Objective:To explore the feasibility and consistency of a new digital classification system of pelvic fractures named as JST classification based on close reduction techniques.Methods:A retrospective collection was conducted of the data from the 63 patients with pelvic fracture who had undergone surgical treatment after JST classification at Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital from March 2021 to March 2023. Digital classification of the pelvic fractures was performed based on their locations and displacements. The classification first divides the pelvis into 4 parts: left half pelvis and right half pelvis; sacral Denis Ⅲ area and pubic symphysis. The symmetrical left and right sacral Denis Ⅰ and Denis Ⅱ areas are also included in the left/right half pelvis. Subsequently, the left half pelvis and right half pelvis are divided into 4 regions and marked by capitalized English letters: Sacrum Area (including Denis Ⅰ and Denis Ⅱ, denoted as S), Sacroiliac Joint Area (denoted as J), Iliac Area (denoted as I), and Pubic Area (denoted as P); to distinguish right/left, R and L are used as prefixes. The 2 asymmetric parts are also marked with English letters: Denis Ⅲ area of the sacrum (denoted as Sac), and pubic symphysis (denoted as C). Afterwards, the fracture line morphology and displacement in each region are marked digitally to form a complete JST classification system. The inter- and intra-observer reliabilities (Fleiss' and Cohen's Kappa) of the JST classification system were tested by 3 observers with more than 10 years of experience in pelvic fracture treatment.Results:Consistency analysis of the JST classification results showed that the mean κ value of the intra-observer reliability was 0.818 (from 0.658 to 0.946, P<0.001) and the inter-observer reliability 0.873 (from 0.674 to 1.000, P<0.001), both indicating excellent agreement. Of the 63 patients, 59 obtained successful closed reduction with the assistance of the Rossum Robot R-Universal intelligent orthopedic surgical robot system after fracture classification by the JST system, yielding a success rate of 93.7% (59/63). Conclusions:The new JST classification system for pelvic fractures demonstrates strong intra and inter-observer reliabilities compared with traditional classification systems. As JST classification system labels each fracture site and key bones, it is of great significance for the deep learning and intraoperative operations of intelligent fracture robots.

Based on the demand of enterprise talents and the characteristics of manufacturing process management in biotechnology, in order to make the students acquire the ability to solve complex engineering problems in the production process, we developed a "Comprehensive Biotechnology Experiment" course, where two-step enzymatic production of l-aspartate and l-alanine were the key processes. In this course, we drew lessons from the site management of the production enterprise, performed the experimental operation mode of four shifts and three operations. The content of this course includes principles, methods and experimental techniques of several core curricula and the site management mode of enterprises. As to the evaluation, the summary of the experimental staff's handover records and the content of teamwork were examined and scored. Through teaching practice and continuous improvement, we developed a complete experimental teaching process and assessment mechanism. Overall, the Comprehensive Biotechnology Experiment course achieved good teaching effect, which may serve as a reference to promote the development of experimental teaching of biotechnology.
Humans ; Biotechnology ; Curriculum ; Students

Objective:To evaluate open reduction and internal fixation via the anterior approaches in the treatment of geriatric acetabular fractures.Methods:Retrospectively analyzed were the clinical data of 74 consecutive patients with acetabular fracture who had been treated by open reduction and internal fixation via the anterior approaches from June 2018 to December 2020. The patients were divided into 2 groups. In the geriatric group (≥65 years old): 16 patients [8 males and 8 females with an age of (74.0±5.9) years]; 7 both column fractures, 4 anterior column fractures, and 5 anterior column plus posterior hemi-transverse fractures according to the Letournel-Judet classification; time from injury to operation: (6.1±3.4) d. In the young group (<65 years old): 58 patients [48 males and 10 females with an age of (46.7±10.9) years]; 28 both column fractures, 14 anterior column fractures, 8 anterior column plus posterior hemi-transverse fractures, 5 T type fractures and 3 transverse fractures; time from injury to operation: (5.4±2.7) d. The 2 groups were compared in terms of operation time, intraoperative blood loss, postoperative reduction, operative complications, and functional results.Results:The 2 groups were comparable because there was no significant difference in the preoperative general data like fracture Letournel-Judet classification or dome impaction between them ( P>0.05). The intraoperative blood loss in the geriatric group was (715.6±285.0) mL, significantly less than that in the young group [(1,008.6±463.9) mL]( P<0.05). In the geriatric and young groups, respectively, the operation time was (167.2±44.3) min and (172.9±56.6) min, 3 and 6 cases had main operative complications, the good to excellent rate of postoperative reduction was 87.5% (14/16) and 84.5% (49/58), and the follow-up time was (26.6±10.7) months and (23.6±10.1) months, all showing no significant difference ( P>0.05). According to the improved Merle d'Aubigné & Postel scoring system, the hip function at the last follow-up was evaluated as excellent in 5 cases, as good in 10 cases, and as fair in 1 case in the geriatric group while as excellent in 21 cases, as good in 33 cases, and as fair in 2 cases (the other 2 cases were lost) in the young group, showing no statistically significant difference between the 2 groups ( P>0.05). Conclusion:Open reduction and internal fixation via the anterior approaches is as safe and effective for the geriatric patients with acetabular fracture as for the young and middle-aged ones.

Objective:Hepatocellular carcinoma(HCC)prognosis involves multiple clinical factors.Although nomogram models targeting various clinical factors have been reported in early and locally advanced HCC,there are currently few studies on complete and effective prognostic nomogram models for stage Ⅳ HCC patients.This study aims to creat nomograms for cancer-specific survival(CSS)in patients at stage Ⅳ of HCC and developing a web predictive nomogram model to predict patient prognosis and guide individualized treatment. Methods:Clinicopathological information on stage Ⅳ of HCC between January,2010 and December,2015 was collected from the Surveillance,Epidemiology,and End Results(SEER)database.The patients at stage Ⅳ of HCC were categorized into ⅣA(without distant metastases)and ⅣB(with distant metastases)subgroups based on the presence of distant metastasis,and then the patients from both ⅣA and ⅣB subgroups were randomly divided into the training and validation cohorts in a 7:3 ratio.Univariate and multivariate Cox regression analyses were used to analyze the independent risk factors that significantly affected CSS in the training cohort,and constructed nomogram models separately for stage ⅣA and stage ⅣB patients based on relevant independent risk factors.Two nomogram's accuracy and discrimination were evaluated by receiver operator characteristic(ROC)curves and calibration curves.Furthermore,web-based nomogram models were developed specifically for stage ⅣA and stage ⅣB HCC patients by R software.A decision analysis curve(DCA)was used to evaluate the clinical utility of the web-based nomogram models. Results:A total of 3 060 patients were included in this study,of which 883 were in stage ⅣA,and 2 177 were in stage ⅣB.Based on multivariate analysis results,tumor size,alpha-fetoprotein(AFP),T stage,histological grade,surgery,radiotherapy,and chemotherapy were independent prognostic factors for patients with stage ⅣA of HCC;and tumor size,AFP,T stage,N stage,histological grade,lung metastasis,surgery,radiotherapy,and chemotherapy were independent prognostic factors for patients with stage ⅣB HCC.In stage ⅣA patients,the 3-,6-,9-,12-,15-,and 18-month areas under the ROC curves for the training cohort were 0.823,0.800,0.772,0.784,0.784,and 0.786,respectively;and the 3-,6-,9-,12-,15-,and 18-month areas under the ROC curves for the validation cohort were 0.793,0.764,0.739,0.773,0.798,and 0.799,respectively.In stage ⅣB patients,the 3-,6-,9-,and 12-month areas under the ROC curves for the training cohort were 0.756,0.750,0.755,and 0.743,respectively;and the 3-,6-,9-,and 12-month areas under the ROC curves for the validation cohort were 0.744,0.747,0.775,and 0.779,respectively;showing that the nomograms had an excellent predictive ability.The calibration curves showed a good consistency between the predictions and actual observations. Conclusion:Predictive nomogram models for CSS in stage ⅣA and ⅣB HCC patients are developed and validated based on the SEER database,which might be used for clinicians to predict the prognosis,implement individualized treatment,and follow up those patients.

Objective:To observe alterations of macular outer retinal reflectivity (ORR) and the associations with macular vessel density in patients with nonproliferative diabetic retinopathy (NPDR).Methods:A retrospective cross-sectional study. From August 2021 to March 2022, a total of 63 NPDR patients with 63 eyes (NPDR group) diagnosed by Department of Ophthalmology of Guangdong Provincial People'sHospital were included in the study. There were 39 males with 39 eyes and 24 females with 24 eyes. Age was 60 (52, 68) years. A total of 66 eyes of 66 healthy volunteers matching age and sex were selected as the control group. Among them, 40 men had 40 eyes and 26 women had 26 eyes. Age was 58 (52, 67) years. Optical coherence tomography (OCT) and OCT angiography (OCTA) were performed in all affected eyes. Image J software was used to calculate ORR, including the optical density of ellipsoid zone (EZ), photoreceptor outer segment (OS), photoreceptor inner segment (IS) and outer nuclear layer (ONL) by OCT examination. The sampling sites were horizontal and vertical scanning of the fovea of the macula on 500 μm (nasal 500, temporal 500, superior 500, inferior 500), 1 000 μm (nasal 1 000, temporal 1 000, superior 1 000, inferior 1 000) and 2 000 μm (nasal 2 000, temporal 2 000, superior 2 000, inferior 2 000). The software automatically divided the retina within 6 mm of the macular fovea into the fovea with a diameter of 1 mm, the parafovea with a diameter of 1-3 mm, and the perifovea with a diameter of 3-6 mm by macular OCTA examination. The blood density of superficial capillary plexus and deep capillary plexus in different zones in the macular area were measured by the built-in software of the device. Spearman correlation analysis was used to analyze the correlation between ORR and blood flow density. Results:Compared with the control group, retinal reflectivity of EZ in NPDR group was significantly decreased at other sites except the fovea, retinal reflectivity of OS was significantly decreased at nasal 2 000, temporal 2 000, superior 2 000 and superior 1 000; retinal reflectivity of IS was significantly decreased at superior 1 000, superior 500 and inferior 500. The retinal reflectivity of ONL in macular fovea was significantly decreased, and the differences were statistically significant ( P<0.05). The ORR was positively correlated with blood flow density, and the correlation coefficient in NPDR group was lower than that in control group. The results of multifactor linear regression analysis showed that the superior and temporal ORR were correlated with blood flow density ( P<0.05). Conclusions:Compared with the control group, ORR is reduced and less correlated with vessel density in NPDR patients. ORR is more affected by retinal blood flow density in temporal and superior parts.

Objective:To compare the perioperative data between the pararectus and ilioinguinal approaches in the internal fixation of acetabular fractures.Methods:A randomized controlled trial was conducted to enroll 74 patients with acetabular fracture who were admitted to Department of Orthopaedic Trauma, Beijing Jishuitan Hospital from June 2018 to January 2021. They were randomly divided into 2 groups. In group A of 37 cases, there were 28 males and 9 females with an age of (55.8±15.2) years, and 10 anterior column fractures, 7 anterior+posterior hemi-transverse fractures, one transverse fracture, 3 T-shaped fractures and 16 both column fractures according to Letournel-Judet classification. In group B of 37 cases, there were 28 males and 9 females with an age of (49.4±14.6) years, and 8 anterior column fractures, 6 anterior+ posterior hemi-transverse fractures, 2 transverse fractures, 2 T-shaped fractures and 19 both column fractures according to Letournel-Judet classification. Group A was subjected to open reduction and plate fixation via the pararectus approach while group B to open reduction and plate fixation via the ilioinguinal approach. The 2 groups were compared in terms of operation time, intraoperative blood loss, postoperative reduction and perioperative complications.Results:There were no significant differences in baseline data between the 2 groups, showing comparability between them ( P>0.05). The operation time in group A [150 (120, 180) min] was significantly shorter than that in group B [180 (150, 225) min] ( P<0.05). There were no significance differences between the 2 groups in intraoperative blood loss [800 (600, 1, 000) mL versus 1, 000(600, 1, 300) mL], rate of good to excellent reduction [91.9%(34/37) versus 78.4%(29/37)], or incidence of complications [24.3%(9/37) versus 45.9%(17/37)] ( P>0.05). Conclusion:Compared with the ilioinguinal approach, the pararectus approach can reduce operation time significantly in the internal fixation of acetabular fractures.

Objective:To understand the social support, social network, and sexual behavior characteristics of foreigners living in Guangzhou, analyze factors relating to aspects of online social interactions and sexual behaviors of foreigners in Guangzhou, and provide references for targeted HIV intervention services for foreigners.Methods:A cross-sectional survey (both online and offline), among those who met the inclusion criteria was conducted between November 2019 and January 2020. Data were collected on demographics, social support, online social interactions, sexual behaviors, and so on. Statistics were compiled to analyze the factors that may influence casual sexual behaviors.Results:A total of 434 participants were included in the study (241 offline and 193 online). The majority of the participants were male 68.4% (297/434), age (31.0±8.8) years old, African 79.0% (343/434), business people 46.5% (202/434), students 48.2% (209/434), who have business partners and family members in China were 59.4% (258/434) and 28.1% (122/434) separately. They also had the following features: less than 10 close friends 57.1% (248/434); spend 1-3 hours on social applications per day 43.3% (188/434), had casual sexual behaviors in the last 3 months 15.2% (55/363). Multiple logistic regression model analysis showed that compared with those who used social applications for less than 1 hour per day, participants who used social applications for more than 6 hours per day were more likely to have casual sexual behaviors in the last 3 months ( OR=3.63, 95% CI: 1.31-10.08). Conclusions:Participants who used social applications for a longer period every day were more likely to have casual sexual behaviors among foreigners in Guangzhou. Good use of social applications for health promotion and education of HIV can increase the health awareness of foreigners in China.

Objective:To investigate the characteristics of macular perfusion and structures in patients with early stages of diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA).Methods:A cross-sectional study was performed.Forty eyes of 27 diabetic patients without diabetic retinopathy (NDR), forty eyes of 24 patients with mild non-proliferative diabetic retinopathy (NPDR) and forty eyes of 28 patients with moderate NPDR were recruited in Guangdong Provincial People's Hospital from June 2017 to August 2018.RTVue-XR OCTA was used to scan a 6 mm×6 mm area centered in the fovea and the superficial vascular complex (SVC) and deep vascular complex (DVC) vessel density, fovea avascular zone (FAZ) area, FAZ perimeter, acircularity index (AI), and vessel density of a 300 μm wide ring area around FAZ (FD300) were quantified.The associations among stages of DR and macular vessel density, structures were analyzed.This study was approved by the Ethics Committee of the Guangdong Provincial People's Hospital (No.2016232A).Results:The vessel density of SVC and DVC tended to decrease as the progression of DR.The vessel density of SVC was (51.25±3.27)%, (48.81±3.99)%, (47.00±3.49)%, (45.73±3.35)%, and the vessel density of DVC was (53.89±6.30)%, (49.94±6.05)%, (46.69±4.87)% and (44.78±4.30)% in the control group, NDR group, mild NPDR group, and moderate NPDR group, respectively.The vessel densities of SVC and DVC were statistically different among the four groups ( F=18.33, 21.53; both at P<0.01). The vessel density of SVC and DVC in the NDR group, mild NPDR group, moderate NPDR group was significantly lower than that in the control group (all at P<0.01). The vessel densities of FD300 in the mild NPDR group and moderate NPDR group were significantly lower than that in the control group (all at P<0.01). The FAZ area of the control group, NDR group, mild NPDR group, and moderate NPDR group was (0.31±0.11), (0.32±0.09), (0.34±0.13), and (0.37±0.10)mm 2, respectively.There was no significant difference in the FAZ area among the four groups ( F=2.18, P=0.09). The FAZ perimeter and AI were significantly higher in the moderate NPDR group than those in the control group (both at P<0.05). Conclusions:OCTA is able to detect the decrease of vessel density in diabetic patients before the occurrence of visible fundus lesions.The vessel density of SVC and DVC in patients with early stages of DR is decreased.DVC vessel density may be a sensitive marker to indicate DR.FD300 is not significantly decreased until mild NPDR, FAZ area and perimeter are significantly increased in moderate NPDR, indicating a more irregular FAZ.

OBJECTIVES: To discuss the demands and countermeasures for outpatients and emergency patients during the outbreak of coronavirus disease 2019 (COVID-19) in large general hospital. METHODS: By analyzing patients' demands, outpatient service system and emergency system complemented each other with the help of "internet medical" to provide online medical treatment, self-diagnosed pneumonia program, online pharmacies, outpatient appointment and online pre-examination services, open green channels for special patients, and to provide referral services for critical patients. The COVID-19 suspected patients and other common fever patients were separated from other patients. RESULTS: From January 28 to March 1, we have received 26 000 patients online, 1 856 special patients, 2 929 suspected patients and common fever patients including 31 confirmed patients, 0 case of misdiagnosis and cross-infection. CONCLUSIONS Targeting patient's demands and taking appropriate measures are effective on meeting the needs of outpatients' and emergency patients' medical services.
Betacoronavirus ; Coronavirus Infections ; epidemiology ; prevention & control ; Cross Infection ; prevention & control ; Emergency Medical Services ; organization & administration ; Health Services Needs and Demand ; Hospitals, General ; organization & administration ; Humans ; Outpatients ; Pandemics ; prevention & control ; Pneumonia, Viral ; epidemiology ; prevention & control

Objective:To analyze the influencing factors of HIV testing behavior among foreigners in Guangzhou, and provide a reference for promoting HIV testing and intervention services in foreigners.Methods:A cross-sectional survey was conducted from November 2019 to January 2020 among 230 eligible foreigners selected in Guangzhou through convenient sampling method in the form of one-to-one questionnaire interview, HIV testing behaviors and related influencing factors were described and analyzed with χ2 test and multivariate logistic regression model. Results:A total of 230 foreigners were included in the study, in whom 156 were males (67.8%), 217 were from Africa (94.3%), 138 (60.0%) were with education level of university and above, 169 (73.5%) were in business, 47 (20.4%) were students, 132 (57.4%) had cumulative residence >12 months in Guangzhou and 113 (49.1%) had health examination in China in the past 6 months. In these foreigners, the rate of AIDS-related knowledge awareness was 76.0%, the proportion of condom use in the last sex was 39.6%(89/225) and 47.8%(110/230) received HIV tests in the past 3 months. Multivariate logistic regression analysis showed, the influencing factors of HIV testing behavior in the past 3 months included cumulative residence ≤12 months (compared with cumulative residence >12 months, OR=3.12, 95 %CI: 1.49-6.56), health examination in China in the past 6 months (compared to those who had not, OR=2.53, 95 %CI: 1.17-5.48), awareness of HIV testing and consulting service in Guangzhou (compared with those who had no awareness, OR=3.65, 95 %CI: 1.71-7.78). Conclusions:Some foreigners in Guangzhou had relatively low rates of HIV testing and condom use. Those who pay attention to their own health status and know well about HIV testing and consulting services are more likely to receive HIV testing, foreigners in Guangzhou should be encouraged to receive HIV testing. Their self-testing awareness should be improved.