Objective:To investigate the clinical efficacy of Kirschner wire reconstruction of periosteal hinge combined with "rolling pin" technique assisting closed reduction and percutaneous Kirschner wire fixation versus closed reduction and percutaneous Kirschner wire fixation in the treatment of flexion-radial deviated supracondylar fracture of the humerus in children.Methods:A retrospective cohort study was used to analyze the clinical data of 85 patients with flexion-radial deviated supracondylar fracture of the humerus treated in Anhui Provincial Children ′s Hospital from January 2017 to December 2021, including 53 males and 32 females; aged 4-14 years [(7.4±2.7)years]. There were 49 patients treated by Kirschner wire reconstruction of periosteal hinge combined with "rolling pin" technique assisting closed reduction and percutaneous Kirschner wire fixation (study group) and 36 patients by closed reduction and percutaneous Kirschner wire fixation (control group). The operation time, number of intraoperative fluoroscopy, rate of incision after failure of closed reduction (hereinafter referred to as rate of incision), fracture healing time, and elbow joint function by Flynn score at the last follow-up were compared between the two groups. Complications were observed at 2 months after operation, such as infection and irritation of the Kirschner pin tail. Results:All patients were followed up for 2-12 months [(6.2±2.2)months]. The operation time and number of intraoperative fluoroscopy was (62.4±21.4)minutes and (34.8±7.1)times in control group, significantly longer or more than (31.2±14.1)minutes and (22.5±5.1) times in study group ( P<0.05 or 0.01). The incision rate was 17% in control group, but was 0 in study group ( P<0.01). The fracture healing time had no significant difference between control group and study group [(4.5±0.8)weeks vs. (4.6±0.6)weeks] ( P>0.05). According to Flynn score at the last follow-up, the excellent and good rate of elbow function was 89% in control group (excellent in 26 patients, good in 6, fair in 4, poor in none), not significantly different from 94% in study group (excellent in 41 patients, good in 5, fair in 3, poor in none) ( P>0.05). There was no infection or irritation of the Kirschner pin tail in the two groups at 2 months after operation. Conclusion:Kirschner wire reconstruction of periosteal hinge combined with "rolling pin" technique assisting closed reduction and percutaneous Kirschner wire fixation has similar effect to closed reduction and percutaneous Kirschner wire fixation in the treatment of flexion-radial deviated supracondylar fracture of the humerus, but the former has relatively shorter operation time, less intraoperative fluoroscopy and lower incision rate.

Objective:To investigate the early predictive factors of periprocedural thrombus migration and the relationship between periprocedural thrombus migration and prognosis after mechanical thrombectomy (MT) in stroke patients.Methods:The patients with anterior circulation acute large vessel occlusion stroke (ALVOS) who underwent MT in the Stroke Center of Yijishan Hospital of Wannan Medical College from May 2015 to December 2019 were retrospectively analyzed. The baseline characteristics, procedural and clinical outcomes were collected. Univariate and multivariate regression analysis was used to explore the risk factors of thrombus migration and the relationship between thrombus migration and prognosis of patients.Results:There were 302 ALVOS patients [(68.8±11.0) years old and 166 males (55.0%)] included, of whom thrombus migration was identified in 80 patients (26.5%), including 60 cases (75.0%) of proximal migration. Cardiogenic stroke ( OR=2.722, 95% CI 1.367-5.418, P=0.004) and clot burden score (CBS; OR=0.849, 95% CI 0.745-0.968, P=0.015) were independent risk factors of thrombus migration. Proximal migration ( OR=2.822, 95% CI 1.220-6.528, P=0.015) was an independent risk factor of 90-day clinical outcome, while the effect of distal migration on 90-day clinical outcome was not statistically significant. Conclusions:Cardiogenic stroke and lower CBS score are independent predictors of periprocedural thrombus migration in ALVOS patients who underwent MT. Proximal migration is an independent risk factor for the prognosis of patients, which has important clinical intervention significance.

Objective: To explore the correlation between screen time, exposure time to different screens and psychology behaviors of preschool children. Methods: A total of 2 582 children from kindergartens in urban Xuzhou areas were recruited to perform the physical examination, a cluster sampling method being explored. Parent questionnaires were performed to understand the time of screens and children’s psychology behaviors. Multi-linear regression and Logistic regression models were also used to analyze the correlation between them in preschool children. Results: The prevalence of abnormal internalization behavior of preschool children in Xuzhou City was 3.8%, the detection rate of abnormal externalization behavior was 22.4%, and the detection rate of prosocial behavior abnormality was 20.9%. The time spent by the preschool boys on TV time, learning day screen time and one-week video time is significantly higher than the girls (P<0.05). After adjusting for age and gender, the results of multiple linear regression analysis showed that the longer the average screen time, the more serious the problem of internalizing and externalizing problems; and the longer the average screen time of the weekend and the week, the worse the prosocial behavior of children (P<0.05). After correcting multiple covariates, it was found that the average screen time was positively correlated with children’s internal and external behavioral problems (P<0.05). Logistic regression analysis showed that after adjusting for age and gender, the average screen time of study day, weekend and week was a risk factor for preschool children’s internal and external behavior problems, and the average weekly screen time was a protective factor for prosocial behavior (P<0.05). After adjusting for multiple covariates, the learning day and the average weekly screen time were risk factors for children’s internal and external behavior (P<0.05). In addition, the results of association analysis between different types of video time exposure and psychological behavior showed that after adjusting for age and gender, all types of video exposures affected the internal and external behaviors of patients (P<0.05); after correcting multiple covariates The association was still statistically significant (P<0.05). Logistic regression analysis showed that after adjusting for age and gender, the exposure time of each type of video screen was a risk factor for children’s internal and external behavior problems (P<0.05). After correcting multiple covariates, all types of video exposure were internalized behavior problems. The risk factors, and the video time of other electronic products were risk factors for externalization behavior problems (P<0.05). Conclusion Average screen time has a significant positive correlation with psychological behavior, and the exposure time of screens such as TV and mobile phone could increase the incidence of psychological behaviors in preschool children.

Objective To firstly report the clinical features,diagnosis and treatment response of patients with anti-γ-aminobutyric acid type A receptor (GABAAR) encephalitis in China,thus raising neurologists' awareness of this emerging type of autoimmune encephalitis.Methods Specific anti-GABAAR autoantibodies in the serum and cerebrospinal fluid (CSF) of patients with suspected autoimmune encephalitis but negative for commercial available antibody tests were detected by live cell-based assay (CBA).The clinical features,laboratory examinations and treatment of two cases of autoimmune encephalitis with anti-GABAAR autoantibodies were analyzed,who admitted to Huashan Hospital,Fudan University between 2013 and 2014.Results By using live CBA,serum and CSF of the two patients diagnosed with possible autoimmune encephalitis both contained autoantibodies targeted to the GABAAR.These two patients had onset symptom of seizure or refractory seizures.Memory impairment,psychiatric symptoms and decreased consciousness were also presented.One patient was combined with mass in anterior superior mediastinum.Both patients had multifocal cortical and subcortical T2 /fluid attenuated inversion recovery-weighted images hyperintensity signal on brain magnetic resonance imaging.The two patients had poor response to antiepileptic drugs,but showed noticeable recovery with sufficient immunotherapeutic treatments.Conclusions Anti-GABAAR encephalitis is characterized by prominent epilepsy and multifocal abnormalities on brain magnetic resonance imaging.Autoantibodies specifically against GABAAR could be detected by CBA in this group of patients.Early diagnosis and immunotherapy are critical to improve clinical symptoms and outcomes of the disease.