BACKGROUND:Intramedullary nails and locking plates are widely used in the treatment of proximal humeral fractures,but there is no consensus on the choice of internal fixation. OBJECTIVE:To compare the biomechanical stability of intramedullary nails and locking plates in the treatment of two-part and three-part proximal humeral fractures by finite element analysis. METHODS:CT data of the humerus of a volunteer were collected and imported into Minics 21.0,Geomagic Wrap,Soildwork 2017,and Abaqus 2021 to establish finite element models of two-part and three-part fractures treated with two internal fixation methods,respectively.Group A:two-part fracture fixed with intramedullary nail model;group B:two-part fracture fixed with locking plate model;group C:three-part fracture fixed with intramedullary nail model;group D:three-part fracture fixed with locking plate model.The stress distribution,displacement degree,and maximum value of the humerus and internal fixation were compared and analyzed. RESULTS AND CONCLUSION:(1)The maximum stress and maximum displacement of the humerus were the smallest in the model of group A,and the maximum stress and maximum displacement of the humerus were the largest in the model of group D.The stress of the locking plate group was mainly concentrated in the medial inferior part of the humeral head and the screw hole area,while the stress of the intramedullary nail group was mainly concentrated around the fracture line and the lateral inferior part of the surgical neck of the humerus.There is no significant difference in displacement distribution between the two.It is mainly concentrated in the distal humerus.(2)The maximum stress value of the intramedullary nail was the lowest in the model of group A,and the maximum stress value of the locking plate was the highest in the model of group D.The maximum stress of the two internal fixations was mainly concentrated in the talar screw and the connection with the internal fixation.The stress cloud distribution of the locking steel plate was concentrated,while the stress cloud distribution of the intramedullary nail was more uniform.(3)The results showed that compared with the locking plate,the intramedullary nail had more biomechanical advantages,and this advantage was more obvious in three-part fractures.

Objective:To explore the reference interval of urinary iodine concentration(UIC)/urinary creatinine(UCr) ratio evaluating the iodine nutritional status in early pregnancy women.Methods:A reference interval of UIC/UCr ratio was determined among 5 609 early pregnant women with normal thyroid function, negative thyroid autoantibodies, and no history of diseases or taking drug that may affect thyroid function. Then we verified the reliability of this reference interval in a group of 7 514 women in early pregnancy.Results:We determined the UIC/UCr ratio of 75-149 μg/g as the reference interval. In the reference interval, thyroglobulin antibody(TgAb), thyroid peroxidase antibody(TPOAb), and thyroglobulin(Tg) were all at lower levels, and the overall distributions were approximately U-shaped. The prevalence of thyroid dysfunction, the positive rates of antibodies and the proportion of Tg>40 μg/L were the lowest within the reference interval, while higher on both sides of the interval.Conclusion:The reasonable reference interval of the UIC/UCr ratio in iodine-sufficient regions is 75-149 μg/g in early pregnerty women.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Objective:To examine associations of sex hormone levels with bone turnover markers(BTMs) among men in the Northeast region of Henan Province.Methods:From December 2015 to March 2016, 707 male subjects were selected from a National Epidemiological Survey-2014(Thyroid Disorders, Iodine status and Diabetes, TIDE)research—Henan sub-center survey by using multistage stratified cluster random sampling. Fasting venous blood was collected to determine the levels of luteinizing hormone(LH), follicle stimulating hormone(FSH), estradiol(E 2), testosterone(T), dehydroepiandrosterone-sulfate (DHEAS), androstenedione(AD), sex hormone binding globulin(SHBG), dihydrotestosterone(DHT), free testosterone(FT), osteocalcin(OC), pro-collagen type 1 N-terminal propeptide(PINP), C-terminal-cross-linking telopeptide of type 1 collagen(β-CTX), 25-hydroxyvitamin D [25(OH)D], and parathyroid hormone(PTH). Results:A total of 697 men with an average age of(46.6±15.9)years were included in the study. Pearson correlation analysis showed that age was positively associated with LH, FSH, T, and SHBG, while negatively associated with E 2, DHEAS, AD, FT, β-CTX, OC, and PINP, without significant correlation with DHT, 25(OH)D, and PTH. Pearson correlation analysis and linear regression analysis showed that E 2 was negatively associated with β-CTX; T was positively associated with OC, FSH was negatively associated with OC; LH, FSH, and SHBG were negatively associated with PINP; E 2, T, FT, DHT, and AD were positively associated with PINP. After adjusting for age and BMI, linear regression analysis showed that T was still significantly positively associated with OC and PINP, with 0.302 ng/ml and 0.015 ng/ml increasing for OC and PINP every 1 ng/ml increase in T; E 2 and DHT were positively associated with PINP, with 0.250 and 0.047 ng/ml increasing for PINP every 1 pg/ml increase in E 2 and DHT. Conclusions:Age is an important factor influencing sex hormones and BTMs. Serum levels of T, E 2, and DHT are associated with bone formation and bone absorption markers.

Objective To investigate the effect of berberine on endoplasmic reticulum stress PERK apoptosis pathway in HK-2 cells by high fructose.Methods HK-2 cells were grown in DMEM/F12, containing 10% fetal bovine serum (FBS) and divided randomly into four groups: normal control group (Group C); Fructose group (Group F): it contains 25mmol/L fructose culture; Berberine group (Group B): 25mmol/L fructose + 10μmol/L berberine treatment group; TUDCA group (Group T):25mmol/L fructose +2μmol/L TUDCA culture group; Cells were collected after culturing 24h. The expression of glucose-regulated protein 78 (GRP78), CHOP protein and the phosphorylation levels of PERK, eIF2α were tested by Western blotting. The cell cycles were detected by flow cytometry and the apoptosis of cells were detected by TUNEL staining.ResultsWestern blotting showed that the expression of GRP78 and CHOP protein in group F was significantly higher than that in group C, and the levels of p-PERK and p-eIF2α in group F were significantly higher than those in group F. Compared with group F, GRP78, CHOP, p-PERK and p-eIF2α in group B and T were significantly lower (P<0.05). The expression of GRP78, CHOP, p-PERK and p-eIF2α in group B had no significant difference. Flow cytometry and TUNEL staining showed that the cell viability of fructose group was significantly lower than that of C group, and the apoptotic index was significantly higher than that of group C (P<0.05). Compared with group F, the activity of HK-2 cells in group B and T significantly increased, otherwise the apoptosis index significantly decreased, and the difference was statistically significant (P<0.05). Compared with group T, the viability index and apoptosis rate of group B had no significant difference (P>0.05).Conclusion Persistent high fructose can activate the intracellular PERK pathway in HK-2 cells, causing endoplasmic reticulum stress. Berberine can inhibit the fructose-induced PERK and eIF2α phosphorylation, down-regulated the expression of GRP78, CHOP protein, thus by regulating PERK Pathways to alleviate cell cycle arrest and reduce cell apoptosis.

Objective To investigate an effective method for the treatment of biliary ascariasis.Methods A retrospective analysis was performed for the clinical data of 32 patients with biliary ascariasis who were treated in The People's Hospital of Huangmei County from January 1994 to January 2014.All the patients were given spasmolysis,pain management,anti-infective therapy,traditional Chinese medicine syndrome differentiation-based treatment,Chinese materia medica for regulating qi and relieving pain,and ascariasis-relieving and parasite -expelling treatment.Patients were given surgical treatment due to poor response.Results Of all the 32 patients,5 (15.6％) had no response to the ascariasis-relieving treatment with Fructus Pruni Mume decoction and were given surgical treatment,and 27 (84.4％) were cured by Western medicine combined with Fructus Pruni Mume decoction.There were no complications such as acute pancreatitis,perfora tion of the gallbladder,and liver abscess.All the patients were treated with Fructus Pruni Mume decoction regularly after discharge and no patient experienced recurrence.Conclusion Integrated traditional Chinese and Western medicine therapy is effective,safe,and reliable in the treatment of biliary ascariasis and holds promise for clinical application.

Objective To explore the application of somatostatin combined with parenteral nutrition in the treatment of patients with colorectal cancer complicated with intestinal obstruction.Methods A total of 66 patients with colorectal cancer complicated with intestinal obstruction were randomly divided into experimental group and control group,33 cases in each group.The control group was treated with parenteral nutrition,gastrointestinal decompression,conventional treatment for water electrolyte imbalance,while experimental group was treated with intravenous infusion of somatostatin on the basis of the control group.Clinical indicators,blood indexes,metabolic disorders,clinical curative effect were compared between two groups.Results In the experimental group,abdominal pain remission rate and anal exhaust defecation remission rate were significantly higher than the control group,abdominal pain,anal exhaust defecation or disappearance time recovery time were significantly less than the control group,and gastrointestinal decompression drainage was significantly lower than the control group(P<0.05).After treatment,the blood indexes such as albumin,pre albumin,CRP,TNF-α,hemoglobin,WBC in experimental group were significantly better than those in the control group(P<0.05).In the experimental group,blood glucose abnormalities,abnormal blood glucose and abnormal rate of blood sodium were significantly lower than the control group

Objective To explore the application of somatostatin combined with parenteral nutrition in the treatment of patients with colorectal cancer complicated with intestinal obstruction.Methods A total of 66 patients with colorectal cancer complicated with intestinal obstruction were randomly divided into experimental group and control group,33 cases in each group.The control group was treated with parenteral nutrition,gastrointestinal decompression,conventional treatment for water electrolyte imbalance,while experimental group was treated with intravenous infusion of somatostatin on the basis of the control group.Clinical indicators,blood indexes,metabolic disorders,clinical curative effect were compared between two groups.Results In the experimental group,abdominal pain remission rate and anal exhaust defecation remission rate were significantly higher than the control group,abdominal pain,anal exhaust defecation or disappearance time recovery time were significantly less than the control group,and gastrointestinal decompression drainage was significantly lower than the control group(P<0.05).After treatment,the blood indexes such as albumin,pre albumin,CRP,TNF-α,hemoglobin,WBC in experimental group were significantly better than those in the control group(P<0.05).In the experimental group,blood glucose abnormalities,abnormal blood glucose and abnormal rate of blood sodium were significantly lower than the control group

OBJECTIVETo develop a brief version scale with good validity and reliability to evaluate self-management knowledge, attitude and behavior (KAB) of diabetes patients in a shorter time.

METHODS20 authority experts who specialized in the field of diabetes clinical and non-communicable disease self-management, and familiar with the relevant content of diabetes self-management were selected. Face to face and Email consultation methods were applied in two rounds delphi expert consultations to choose items from the Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB, total scale, 98 items). In the first round of expert consultation, experts were asked to select the core items from every dimension and score the extent of familiarity and basis of judgment. In the second round of expert consultation, the significance of the core items which were selected by experts in first round, were graded. The items which entered into the brief scale were determined by harmonious condition of expert opinions.

RESULTSTwo rounds of consultation reclaimed 16 and 15 responses respectively, Positive coefficients of experts were 80% and 94% respectively, and both authoritative coefficients were 0.90. In the first round of consultation, experts selected 44.3 ± 6.2 items on average, 42 items were selected according to the integrity of the scale for measuring dimension and content at last. In the second round of consultation, experts thought that the 42 items could measure the important contents of each dimension comprehensive and representative, the item importance scores of knowledge, attitude, and behavior subscale were 8.42 ± 1.17, 8.61 ± 1.24, 8.61 ± 1.02 respectively, and the coordination coefficients of the three subscale were 0.36, 0.20, 0.49 (χ(2) were 89.74, 11.13, 96.03, P<0.05). The total coordination coefficient was 0.38 (χ(2) =199.36, P<0.001), which indicated the concentration of experts(')opinion was acceptable, showed the brief scale with good face validity and content validity.

CONCLUSIONThe brief scale could evaluate Diabetes Self-management KAB Scale rapidly and relatively comprehensive in groups or individuals diabetes with good face validity and content validity.