Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

Abstract On August 11, 2022, Tongxiang Center for Disease Control detected a case of brucellosis, and the case was not engaged in related work. Case finding and risk factor investigation were immediately conducted to trace the source of infection. It was revealed that the case sold aquatic products at a farmer's market and frequently picked up goods at a seafood warehouse adjacent to a lamb slaughtering site. There was a potential risk of infection due to indirect contact with slaughtered lambs or contaminants. Serological tests were conducted on 9 employees of the slaughtering site and 48 residents nearby, and the brucellosis cases diagnosed in hospitals in the same area were searched. A total of 11 brucellosis cases were identified, including 9 confirmed cases and 2 asymptomatic infections. There were 2 cases of slaughtering workers and 9 cases of non-occupational individuals from the surrounding area of the slaughtering site. Brucella melitensis biovar 3 were isolated from a slaughtering worker and a non-occupational individual. The slaughtered lambs primarily came from northern regions such as Inner Mongolia and Heilongjiang. It was concluded that it was a cluster caused by Brucella melitensis biovar 3 and spread through direct or indirect contact with imported infected lambs or contaminated environments from a lamb slaughtering site. It is suggested to strengthen the quarantine of imported sheep, legally shut down non-compliant lamb slaughtering sites, implement designated slaughtering and enhance occupational protection.

Objective:To explore potential predictors of refractory Mycoplasma pneumoniae pneumonia (RMPP) in early stage. Methods:The prospective multicenter study was conducted in Zhejiang, China from May 1 st, 2019 to January 31 st, 2020. A total of 1 428 patients with fever >48 hours to <120 hours were studied. Their clinical data and oral pharyngeal swab samples were collected; Mycoplasma pneumoniae DNA in pharyngeal swab specimens was detected. Patients with positive Mycoplasma pneumoniae DNA results underwent a series of tests, including chest X-ray, complete blood count, C-reactive protein, lactate dehydrogenase (LDH), and procalcitonin. According to the occurrence of RMPP, the patients were divided into two groups, RMPP group and general Mycoplasma pneumoniae pneumonia (GMPP) group. Measurement data between the 2 groups were compared using Mann-Whitney U test. Logistic regression analyses were used to examine the associations between clinical data and RMPP. Receiver operating characteristic (ROC) curves were used to analyse the power of the markers for predicting RMPP. Results:A total of 1 428 patients finished the study, with 801 boys and 627 girls, aged 4.3 (2.7, 6.3) years. Mycoplasma pneumoniae DNA was positive in 534 cases (37.4%), of whom 446 cases (83.5%) were diagnosed with Mycoplasma pneumoniae pneumonia, including 251 boys and 195 girls, aged 5.2 (3.3, 6.9) years. Macrolides-resistant variation was positive in 410 cases (91.9%). Fifty-five cases were with RMPP, 391 cases with GMPP. The peak body temperature before the first visit and LDH levels in RMPP patients were higher than that in GMPP patients (39.6 (39.1, 40.0) vs. 39.2 (38.9, 39.7) ℃, 333 (279, 392) vs. 311 (259, 359) U/L, both P<0.05). Logistic regression showed the prediction probability π=exp (-29.7+0.667×Peak body temperature (℃)+0.004×LDH (U/L))/(1+exp (-29.7+0.667×Peak body temperature (℃)+0.004 × LDH (U/L))), the cut-off value to predict RMPP was 0.12, with a consensus of probability forecast of 0.89, sensitivity of 0.89, and specificity of 0.67; and the area under ROC curve was 0.682 (95% CI 0.593-0.771, P<0.01). Conclusion:In MPP patients with fever over 48 to <120 hours, a prediction probability π of RMPP can be calculated based on the peak body temperature and LDH level before the first visit, which can facilitate early identification of RMPP.

Objective:To investigate the clinical effect of transsphincter fistulectomy in the treatment of anal fistula.Methods:Seventy-three patients with anal fistula who received treatment in Zhoushan Hospital from March 2016 to March 2020 were included in this study. They were randomly assigned to undergo either conventional incision combined with thread-drawing drainage (control group, n = 35) or transsphincter fistulectomy (observation group, n = 38). Operative time, wound healing time, length of hospital stay, Visual Analogue Scale (VAS) score 24 and 48 hours after surgery, complications, the improvement in anal sphincter function before and 3 months after surgery were compared between the two groups. Results:Operative time, wound healing time and length of hospital stay in the observation group were (49.83 ± 7.67) minutes, (20.78 ± 3.54) days and (5.31 ± 1.27) days, which were significantly shorter than those in the control group [(62.31 ± 5.45) minutes, (25.87 ± 3.10) days, (7.78 ± 1.32) days, t = 8.063, 6.512, 8.133, all P < 0.05). The VAS score 24 and 48 hours after surgery in the observation group were (2.43 ± 0.64) points and (1.21 ± 0.36) points, respectively, which were significantly lower than those in the control group [(3.87 ± 1.23) points, (2.83 ± 0.97) points, t = 6.347 and 9.607, both P < 0.05]. The incidence of complication in the observation group was significantly lower than that in the control group [5.26% (2/38) vs. 28.57% (10/35), χ2 = 7.206, P < 0.05]. Conclusion:Transsphincter fistulectomy in the treatment of anal fistula has good therapeutic effects, can reduce pain and has little impact on the function of anal sphincter. It is innovative and scientific.

Objective To study the relationship of serum UA level with coronary heart disease (CHD) and cerebral stroke in elderly female essential hypertension (EH) patients. Methods Four hundred and seventy-two female EH patients admitted to our hospital from February 2014 to June 2018 were divided into normal UA group (n = 389) and hyperuricemia group (n = 83) according to their serum UA level. The clinical characteristics, blood pressure, incidence of CHD and cerebral stroke were compared between the two groups. The relationship of serum UA level with CHD and cerebral stroke was analyzed by logistic regression analysis. Results The age was significantly older, the course of hypertension was significantly longer, the SBP and BMI were significantly higher, the circumstances of lumber and buttock were significantly longer, the serum FPG,TB, UA levels and the incidence of grade 2 hypertension and grade 3 hypertension were significantly higher while the serum HDL-C level was significantly lower in hyperuricemia group than in normal UA group (P＜0.05, P＜0.01). Multivariate logistic regression analysis showed that serum UA level was positively related with CHD and cerebral stroke in elderly female EH patients after adjustment for risk factors such as age (OR = 1.003, 95％CI:1.000-1.007, P=0.045;OR = 1.006, 95％CI:1.000-1.012,P = 0.042). Conclusion Hyperuricemia is closely related with CHD and cerebral stroke in elederly EH patients.

Objective To study the serum ox-LDL level and its influencing factors in elderly female hypertension patients.Methods Two hundred and ninety elderly females were divided into hypertension group(n=96)and hypertension-free group(n=194).Their age and blood routine examination data were recorded.The patients in hypertension group were further divided into≥60years old group(n=47)and＜60years old group(n=49),their clinical characteristics were compared. The influencing factors of ox-LDL were analyzed.Results The age was significantly older,the SBP and DBP,serum FBG,ox-LDL,Lp-PLA2,TC,LDL-C levels,BMI,incidence of DM and CHD were significantly higher in hypertension group than in hypertension-free group(P＜0.05,P＜0.01).The age was significantly older,the SBP,serum FPG,ox-LDL,Lp-PLA2,TC,LDL-C levels and incidence of CHD were significantly higher while the DBP was significantly lower in ≥60 years old group than in＜60years old group(P＜0.05,P＜0.01).Serum ox-LDL level was positively related with age,SBP,DBP,serum FPG,creatinine,TC,LDL-C,Lp-PLA2levels and smoking( P＜0.05,P＜0.01).Multivariate linear regression analysis showed that serum TC,Lp-PLA2,LDL-C levels and DBP were the risk factors for ox-LDL in female hypertension patients(P＜0.05,P＜0.01).Conclusion The serum ox-LDL level is significantly higher in elderly female hypertension patients than in elderly male hypertension patients.Serum TC,Lp-PLA2,LDL-C levels and DBP are the risk factors for ox-LDL in elderly female hypertension patients

Objective To study the relationship between serum uric acid (UA) level and metabolic syndrome (MS) in elderly essential hypertensive (EH) patients.Methods Two hundred and one elderly EH patients were divided into hyperuricemia group (n=47) and normal UA group (n=154).Hyperuricemia was defined in males with their serum UA level ＞ 420 μmol/L and in females with their serum UA level ＞ 360 μmol/L.Relationship between serum UA level and MS in elderly EH patients was analyzed by Pearson correlation analysis and logistic regression analysis respectively.Results The age was significantly older,the waist circumference was significantly longer,the BMI and serum SCr,FPG,TG level and the incidence of MS,central obesity,high blood glucose and high TG were significantly higher while the serum HDL-C level was significantly lower in hyperuricemia group than in normal UA group.Pearson correlation analysis showed that waist circumference,BMI,serum FPG and TG level were positively related with serum UA level while serum HDL-C level was negatively related with serum UA level (P＜0.05,P＜0.01).Logistic regression analysis showed that waist circumference and serum TG level were the independent risk factors for elevated serum UA level in elderly EH patients (OR=1.080,95％ CI:1.035-1.127,P=0.000;OR=1.472,95％CI:1.021-2.122,P=0.038).Conclusion Serum UA level is closely related with MS and its components while waist circumference and serum TG level are the independent risk factors for hyperuricemia in elderly EH patients.

Objective To investigate the prevalence and related characteristics of alcohol dependence in the Pumi people of Ninglang area in Yunnan Province.Methods By stratified multistage cluster randomization,542 residents were interviewed by psychiatrists using the structural questionnaire MINI-International Neuropsychiatric Interview.Results The prevalence of drinking in the study were 37.3％,13.6％ and 22.5％ for the male,female and the total sample.There were significant differences of alcohol dependence between males and females (x2 =304.310,P＜0.01) in which males were significantly higher than those in females.The current prevalence of alcohol dependence in Pumi people was 4.8％(95％CI=3.0％-6.6％),and standardized current prevalence was 3.3％.The current prevalence of alcohol dependence in males was 9.3％,which was significantly higher than that (2.1％) in females (x2 =14.613,P＜0.01).The prevalence of alcohol dependence in the Pumi people was 6.1％ in the 21-30 years old,and 8.6％ in the 51-60 years old.There were one case of major depression,one case of panic disorder,and five cases of insomnia.Conclusion The prevalence of alcohol dependence in Pumi people of Ninglang areas is high.Alcohol dependence has become one of the most common mental disorders and the public health problem.It is necessary to carry out prevention research in the future.

Objective To explore the prevalence of depressive disorder in the Mosuo ethnic minority in Ninglang district,Yunnan Province.Methods By stratified random sampling,1 121 Mosuo subjects aged 15 or above were selected and assessed by the MINI-international neuropsychiatric interview according to the Structured Clinical Interview for DSM-V-TR Axis I Disorders-Patient Edition for mental disorders.Results The standardized time-point prevalence of major depressive disorder in Mosuo nationality was 1.74％,and 1.69％ (95 ％ CI =1.32％-2.15 ％) in males and 1.77％ (95 ％ CI =1.39％-2.15 ％) in females.There was no statistically significant difference in the prevalence of major depressive disorder between males and females (x2 =0.051,P＞0.05).The standardized time-point prevalence of dysthymic disorder in Mosuo nationality was 0.78％,and 0.66％ (95％ CI=0.54％-0.78％) in males and 0.88％ (95％ CI=0.74％-1.02％) in females (x2=1.232,P＞0.05).Those aged 40-54 years old had the highest adjusted prevalence of depressive episodes(1.48％ (95％CI=0.77％-2.18％)).Conclusion The prevalence of depressive disorder in Mosuo nationality is in a low level,and the middle-age Mosuo people has the highest time-point prevalence.

OBJECTIVE: The pathogenesis of depression is not fully understood yet, but studies have suggested higher circulating C reactive protein (CRP) level might relate to depression occurrence. However, due to high variability of patients’ individual condition, the results to date are inconsistent. Considering CRP single-nucleotide polymorphisms (SNPs) could also regulate plasma CRP levels, in the present study, we hypothesized that inherited CRP allelic variations may co-vary with depressive symptomatology. METHODS: We recruited 60 depression patients with family depression history and 60 healthy control volunteers into this project. We detected circulation CRP level as well as genome CRP SNPs from participants of this project. RESULTS: We have found a significantly higher circulating CRP level in patients with a positive family history. Furthermore, we also identified some certain inherited CRP SNPs (A allele in rs1417938 and C allele in rs1205) could up regulate serum CRP level and distributed more in depression patients with family history. CONCLUSION: Our finding may raise new evidence that genetically increased serum CRP level through SNPs variation is likely to induce family inherited depression.
Alleles ; C-Reactive Protein* ; Depression* ; Genome ; Humans ; Plasma ; Polymorphism, Single Nucleotide ; Volunteers