Objective: To explore the association between light intensity physical activity (LPA) and sedentary behavior (SB) with body composition, so as to provide data references for improving adolescent physical health. Methods: From August 2020 to January 2021, general information of 694 students in grade one of a high school in Foshan City was collected, and the 24 hour activity behavior and body composition of the students were measured objectively by triaxial accelerometer and bioelectrical impedance tester. Dual component multivariate regression and dual compositional isotemporal substitution model were used to explore the relationship between LPA and SB and body composition. Results: LPA was associated with lower fat relative dominance (FRD) (male weekends FRD=-21.44%, female weekly FRD=-17.83%, weekdays FRD=-18.27%, P <0.05), and LPA was also associated with higher muscle relative dominance (MRD) and bone relative dominance (BRD) (male weekends MRD=12.78%, BRD= 12.87 %; female weekly MRD=11.64%, BRD=9.01%; female weekdays MRD=12.02%, BRD=9.23%, P <0.05). Replacing sedentary behavior (SB) with 10 minutes of LPA could reduce fat proportion [male:weekly -0.15(-0.26--0.04), weekdays -0.12 (-0.22--0.02); female:weekly -0.18(-0.27--0.08), weekdays -0.16(-0.25--0.07)) and increase muscle proportion (male:weekly 0.14(0.03-0.24), weekdays 0.11(0.02-0.21); female:weekly 0.17(0.07-0.26), weekdays 0.15(0.07-0.24)]. Conclusion Interrupting continuous SB with LPA can serve as an intervention measure to promote physical health and fitness in adolescents. School should encourage students to engage in frequent LPA during breaks and after school activities, while avoiding prolonged SB.

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 establish a UHPLC method for the determination of zolpidem tartrate tablets after radiation, and to investigate the effect of different radiation doses on the content of zolpidem tartrate tablets. Methods Ultra high performance liquid chromatography was used. The content of zolpidem tartrate tablets irradiated by γ-ray was determined. Using C₁₈ column, acetonitrile methanol-0.05 mol/L phosphoric acid solution (the pH value as 5.5 with triethylamine) (18∶26∶56) was used as the mobile phase. The flow rate was 0.7 ml/min, and the detection wavelength was 254 nm. Results The method validation showed good linearity in the concentration range of 5-80 μg/ml (r=0.999 6); The average recovery was 98.2%, RSD was 1.72%, and the repeatability was 0.87%. The contents of zolpidem tartrate were 105.1%, 106.4%, 102.7% and 105.4% under 0, 8, 25 and 80 kGy radiation. Conclusion UHPLC has accurate results with short analysis cycle in this study. It is suitable for the determination of zolpidem tartrate tablets after radiation. The content of zolpidem tartrate tablets remained basically unchanged after radiation.

Objective To assay the contents of acetaminophen with ultra high-performance liquid chromatography (UHPLC) method in the sustained-release tablets radiated by Gamma ray. Methods Acetaminophen sustained-release tablets were radiated by ⁶⁰Co. UHPLC equipped with the Shim-pack GISS-C₁₈（2.1 mm×50 mm, 1.9 μm）was used for the assay. The mobile phase was methanol-0.05 % ammonium acetate solution (15∶85). The flow rate was 0.3 ml/min with the detection wavelength at 245 nm. Results The acetaminophen showed good linear relationship within the range of 20-100 μg/ml (r=0.999 4). The RSD values of repeatability was 0.9 %. The average recovery was 97.9 %-104.9 %. Acetaminophen content was 96.2 %, 92.2 %, 91.8 %, 83.9 % at 0, 8, 50 and 80 kGy radiation, respectively. Conclusion This method is speedy and accurate. It can be used to assay the content of acetaminophen in the sustained-release tablets after radiation. The content of acetaminophen decreased after radiation.

Objective:To conduct interviews from the perspective of caregivers of children with autism spectrum disorders (ASD) and to conduct a multi-level and multi-dimensional strategy to provide help for families of children with ASD by exploring the experience of oral health care of such children.Methods:Using the purposive sampling method, a total of 11 family caregivers of children with ASD aged 12 and below who visited Outpatient Department of Pediatric Dental Prevention in Affiliated Stomatological Hospital of Nanjing Medical University from May 2020 to May 2021 were selected for semi-structured interviews. The subject was finally determined using Colaizzi's 7-step analysis method and assisted by Nvivo 12 software.Results:The current situation of oral care for children with ASD had three themes, namely, caregiver emotion, care dilemma and needs.Conclusions:More attention should be paid to the mental health of family caregivers with ASD. The oral health of children with ASD not only needs family caregivers, but also needs the common attention and support of the whole society, including multi-disciplinary and multi-department, to provide effective oral health management programs for children with ASD, so as to promote the oral health of this group of children.

Objective:To explore the related factors of nutritional status in hospitalized elders with mental disorders.Methods:A total of 584 elders with mental disorders admitted to Beijing Huilongguan Hospital from June 2020 to June 2021 were selected by convenience sampling method. General questionnaire, Barthel Index Scale, Frailty Phenotype, Mini Nutritional Assessment, Simple Physical Fitness Scale (SPFS) , Family Function Assessment Scale were collected. Univariate analysis and Pearson correlation analysis were used to analyze the related factors of patients' nutritional status. Multivariate correspondence analysis was performed for significant variables in univariate analysis.Results:The incidence of malnutrition in hospitalized elders with mental disorders was 51.88% (303/584) , and patients were divided into three groups according to nutritional status, including good nutritional status group, risk of malnutrition group, and malnutrition group for statistical analysis. Univariate analysis showed that there were significant differences in age, diagnosis, frailty, smoking, drinking, BMI, Barthel score, SPPB, family function among three groups ( P<0.01) . Correlation analysis showed that BMI ( r=0.144, P<0.01) , Barthel index ( r=0.087, P<0.05) , family social function ( r=0.257, P<0.01) and nutritional status were positively correlated with nutritional status, while age ( r=-0.252, P<0.01) , frailty ( r=-0.216, P<0.01) were negatively correlated with nutritional status. Multiple correspondence analysis showed that dementia, over 81 years old, frailty, impaired activities of daily living, and family dysfunction were the related factors of malnutrition; schizophrenia, 71-80 years old, pre-debility, good ability of daily living were the associated factors of good nutritional status; bipolar disorder, 60-70 years old were the associated factors of malnutrition. Conclusions:The health supervision and nutrition screening of hospitalized elders with mental disorders should be strengthened, and targeted nutritional intervention strategies should be adopted for patients with different mental disorders, so as to reduce the health problems.

Objective: To investigate the smartphone addiction among college students during the Coronavirus Disease 2019 (COVID-19) pandemic and its association with daily behaviors and mental health,and to provide reference for heath education and psychological counseling for college students. Methods: An observational study using online quyestionnaire was conducted among 10 357 college students of two provincial medical schools in Guangdong and Shanxi Province from February 24th to March 4th in 2020. Participants were investigated on demographic information, smartphone addiction, daily routine, physical activity, weight status, anxiety, and other health information. Logistic regression with inverse probability treatment weighting (IPTW) based on propensity score was used to analyze the association between smartphone addiction with daily behavior and mental health. Results: The prevalence of smartphone addiction was 59.42%. The prevalence of phone addiction was higher in postgraduates, senior undergraduates, students with non-medical major, students living in GuangDong and those without regular exercise habit before vacation(χ 2=47.91，17.78，42.75，138.58，P<0.05). With IPTW, there were significant associations between smartphone addiction and late bedtimes (OR=1.82, 95%CI=1.66-1.98) and wake-up times (OR=1.55, 95%CI=1.44-1.68), more sedentary behaviors (OR=1.21, 95%CI=1.12-1.31), less moderate to vigorous physical activity (OR=1.33, 95%CI=1.22-1.44), anxiety (OR=2.98, 95%CI=2.52-3.40), weight gain(OR=1.27，95%CI=1.17-1.37) and other detrimental daily behavior and feelings. Conclusion High prevalence of smartphone addiction has been observed during the COVID-19 pandemic, with impaired daily behavior and mental health.

Objective:To explore the clinical effectiveness of arthroscopic treatment of tibial eminence avulsion fracture by four-point fixation with suture anchors.Methods:A retrospective analysis was performed of the 58 patients with tibial eminence avulsion fracture who had been treated by the same group of surgeons using four-point fixation technique with suture anchors under arthroscopy at Department of Sports Medicine, The Affiliated Hospital to Qingdao University from January 2015 to December 2018. They were 33 males and 25 females, with an average age of 18.4 years (from 14 to 32 years). By the modified Meyers-McKeever classification, 15 fractures were type Ⅱ, 19 type Ⅲ and 24 type Ⅳ. Recorded and compared were knee Lysholm scores, International Knee Documentation Committee (IKDC) scores and tibial eminence height between preoperation and one year postoperation; recorded at the last follow-up were range of knee motion and results of Lachman and pivot-shift tests.Results:The 58 patients were followed up for a mean of 20.7 months (from 12 to 33 months). Bony union was achieved in all patients within 12 weeks after operation. In this cohort, the Lysholm score (85.2±4.9) and IKDC score (86.2±4.3) at one year postoperation were significantly higher than the preoperative values (43.2±5.2 and 51.2±4.9), and the post-operative tibial eminence height [(9.1±1.2) mm] was significantly lower than the preoperative value [(12.6±1.2) mm] (all P<0.05). The correlation coefficients between the tibial eminence height and the Lysholm & IKDC scores at one year postoperation were -0.16 and -0.17, respectively. The last follow-up showed a 132°±5° range of knee motion for all patients, a positive result of pivot-shift test (grade Ⅱ) for 3 and a positive result of Lachman test (grade Ⅰ) for 2. Conclusion:Arthroscopic treatment of tibial eminence avulsion fracture by four-point fixation with suture anchors can lead to satisfactory effectiveness, showing advantages of minimal invasion, anatomic reduction, reliable fixation, and little impact on the epiphysis plate.

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumors in the gastrointestinal tract. Surgical resection is the only curative treatment, while imatinib is the first-line therapy for recurrent, metastatic, and unresectable GIST. However, more than half of GIST patients suffer from secondary resistance to imatinib within 2 years after treatment initiation. Therefore, early diagnosis, drug resistance and recurrence surveillance are critical for GIST patients. Liquid biopsy is a new method which utilizes the detection of tumor biomarkers in peripheral blood for early diagnosis and therapeutic efficacy assessment. In recent years, liquid biopsy has achieved significant research progress in several kinds of malignancy. This review aims at presenting an overview on research advance of liquid biopsy in GIST and may provide a new method for early diagnosis and therapeutic efficacy assessment of GIST.

Objective:Platelet-derived growth factor α (PDGFRA)-mutant gastrointestinal stromal tumor (GIST) is a relatively rare disease, whose clinicopathological characteristics and prognosis have been poorly studied. In this paper, the clinicopathological features and prognostic factors of PDGFRA-mutant GIST are investigated to provide more data for its understanding and treatment. Methods:A retrospective case-control study was used to collect the medical records of patients with GIST who underwent surgical resection in Zhongshan Hospital of Fudan University from January 2015 to August 2019. Patients with PDGFRA-mutant GIST were enrolled, and those with synonymous PDGFRA mutations, non-tumor-related deaths, and lack of clinicopathological data were excluded. The clinicopathological data were collected and the risk factors associated with prognosis were analyzed.Results:Among the enrolled 59 patients, there were 41 males (69.5%) and 18 females (30.5%) with the median age of 60 (25-79) years. All tumors originated from the stomach. The tumor size was 5 (3-7) cm, and the mitotic count was 2 (1-4)/50 high-power fields (HPF). According to the modified NIH risk stratification, 8 cases were classified as very low risk (13.6%), 25 cases as low risk (42.4%), 14 cases as moderate risk (23.7%), and 12 cases as high risk (20.3%). There were 7 cases of exon 12 mutation and 52 cases of exon 18 mutation (including 36 cases of D842V mutation). A comparison of clinicopathological features between the D842V mutation group and the non-D842V mutation group showed no statistically significant difference (all P>0.05). During a median follow-up of 21 (0-59) months, the 1- and 3-year relapse-free survival (RFS) rates of all the patients were 96.6% and 91.5%, respectively. There were 8 cases of recurrence and 3 cases of death. Six GIST patients with D842V mutation had tumor recurrence after operation, of whom 4 cases achieved varying degrees of tumor remission after being treated with dasatinib or avapritinib. Log-rank analysis showed that the overall survival (OS) of male was better than that of female (100% vs. 83.3%, P=0.046), but there was no significant difference in OS among patients with different risk grades ( P=0.057). The RFS and OS of patients with D842V mutation and non-D842V mutation, exon 12 and exon 18 mutation were similar (all P>0.05). Univariate Cox analysis showed that RFS was associated with gender ( P=0.010), tumor size ( P=0.042), mitotic count ( P=0.003), and the modified NIH risk stratification ( P=0.042), while multivariate analysis revealed that higher risk grade was an independent risk factor for recurrence of PDGFRA-mutant GIST (HR=12.796, 95%CI: 1.326-123.501, P=0.028). Gender was an independent factor for recurrence, and the risk of recurrence in males was lower than that in females (HR=0.154, 95%CI: 0.028-0.841, P=0.031). Conclusions:Gender and the modified NIH risk stratification are independent risk factors for recurrence of PDGFRA-mutant GIST, while patients with D842V and non-D842V mutation, and exon 12 and exon 18 mutation have a similar risk of recurrence and death.