Objective To understand the surveillance situation of poliovirus in Guangzhou from 2011 to 2024, and to further strengthen polio surveillance and ensure the continued maintenance of a polio-free status. Methods An analysis was conducted on the discovery and investigation results of six cases of vaccine-derived poliovirus (VDPV) detected in Guangzhou. Results A total of 6 VDPV incidents were reported in Guangzhou from 2011 to June 2024, among which 5 incidents were from sewage sample testing in the Liede Sewage Treatment Plant in Guangzhou, all of which were confirmed as VDPV, with 1 for type I, 1 for type II, and 3 for type III. In addition, one confirmed HFMD case was identified as a type VDPV II carrier. No presence of any wild poliovirus (WPV), VDPV cases, or circulating VDPV (cVDPV) was reported. Conclusion Guangzhou City has maintained a high level of vigilance and effectiveness in the monitoring and prevention of polio. Continuously strengthening the construction of the polio monitoring network, optimizing vaccination strategies, and comprehensively improving public health awareness are still the focus of the prevention and control work in the future.

By reviewing the historical materia medica， medical books and modern literature， this paper has systematically sorted out and verified the name， origin， quality and other aspects of Ophicalcitum. After herbal textual research， it is shown that before the Qing dynasty， the mineral medicine was mostly recorded in the name of Huarushi， but now it is called Huaruishi， and there is another mixed name Baiyunshi. The light white spots described in the historical materia medica are consistent with the characteristics of marble with sparkling star-like luster， combined with the color like sulfur， color are green， black spots and other serpentine features， it is deduced that it is serpentine marble， consistent with the present-day Ophicalcitum， and Ophicalcitum in the Song dynasty has a high content of serpentine. The main producing areas are Henan， Shaanxi， Shanxi and Sichuan， Jiangsu， Zhejiang， Hebei and other places are also available. Successive generations of materia medica on the quality evaluation of Ophicalcitum is less， the modern to neat and firm in the texture， sandwiched with yellow-green mottled for the best. Ophicalcitum is acidic， astringent and neutral in nature， belonging to the liver meridian， with the efficacy of treatment of gold sores and blood flow， internal leakage of cataracts， dropping afterbirth， now describing its efficacy as removing blood stasis and stopping bleeding. In ancient times， the earliest processing method was burning， followed by calcination by sulphur， calcination， quenching with vinegar and other methods. In modern times， it has been simplified to open calcination， processing with vinegar and the addition of water quenching. The gravimetric method and ethylenediaminetetraacetic acid titration were used to detect the contents of CO₃^2- and CaCO₃ in Ophicalcitum， respectively， and it was found that the gap in CaCO₃ content among commercially available products was wide， and the content of CaCO₃ in sample S13 and sample S18 was the same， but their compositions were different， and according to the contents of CO₃^2- and CaCO₃， the dolomite and calcite contents could be calculated， of which the higher the calcite content the more obvious the sparkling star-like luster. Raman spectroscopy and X-ray diffraction（XRD） were used to detect the physical phase composition of the powder of the samples， and Raman spectroscopy was used for the rapid non-destructive testing of the striped part， which showed that Ophicalcitum was mainly composed of dolomite， calcite， serpentine， olivine and pyroxene， with serpentine dominanting the striped part. In summary， the 2020 edition of Chinese Pharmacopoeia stipulates that the content of CaCO₃ in Ophicalcitum is not less than 40%， which is difficult to control its quality， and it is suggested to increase the detection of CO₃^2- content. This study can provide a scientific basis for the traceability of Ophicalcitum and better guide the clinical medication and rational utilization of resources.

ObjectiveTo observe the lower limb muscle activation strategy of healthy middle-aged and old women during stair ascent and descent with surface electromyography. MethodsFrom August, 2021 to February, 2022, 20 healthy middle-aged and old women were measured the surface electromyography root mean square (RMS) and integrated electromyography (iEMG) of bilateral vastus lateral, rectus femoris, vastus medialis, biceps femoris and semitendinosus during stair ascent and descent, and co-contraction ratio was calculated. ResultsDuring stair ascent, the RMS of bilateral vastus lateral, rectus femoris and vastus medialis was higher at starting stage than at following stage (|t| > 6.650, P < 0.001), while the RMS of biceps femoris and semitendinosus was lower (t > 3.559, P < 0.01); and the co-contraction ratio of hamstrings/quadriceps was lower at starting stage than at following stage (t > 8.185, P < 0.001). During stair descent, the RMS of bilateral vastus lateral, vastus medialis, biceps femoris and semitendinosus was higher at following stage than at starting stage (t > 2.345, P < 0.05), as well as the co-contraction ratio of hamstrings/quadriceps (t > 2.405, P < 0.05). ConclusionThe activities of the muscles around the knees are almost symmetrical during stair ascent and descent for healthy middle-aged and old women. The activation and co-contraction ratio of quadriceps and hamstring are various at starting/following stages.

Objective:To investigate the efficacy of Masquelet induced membrane technique combined with an external locking plate in the treatment of infectious bone defects of the tibia.Methods:A retrospective study was conducted to analyze the data of 32 patients with infectious bone defects of the tibia who had been treated by Masquelet induced membrane technique combined with an external locking plate at Department of Orthopaedic Surgery, The Fourth Hospital of Wuhan from January 2011 to January 2021. There were 22 males and 10 females, with an age of (43.2±13.1) years. The length of bone defects was (5.1±1.3) cm. By the Cierny-Mader classification, there were 12 cases of type Ⅲ and 20 cases of type Ⅳ. The defects were located at the proximal tibia in 11 cases, at the middle tibia in 12, and at the distal tibia in 9. At the last follow-up, the lower limb function was evaluated by the Paley scale, and the quality of life by the 36-Item Short Form Health Survey (SF-36).Results:All the 32 patients were followed up for (21.2±5.7) months. Normal healing was achieved in 30 cases but delayed healing occurred in 2 cases. The external plate and screws were removed at (23.1±4.6) weeks after operation. There was no infection in the original surgical incision or no injury to the nerve, blood vessel or tendon after operation, but nail tract infection occurred more or less in 3 cases. According to the Paley scale at the last follow-up, the lower limb function was evaluated as excellent in 22 cases, as good in 8, and as fair in 2, giving an excellent and good rate of 93.75% (30/32). The SF-36 quality of life score was (88.9±3.8) points.Conclusion:In the treatment of infectious bone defects of the tibia, Masquelet induced membrane technique combined with an external locking plate can achieve satisfactory clinical outcomes due to its effective control of infection, reduction in delayed healing, good stability and good patient tolerance.

Objective:To explore the fixation with S 2 alar iliac screws (S 2AI) for unstable injury to the pelvic posterior ring. Methods:The clinical data of 18 patients were analyzed retrospectively who had been treated for unstable injury to the posterior pelvic ring by S 2AI screw fixation at Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University and at Department of Orthopaedics and Traumatology, The First Affiliated Hospital to University of South China from September 2017 to December 2020. They were 8 males and 10 females, with an average age of 40 years (from 20 to 64 years). According to Tile classification, there were 3 cases of type B2, 10 cases of type C1 and 5 cases of type C2. Sacral nerve injury was complicated in 3 patients (2 cases of Gibbons grade Ⅱ and one of Gibbons grade Ⅲ). Short-segment S 1-S 2AI fixation was used in 6 cases, contralateral S 1-S 2AI fixation in one case, lumbar-pelvic fixation in 5 cases, and sacroiliac triangle fixation in 6 cases. The accuracy of S 2AI placement was evaluated by CT after operation according to the Shillingford method; the reduction quality of pelvic fractures and complications were documented. Results:All the 18 patients were followed up for 19.8 months (from 12 to 36 months). Bony union was achieved in all fractures. A total of 21 S 2AI were implanted in the 18 patients without intraoperative neurovascular injury. Postoperative CT found penetration into the iliac cortex by S 2AI in 2 cases. According to the Matta criteria, the fracture reduction was excellent in 10 cases, good in 7 and fair in one. Of the 3 patients with preoperative sacral nerve injury, 2 with grade Ⅱ injury recovered to grade Ⅰ and one with grade Ⅲ injury recovered to grade Ⅱ after operation. Superficial infection occurred at the incision site in 2 patients after operation, and complications such as protrusion, rupture or loosening of implants were observed in none of the patients. Conclusion:S 2AI fixation can be flexibly applied to various types of posterior pelvic ring injury and can provide the pelvic ring and the lumbosacral junction with rigid fixation, leading to a low complication rate.

Unstable sacral fracture is usually caused by high-energy trauma. Unstable sacral fracture often results in damage to the mechano-conductive structures of the spine and pelvis and thereby affects walking dysfunction. Treatment of sacral fracture has been a challenge due to the complex local anatomy, unique biomechanics and poor bone quality of the sacrum. The screw-rod fixation system has always played an important role in the treatment of variant sacral fracture and more severe sacral fracture. With the introduction of new technology, the screw-rod fixation system has evolved into a variety of structural types. According to whether the fixation range extends to the spine, it can be divided into two categories including spine-pelvic stabilization techniques and pelvic stabilization techniques. The authors review the progress of the screw-rod fixation system in the treatment of sacral fracture from aspects of biomechanical properties and clinical efficacy, so as to provide a reference for the selection of clinical internal fixation.

Objective:To analyze the expression of circular RNA (circRNA) in peripheral blood mononuclear cells (PBMCs) of patients with gout and to explore the possible mechanism of circRNA in the pathogenesis of gout.Methods:Peripheral blood samples of 24 patients with acute gout (AG), 24 patients with intermittent gout (IG) and 24 healthy control subjects (HC) were collected. Three cases of AG, IG, and HC were randomly selected, and the differentially expressed circRNA in PBMCs was screened by human circNA microarrays. The 6 circRNAs with large differences between the two comparison groups were selected, and the relative expression levels of 6 circRNAs in all the collected 72 PBMCs of the study subjects were detected by real-time fluorescent quantitative polymerase chain reaction (RT-qPCR). The significantly differentially ex-pressed circRNA (fold change>1.5, P<0.05) was analyzed by GO analysis, Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis, and its interaction with microRNA (miRNA) was predicted. The median (interquartile range) was used to describe the data, and the Mann-Whitney U test was used for comparison between groups. Results:(1) The microarray analysis results showed that compared with the HC group, the AG group and the IG group had 116 and 41 significantly differently expressed circRNAs, respectively; com-pared with the IG group, the AG group had 105 significantly differently expressed circRNAs. (2) Among the 6 circRNAs verified by PT-qPCR, the expression trends of 5 were consistent with the microarray results. The expression of hsa_circRNA_105034 in the AG group [5.17(4.60)] was statistically significantly different com-pared to the IG [1.68(2.39)] and HC [0.90(0.73)] groups (AG vs IG: Z=-4.413, P<0.01; AG vs HC Z=-5.052, P<0.01). (3) Bioinformatics analysis: ① GO analysis found that differential circRNA swere mainly involved in DNA transcriptional regulation, positive cell regulation and protein modification, etc. ② KEGG pathway analysis revealed that differential circRNA might be involved in the immune response mediated by the mitogen-activated protein kinase signaling pathway. ③ CircRNA might affect its inflammatory response by targeting molecules such as miRNA-146a, miRNA-302b and miRNA-23a. Conclusion:There are differentially expressed circRNAs in PBMCs of patients with gout, which may be closely related to the occurrence and development of gout.

Objective:To screen for circle RNA (circRNA) differentially expressed in peripheral blood mononuclear cells (PBMCs) of patients with ankylosing spondylitis (AS), and to analyze its expression profile to explore the role of circRNAs in the pathogenesis of AS.Methods:CircRNA microarray chip technology was used to detect the expression of circRNAs in PBMCs of 3 patients with active AS, 3 patients with stable AS and 3 healthy controls (HC), and then screening for differentially expressed circRNAs by fold change (FC) and P value. Then differentially expressed circRNAs among the circRNAs with the highest differential expression were selected randomly to verify the chip results by real-time fluorescence quantitative polymerase chain reaction (qPCR); Differentially expressed circRNAs were subjected to Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, and microRNA (miRNA) target prediction software was used to predict the circRNA/miRNA interaction relationship. Finally, the data were statistically analyzed by t test and Mann-Whitney U test. Results:① Chip text results showed that there were 800 circRNAs with significantly different expression (FC>1.5, P<0.05) in active AS than HC, of which 466 were up-regulated and 334 were down-regulated; the stable AS had a total of 1 149 significantly differentially expressed when compared with the HC (FC>1.5, P<0.05) circRNAs, of which 589 were up-regulated and 560 were down-regulated. 233 circRNAs were significantly differentially expressed (FC>1.5, P<0.05) between active AS and stable AS, of which 145 were up-regulated and 88 were down-regulated. ②The RT-qPCR verification results suggested that the expression trends of the four differentially expressed circRNAs were consistent with the results of the chip. ③ GO analysis results suggested that these differentially expressed circRNAs were mainly involved in nonsense-mediated mRNA decay, Rho GTPase binding and other processes. The analysis showed that the KEGG pathway were enriched in Th17 cell differentiation and chemokine signaling pathways. The results of miRNA target prediction software analysis suggested that differentially expressed circRNAs might play a role by targeting miR-650, let-7b-5p and other miRNAs. Conclusion:Compared with HC group, there were differentially expressed circRNAs in Peripheral Blood Mononuclear Cells (PBMCs) of AS patients, The results of this study suggest that these circRNAs may be involved in the pathogenesis of AS.

Objective:Comparison of biomechanical stability of S 2-alar-iliac screw and S 1 pedicle screw fixation (S 2AI-S 1) with conventional sacroiliac screw in the treatment of Denis type II sacral fractures by finite element analysis. Methods:The lumbar spine and pelvis of a male volunteer with normal skeletal structure were scanned by CT, followed by three-dimensional reconstruction. The finite element model of right Denis type II sacral fracture and pubic symphysis injury was constructed using ANSYS 17.0 software. The anterior pelvic ring is fixed with a five-hole steel plate, and the posterior pelvic ring is fixed with four different internal fixation methods, namely, sacroiliac screw (S 1 segment half-thread hollow screw), S 2AI-S 1 and S 2AI screw and contralateral S 1 screw fixation (S 2AI-CS 1). By restraining the bilateral acetabular and applying 500 N vertical stress above the L 4 vertebral body, the maximum displacement, maximum von Mises stress and vertical stiffness of the three groups of internal fixation were compared. Results:In terms of the maximum displacement of the sacrum in the vertical and anteroposterior directions, the S 2AI-S 1 model was the smallest (1.40 mm, 1.40 mm, respectively), while the S 2AI-CS 1 model was the largest (1.60 mm, 1.56 mm, respectively); In terms of the maximum displacement of the sacrum in the horizontal direction, the S 2AI-S 1 model is the smallest (0.19 mm), while the SIS model is the largest (0.37 mm); In terms of the maximum von Mises stress of internal fixation, the stress of the sacroiliac screw model is the largest (216.02 MPa), while the stress of the S 2AI-S 1 model is the smallest (39.82 MPa); In terms of the maximum von Mises stress of the bone around the screw, the stress of the sacroiliac screw model (39.68 MPa) is the largest and that of the S 2AI-S 1 model is the smallest (31.56 MPa); In terms of the vertical displacement of the center point of the upper surface of the S 1 vertebral body, the sacroiliac screw, S 2AI-S 1 and S 2AI-CS 1 groups were 0.83 mm, 0.73 mm and 0.93 mm, respectively. Using the vertical displacement of the center point of the upper surface of the S 1 vertebral body to predict the vertical stiffness of the three groups of models, from large to small, are S 2AI-S 1, sacroiliac screw and S 2AI-CS 1. Conclusion:S 2AI-S 1 fixation has good biomechanical stability in three-dimensional finite element analysis. It can be used as a new type of internal fixation for the treatment of sacral fractures and is worthy of promotion.