2010 to December 2011. Twenty-ifve patients received PCI and used the Diver CE aspiration thrombus catheter (aspiration group);and the other 25 patients received routine PCI (routine PCI group). The basic characteristics, PCI characteristics, myocardial perfusion indexes and clinical data were compared and analyzed. Results There was no statistically difference between two groups in basic characteristics. Compared with the routine PCI group, higher rate of myocardial blush grade 3 but lower thrombus scores were found in the aspiration group. The incidence of no-lfow or slow-lfow were also lower in aspiration group (all P<0.05). The LVEF after 6 and 12 months were higher in the aspiration group (both P<0.05), no difference in MACE between the two groups. Conclusions Using the Diver CE thrombus aspiration in PCI is a simple and safe by method for treatment of acute myocardial infarction with high thrombosis burden. It can improve reperfusion decrease the rates of no-relfow on slow-relfow and can improve the long-term left ventricular function.

Animals ; Autoantibodies ; blood ; Cytokines ; biosynthesis ; Dose-Response Relationship, Drug ; Female ; Immunohistochemistry ; Rats ; Rats, Inbred Lew ; Selenium ; administration & dosage ; therapeutic use ; Th1 Cells ; drug effects ; immunology ; Th2 Cells ; drug effects ; immunology ; Thyroid Gland ; drug effects ; immunology ; pathology ; Thyroiditis, Autoimmune ; drug therapy ; immunology ; Trace Elements ; administration & dosage ; therapeutic use

Adult ; Brain ; drug effects ; pathology ; Caffeine ; adverse effects ; Fathers ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Male ; Middle Aged ; Nuclear Family

Objective To explore the correlations of adult attachment with interpersonal conflict resolu-tions styles and differences between soldiers and employees. Methods Relationship questionnaire (RQ),experi-ence in close relationships (ECR),and Rahim handling interpersonal conflict inventory (ROCI-II) were adminis-tered to 543 employees from different enterprises in Beijing and Liaoning province and 701 soldiers. Results The results suggested the distribution of adult attachment style between soldiers and employees were significantly differ-ent. Compared with employees, there were higher dismissing hat lower secure rate in soldier sample. On handling interpersonal conflict strategy indices, such as integrating, avoiding, dominating and obliging but not compromising (t_((1120))=1.97, P<0.05), there were no significant differences between soldiers and employees. Only on in-tegrating, there were significant ditterenees among four adult attachment styles (F_((3,1009))=10.18, P<0.001).Attachment avoidance had a significantly negative correlation with integrating, obliging and compromising (r=-0.31,-0.11,-0.13 respectively), while attachment anxiety had moderate but significant correlations with a-voiding, dominating and obliging and compromising (r=0. 16,0.35, 0.35, 0.39, 0.30 respectively). Conclu-sion Adult attachment is closely related to handling interpersonal conflict strategies, and there was difference on compromising between soldiers and employees.