Objective:To evaluate the performance of our self-developed deep learning (DL) model which was designed to automatically classify the knee X-ray images into one non-surgical category and 4 surgical categories, including non-surgical knees (NSK), high tibial osteotomy (HTO), total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA), and tibial plateau fracture fixation with an internal fixation plate (TPFF).Methods:The knee X-ray images were collected of the patients who had undergone knee joint surgery at Department of Orthopaedics, Fuzhou Second General Hospital from January 2017 to December 2022. On the Baidu EasyDL AI platform, a multi-class object recognition DL model was built using the You Only Look Once (YOLO) algorithm. The model was trained on a dataset of 1,281 knee anteroposterior X-ray images (including NSK, HTO, TKA, UKA, and TPFF) to generate a DL model which was able to automatically recognize and classify the knee X-ray images. The reliability of the model classification performance was evaluated by analyzing the 5 indicators [accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV)] using a test set of 450 knee anteroposterior X-ray images with the above 5 categories. The receiver operating characteristic curve was plotted and the area under the curve (AUC) was calculated to further quantify the classification performance of the model.Results:In the test set, on the whole, the model achieved an accuracy of 97.0%, a sensitivity of 92.4%, a specificity of 98.1%, a PPV of 92.4%, and a NPV of 98.1%, an AUC of 0.947, indicating a high reliability in classifying various categories. The model showed a best performance for TKA, with the 5 indicators being 99.1%, 99.0%, 99.1%, 97.1% and 99.7%. The model showed a slightly lower sensitivity for TPFF and HTO (87.0% and 86.0%, respectively).Conclusion:A successful DL model has been developed which can automatically classify the knee X-ray images into non-surgical and surgical categories due to its satisfactory performance, particularly in accuracy and AUC.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

Microglial surveillance plays an essential role in clearing misfolded proteins such as amyloid-beta, tau, and α-synuclein aggregates in neurodegenerative diseases. However, due to the complex structure and ambiguous pathogenic species of the misfolded proteins, a universal approach to remove the misfolded proteins remains unavailable. Here, we found that a polyphenol, α-mangostin, reprogrammed metabolism in the disease-associated microglia through shifting glycolysis to oxidative phosphorylation, which holistically rejuvenated microglial surveillance capacity to enhance microglial phagocytosis and autophagy-mediated degradation of multiple misfolded proteins. Nanoformulation of α-mangostin efficiently delivered α-mangostin to microglia, relieved the reactive status and rejuvenated the misfolded-proteins clearance capacity of microglia, which thus impressively relieved the neuropathological changes in both Alzheimer's disease and Parkinson's disease model mice. These findings provide direct evidences for the concept of rejuvenating microglial surveillance of multiple misfolded proteins through metabolic reprogramming, and demonstrate nanoformulated α-mangostin as a potential and universal therapy against neurodegenerative diseases.

Cancer treatments may improve the long-term survival rate of young patients with breast cancer, but also lead to a decrease in fertility. With the younger incidence of breast cancer in China, the fertility needs of this group have received more attention, and fertility preservation technology suitable for cancer patients is developing continuously. However, there are still many problems in the implementation of fertility preservation for young breast cancer patients in China. Patients and breast surgeons have insufficient understanding and conservative attitudes towards fertility preservation technology. And there is a lack of reproductive experts in the treatment process. What′s more, the long-term follow-up and information management of patients undergoing fertility preservation are defective. In response to the above, this paper discusses how to deal with patients with potential reproductive needs in clinical practice from the perspective of breast surgeons. The first is to improve their own understanding of fertility preservation, such as the progress of relevant technologies and applicable population, when to intervene, when and how to get pregnant after cancer treatment. Secondly, education for patients must be strengthened, which should include not only fertility preservation, but also scientific contraceptive methods during cancer treatment and treatment measures for unexpected pregnancy. Finally, hospitals and relevant units should standardize the multidisciplinary team of breast cancer, and strengthen the comprehensive management of young breast cancer patients, thus to provide young breast cancer patients with more scientific cancer treatment programs and more reproductive opportunities.

Cancer treatments may improve the long-term survival rate of young patients with breast cancer, but also lead to a decrease in fertility. With the younger incidence of breast cancer in China, the fertility needs of this group have received more attention, and fertility preservation technology suitable for cancer patients is developing continuously. However, there are still many problems in the implementation of fertility preservation for young breast cancer patients in China. Patients and breast surgeons have insufficient understanding and conservative attitudes towards fertility preservation technology. And there is a lack of reproductive experts in the treatment process. What′s more, the long-term follow-up and information management of patients undergoing fertility preservation are defective. In response to the above, this paper discusses how to deal with patients with potential reproductive needs in clinical practice from the perspective of breast surgeons. The first is to improve their own understanding of fertility preservation, such as the progress of relevant technologies and applicable population, when to intervene, when and how to get pregnant after cancer treatment. Secondly, education for patients must be strengthened, which should include not only fertility preservation, but also scientific contraceptive methods during cancer treatment and treatment measures for unexpected pregnancy. Finally, hospitals and relevant units should standardize the multidisciplinary team of breast cancer, and strengthen the comprehensive management of young breast cancer patients, thus to provide young breast cancer patients with more scientific cancer treatment programs and more reproductive opportunities.

Objective To evaluate the clinical application of modified bony landmark measurement ( MBLM ) to deal with leg length discrepancy ( LLD ) during total hip arthroplasty ( THA ). Methods We retrospectively analyzed the 36 patients in whom MBLM was used to deal with LLD during THA from January 2014 to May 2015 at Department of Orthopaedics, The Second Hospital of Fuzhou. They were 17 men and 19 women, aged from 42 to 78 years ( average, 68.7 ± 10.1 years ). They were divided into 3 groups according to their pre-operative LLD value ( d ) : 16 cases in group A with d≤10 mm, 11 cases in group B with 10 mm ＜d≤20 mm and 9 cases in group C with d ＞ 20 mm. After the sizes of prosthetic cup and femoral component and the location of implant were determined using preoperative X-ray, a special formula was used to calculate the prosthetic length of femoral head neck and the osteotomy area at the femoral neck. MBLM was used to measure the leg lengths before hip joint dislocation and after placement of the hip implant. The neck length and depth of the femoral component was adjusted according to the measurements. Post-operative X-ray was used to measure the LLD ( d'). The value of MBLM in judgment of LLD during THA was assessed by comparison of d and d' and analysis of distribution of d' . Results The postoperative d' ( 6.0 ± 3.0 mm) was signifi-cantly shorter than the preoperative d ( 11.0 ± 5.0 mm) ( t＝5.145, P ＜0.001 ). There were 30 cases with d' ≤ 10 mm, 6 cases with 10 mm ＜d'≤ 20 mm and 0 case with d' ＞ 20 mm. The cases with d'≤ 10 mm were significantly more than those with d ≤ 10 mm and the cases with d' ＞ 20 mm significantly fewer than those with d ＞ 20 mm ( χ2＝15.500, P＝0.000 ) . Conclusion MBLM used during THA is a reliable method to judge the leg lengths so that LLD can be effectively reduced after THA.

A rapid method was developed for the determination of 9 organophosphorous flame retardants ( OPFRs) in textiles by ultra high performance liquid chromatography tandem electrospray ionization mass spectrometry ( UHPLC-MS/MS ) . Analytes in textile samples were extracted in a closed bottle at 50℃ with methanol by ultrasonic extraction for 30 min. And then, the extracted solution was injected after filtration and determined by UHPLC-MS/MS. Target analytes were separated by C18 column and methanol/water containing 5. 0 mmol/L NH4 COOH. The positive electrospray ionization and multiple reaction monitoring mode ( MRM) was utilized. The matrix effect (ME) could be compensated by adjusting the concentration of NH4COOH and the composition of the mobile phase after careful investigation with blank samples. An external standard calibration method was chosen to the quantitative analysis. Under the optimized conditions, method precision represent with relative standard deviations (RSDs) was 5. 2% (TOCP) -12. 5% (TRIS) for cotton, 6. 4%(TBEP)-13. 8% (TRIS) for polyester, and 6. 9% (TDCP) -14. 5% (TEPA) for wool samples. The recoveries for standard addition were in the range of 52 . 5% ( TEPA ) -116 . 4% ( TPP ) . The limits of quantification (LOQ, S/N=10) were between 1. 0 (TBP) and 10. 0 (TRIS) μg/kg.

Objective To investigate clinical significance of detection of serum high sensitiv-ity C-reactive protein (hs-CPR)of patients with primary hypertension.Methods A total of 152 patients with primary hypertension were divided into 3 groups according to the classification of hy-pertension.All patients were suggested to have low-salt and low-fat diet and proper physical exercise and received antihypertensive therapy.After half a year,hs-CPR levels before and after observation period were analyzed and compared with healthy people.Results Levels of hs-CRP before and after observation period were higher than that of healthy people (P <0.01).The hs-CRP levels of level 2 and level 3 of hypertension were obviously higher than level 1 of hypertension before grouping(P <0.05).After observation period,hs-CRP levels of level 1,level 2 and level 3 of hypertension were significantly lower than that before grouping in each group (P <0.05)while level 2 and level 3 were markedly higher than that of level 1 (P <0.05).Conclusion Primary hypertension has ob-viously increased hs-CRP and hs-CRP,so they have a strong relationship with the occurrence of hy-pertension.Therefore,effective control of blood pressure can obviously reduce the hs-CRP level.

Objective To investigate clinical significance of detection of serum high sensitiv-ity C-reactive protein (hs-CPR)of patients with primary hypertension.Methods A total of 152 patients with primary hypertension were divided into 3 groups according to the classification of hy-pertension.All patients were suggested to have low-salt and low-fat diet and proper physical exercise and received antihypertensive therapy.After half a year,hs-CPR levels before and after observation period were analyzed and compared with healthy people.Results Levels of hs-CRP before and after observation period were higher than that of healthy people (P <0.01).The hs-CRP levels of level 2 and level 3 of hypertension were obviously higher than level 1 of hypertension before grouping(P <0.05).After observation period,hs-CRP levels of level 1,level 2 and level 3 of hypertension were significantly lower than that before grouping in each group (P <0.05)while level 2 and level 3 were markedly higher than that of level 1 (P <0.05).Conclusion Primary hypertension has ob-viously increased hs-CRP and hs-CRP,so they have a strong relationship with the occurrence of hy-pertension.Therefore,effective control of blood pressure can obviously reduce the hs-CRP level.

Objective To evaluate the clinical effectiveness of interventional therapy in treating thoracic aortic dissection (TAD) . Methods A follow-up visit with 24 TAD patients had been operated in our hospital from November 2008 to March 2010. The clinical data, the therapeutic measures and the follow-up results were retrospectively analyzed. Including the remission of symptom, average day in hospital,complication,the long term survival rates and so on. Results All 24 patients have survived, the symptoms have improved instantly, the hospitalization days was 7.3 days,and no complication occurred. The 3 years survival rate was 95.8%. Conclusion Interventional therapy have advantages of treating thoracic aortic dissection with less complication,more secure and higher long term survival rates.