Objective:To compare the efficacy of double thread elastic locking intramedullary nail (ELIN) and threaded elastic intramedullary nail (TEIN) in the treatment of mid-shaft clavicular fracture.Methods:From August 2017 to September 2020, 33 patients with mid-shaft clavicular fractures were treated with ELIN (double threaded nail group), including 14 males and 19 females, age 52.09±16.32 years old; Robinson classification: 20 cases of type 2A2, 6 cases of type 2B1, and 7 cases of type 2B2. Thirty-two patients were selected as the control group with TEIN fixation (single threaded nail group) during the same period, including 13 males and 19 females; age 43.25±15.03 years old; Robinson classification: 19 cases of type 2A2 and 5 cases of type 2B1, 8 cases of 2B2 type. The operation time, intraoperative incision length, fracture healing time, internal fixation removal time, Constant-Murley shoulder joint score, disabilities of the arm, shoulder, and hand (DASH) score, fracture reduction and postoperative complications were compared between the two groups.Results:The patients in both groups were followed up after operation, the double-threaded screw group was followed up for 16-48 weeks (average, 23.7 weeks), and the single threaded nail group was followed up for 15-51 weeks (average, 22.9 weeks). The operation time of the double threaded nail group and the single threaded nail group were 19.45±6.74 min and 19.59±4.98 min, and the length of the incision was 1.70±0.79 cm and 1.73±0.84 cm. The fracture healing time were 12.12±1.29 weeks and 13.88±1.84 weeks. The internal fixation removal time was 13.09±1.31 weeks and 15.69±1.94 weeks. The Constant-Murley shoulder score was 93.18±3.78 points and 90.09±4.03 points, and the DASH scores were 1.49± 0.49 points and 3.85±1.13 points; There was no significant difference in operation time and incision length between the two groups ( t=0.01, 0.19; P>0.05), while fracture healing ( t=3.70, P<0.001), internal fixation removal time ( t=6.34, P<0.001), Constant-Murley shoulder score ( t=3.19, P<0.001), DASH score ( t=10.95, P<0.001) differences were statistically significant. The length of the clavicle on the healthy side was 16.38±1.09 cm in the double threaded nail group, and the length of the clavicle on the affected side after internal fixation removal was 16.33±1.12 cm. There was no obvious shortening deformity on the affected side, and there was no significant difference in the length of the clavicle between the two sides ( t=1.57, P=0.127). The clavicle lengths of the healthy side and the affected side after internal fixation removal in the single threaded nail group were 16.55±1.12 cm and 15.12±1.18 cm, and the difference was statistically significant ( t=8.02, P<0.001). The postoperative shortening values of the double-threaded screw group and the single-threaded screw group were 9.47±2.12 mm and 17.41±2.42 mm, and the difference was statistically significant ( t=14.07, P<0.001). Postoperatively, 5 cases of bursitis and 2 cases of skin irritation occurred in the double threaded nail group; While 6 cases of bursitis, 3 cases of skin irritation, 4 cases of shortening malunion, and 1 case of broken nail occurred in the single threaded nail group (fracture delayed union after replacement of internal fixation); the other patients did not experience screw retraction, wound infection, delayed fracture union or nonunion, neurovascular injury, and achieved osseous union. Conclusion:Both elastic intramedullary nails are effective surgical methods for the treatment of middle clavicle fractures, and the operation time is short and minimally invasive. However, compared with the TEIN, the fracture healing time of the double-threaded ELIN is shorter, the internal fixation removal time is earlier, the shoulder joint and upper limb function is better, and the shortening deformity is less likely to occur.

Objective To explore the control levels of blood glucose,blood lipid,blood pressure(BP),and body mass index(BMI)in the community-managed patients with type 2 diabetes in Jiangsu and to provide the basis for better management of type 2 diabetes in communities. Methods From December 2013 to January 2014,20 053 patients with type 2 diabetes and have received disease management according to the National Basic Public Health Service were recruited in Changshu County of Suzhou City, Huai'an and Qinghe Districts of Huai'an City. Questionnaire survey, anthropometric and laboratory measurements were conducted. According to the Chinese guidelines for type 2 diabetes prevention and treatment(2013),the control levels of blood glucose,blood lipid,BP, and BMI were assessed. Results Among 20 053 patients with type 2 diabetes,the proportions for controlled fasting plasma glucose(FPG) and HbA1Cwere 31.4% and 41.9% respectively,and 25.3% of the patients simultaneously achieved goals of FPG and HbA1Ccontrol. There were 23.9%,55.7%,75.5% and 24.2% of the patients met goals for total cholesterol (TC), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol(LDL-C), respectively. Only 10. 3% of the patients achieved all the 4 targets of blood lipid. Furthermore,there were 25.4% and 35.9% patients achieved BP and BMI targets respectively,and the control rates for BP and BMI of females were higher than those of males(all P<0.05). Less than 1% of the patients had all eights indices controlled at target levels. Conclusions The achievement of comprehensive targets among community patients with type 2 diabetes remains poor in Jiangsu. Follow-up and management of type 2 diabetes should be strengthened in communities,health education and comprehensive intervention on disease complications should also be reinforced accordingly.

Objective To analyze the urine trace albumin(mALb)/creatinine(Cr) ratio and blood uric acid(UA),and other various metabolic index level in patients with diabetic nephropathy(DN),combined with clinical data such as patients' age,body mass index(BMI),course of diseases,to explore the related mechanism of occurrence and development of DN.Methods 76 DN patients were selected.The microalbuminuria group(urinary mALb/Cr<300μg/mg) had 46 cases,the clinical albuminuria group(urinary mALb/Cr≥300μg/mg) included 30 cases,another 49 diabetic patients without kidney damage were seleted as control group.The urinary mALb/Cr,blood UA,fasting blood glucose(FBG),triacylglycerol(TG),total cholesterol(TC),high-density lipoprotein(HDL),low density lipoprotein(LDL),glycosylated hemoglobin(HbA1c) levels were determined.The BMI and the length of the course of the disease calculate.Results The patients' age,course of the disease,urinary mALb/Cr,blood UA,FBG,TC,TG,LDL,HbA1c and BMI level in the clinical albuminuria group and microalbuminuria group were significantly higher than those in the control group,the differences were statistically significant (F=6.18,12.48,141.43,12.48,8.49,4.98,6.18,3.89,3.17,3.89,all P<0.05).The high uric acid hematic disease rates of the clinical albuminuria group and microalbuminuria group were 26.09% and 26.09%,which were significantly higher than 10.20% of the control group,the differences were statistically significant(x2=4.074,24.833,all P<0.05).Urinary mALb/Cr was positively correlated with age,duration,BMI,UA,TG,TC,LDL,FBG,HbA1c(r=0.120,0.299,0.148,0.340,0.157,0.149,0.103,0.487,0.103).Multiple linear stepwise regression analysis suggested that duration,blood UA,FBG were independent risk factors of urinary mALb/Cr;TG,BMI,urinary mALb/Cr were independent risk factors for blood UA.Conclusion Urinary mALb/Cr and blood UA are the independent risk factors,high uric acid hematic disease may participate in the development process of DN,and diabetes duration,UA,BMI,TG,TC,LDL,FBG,HbA1C associated with increased urinary mALb/Cr excretory DN patients,the effective monitoring can improve the symptoms of DN and quality of life.

Objective To explore the problems of hospital elevator safety management.Methods Retrospective analysis of hospital management status of the elevator was done,and specific improvement measures were presented.Results In hospital elevator safety management,staff plays a very important role,and its technical level directly affects management effect.Conclusion Hospital elevator safety management quality directly affects the patients' visit.It needs to get attention from the hospital.

Objective To understand the epidemiological characteristics of head injuries through data gathered from the Jiangsu Injury Surveillance System.Methods Data on head injury that occurred during 2006-2014 were collected from the Jiangsu injury surveillance system and analyzed by SPSS 19.0 software.Results From 2006 to 2014,data on 133 172 cases of head injuries were collected which accounting for 26.2％ (133 172/509 175) of all the injury cases.Among them,males were 2.18 times higher than the females.The top five leading causes of head injuries were falls 24.6％ (32 796/133 172),blunt force injuries 24.4％ (32 446/133 172),motor car accident injuries 20.3％ (26 993/133 172),knife or sharp force injuries 10.7％ (14 183/133 172) and non-motor car accident injuries 6.7％ (8 919/133 172).Main locations that head injuries occured would involve roads/ streets 32.5％ (43 262/133 172),working places 22.2％ (29 526/133 172),at home 20.5％ (27 925/ 133 172) and public residences 10.8％ (14 367/133 172).Recreation activates 37.9％ (50 479/133 172),driving 26.1％(34 749/133 172),paid jobs 24.8％ (33 034/133 172) were the three major activities related to head injuries.Severity of injuries would depend on the situations on site.As for minor injuries,bruise accounted for 63.5％ (67 929/106 912).Brain trauma 21.5％ (5 119/23 803) and fracture 14.9％ (3 554/23 803) appeared an increasing trend.Severe injuries would include brain trauma 74.6％ (1 833/2 457).78.8％ (104 940/133 172) of the patients with head injuries would go home after receiving treatment the hospital,with fetality only as 0.1％ (134/133 172).Conclusion Data from the Jiangsu surveillance program showed that Head injury appeared the highest proportion among all the body injuries that called for special attention.

Objective To analyze the characteristics on injuries,using data from the Jiangsu sentinel hospitals,from 2006 to 2013,to develop a injury prevention strategy.Methods Data was collected from the ‘National Injury Monitoring Report Card' of six sentinel hospitals from two surveillance points from 2006 to 2013.Results Information from 448 778 cases was analyzed.The numbers of male cases outnumbered the females,with sex ratio as 1.72:1.The top five causes of injuries were as follows:falls (27.21％),traffic-related (26.23％),blunt (17.50％),knife/sharp instrument (13.87％) and animal injury (6.59％).Injuries mainly occurred in June,July and August,at 8 to 10 O'clock in the morning.The major places where injuries occurred were road/street (31.58％),home (23.47％),industries and construction sites (21.38％).Recreation activities (36.12％),driving vehicle (25.26％),and at work (24.78％) were the major activities when injuries took place.Most injury cases were unintentional(92.65％) and deliberately(violence/attack) (6.36％).Conclusion All the injuries showed an yearly increase,from 2006 to 2013,with main causes as falls and traffic-related ones.Injuries among teenagers and the elderly should be paid special attention to,with targeted interventions taken.

Objective:To study the association between non-syndrome cleft lip and palate (NSCL/P)and MAFB (rs6072081, rs6065259,rs17820943,rs11696257)gene polymorphism in NingXia Hui and Han population.Methods:512 cases of NSCL/P,258 case of Hui nationality and 254 of Han,174 cases of complete 3 core family members(patients and their parents),142 cases of single parents families(patients and their single parents),were collected in patient group.505 cases of healthy newborns were collected in control group.The MAFB gene SNPs were determined with TaqMan SNPs genotyping methods and the data were analyzed by case-con-trol analysis,transmission disequilibrium test(TDT)and family based association test(FBAT).Results:Case-control analysis found that,there was a statistical significance of the genotypes and allele frequency between patients and the controls in MAFB of the 4 locus (P <0.05);but all of the 4 locus showed no difference in patients with cleft palate(P >0.05).Conclusion:The 4 locus single nucle-otide polymorphism was associated with NSCL/P in Ningxia population.

Objective To investigate the changes of pulsatile tinnitus on HRCT and MRI CE 3D-SPGR image.Methods CT and MRI images of 1 5 pulsatile tinnitus patients were retrospective analysis.All 1 5 patients underwent temporal bone HRCT and MRI CE 3D-SPGR scan.Abnormal changes on CT and MRI image,which caused the pulsatile tinnitus,were compared.Results In 1 5 patients,9 sides (8 cases)showed abnormal sigmoid sinuses including 4 sides of sigmoid sinuses diverticulum,5 sides sigmoid sinu-ses uncovering,8 sides dominant sigmoid sinuses.The high jugular bulb was showed in 10 sides (8 cases),the thick emissaria mas-toidea in 5 sides (4 cases),bilateral semicircular canal dehiscence in one case,glomus tympanicum tumor in one case and the cochle-ar nerve was constricted by small vessel in one case.Conclusion Cranial base vessel abnormity can be visualized more precisely on MRI CE 3D-SPGR image than that on HRCT.On the contrary,the detection of temporal bone abnormalities is superior on HRCT.

Objective To compare the clinical effect of ERCP and PTCD metal stent implantation in the treatment of malignant obstructive jaundice.Methods 42 patients who were treated successfully with ERCP biliary metal stent implantation in the treatment of malignant obstructive jaundice were selected as the ERCP group,38 patients who were successfully treated with PTCD biliary metal stent implantation in the treatment of malignant obstructive jaundice,were selected as the PTCD group.The changes of alanine aminotransferase,aspartate aminotransferase,direct bilirubin,total bilirubin content and complications of patients were compared between two groups.Results On the third day of the ERCP group after operation,alanine aminotransferase,aspartate aminotransferase,direct bilirubin,total bilirubin levels were (203.94 ±12.53)U /L,(180.94 ±17.53)U /L,(185.63 ±17.53)μmol/L,(240.41 ± 18.79)μmol/L respectively,those of the PTCD group were (230.63 ±13.95)U /L,(209.19 ±19.74)U /L,(192.52 ± 16.93)μmol/L,(266.83 ±20.73)μmol/L respectively,which were significantly lower than before operation(all P <0.05).The incidence rate of complications of ERCP group was 4.76%,which was significantly lower than 23.68% of the PTCD group(χ2 =6.02,P <0.05).Conclusion ERCP and PTCD biliary metal stent placement in the treatment of malignant obstructive jaundice can effectively relieve the obstruction.The incidence of complications of PTCD is slightly higher in both common complications.

BACKGROUNDBased on the excellent medical care and management system for Chinese veterans, as well as the detailed medical documentation available, we aim to construct a Chinese Veteran Clinical Research (CVCR) platform on non-communicable diseases (NCDs) and carry out studies of the primary disabling NCDs.

METHODSThe Geriatric Neurology Department of Chinese People's Liberation Army General Hospital and veterans' hospitals serve as the leading and participating units in the platform construction. The fundamental constituents of the platform are veteran communities. Stratified typical cluster sampling is adopted to recruit veteran communities. A cross-sectional study of mental, neurological, and substance use (MNS) disorders are performed in two stages using screening scale such as the Mini-Mental State Examination and Montreal cognitive assessment, followed by systematic neuropsychological assessments to make clinical diagnoses, evaluated disease awareness and care situation.

RESULTSA total of 9 676 among 277 veteran communities from 18 cities are recruited into this platform, yielding a response rate of 83.86%. 8 812 subjects complete the MNS subproject screening and total response rate is 91.70%. The average participant age is (82.01±4.61) years, 69.47% of veterans are 80 years or older. Most participants are male (94.01%), 83.36% of subjects have at least a junior high school degree. The overall health status of veterans is good and stable. The most common NCD are cardiovascular disorders (86.44%), urinary and genital diseases (73.14%), eye and ear problems (66.25%), endocrine (56.56%) and neuro-psychiatric disturbances (50.78%).

CONCLUSIONWe first construct a veterans' comprehensive clinical research platform for the study of NCDs that is primarily composed of highly educated Chinese males of advanced age and utilize this platform to complete a cross-sectional national investigation of MNS disorders among veterans. The good and stable health condition of the veterans could facilitate the long-term follow-up studies of NCDs and provide prospective data to the prevention and management of NCDs.

Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cross-Sectional Studies ; Disease ; Female ; Health Status ; Humans ; Male ; Veterans ; statistics & numerical data