Objective To evaluate the clinical application effect of fracture liaison service(FLS)mode after percutaneous vertebroplasty(PVP)/percutaneous kyphoplasty(PKP)for thoracolumbar fragility fracture.Methods A prospective study was conducted,and 762 patients with thoracolumbar fragility fracture who underwent PVP/PKP in the department of orthopedics in our hospital from January 2018 to May 2021 were included and divided into the control group(374 cases)and the observation group(388 cases)according to the random number table method.Patients in the control group received routine osteoporosis intervention,while the patients in the observation group implemented FLS through Blue Bull Medical Care or Chronic Health APP on the basis of the control group to systematically manage the osteoporosis treatment after discharge.The follow-up lasted for 12 months,and the 8-item Morisky medication adherence scale(MMAS-8)score,pain visual analogue scale(VAS)score,Oswestry disability index(ODI)score and Hamilton depression rating scale(HAMD)score at discharge,and 6 months and 12 months after discharge of the two groups were compared.The incidences of re-fracture and constipation 6 months and 12 months after discharge of the two groups were compared.The Cobb angle and bone mineral density T-value of injured vertebrae 6 months and 12 months after discharge of the two groups were compared.Results There was no statistically significant difference in the MMAS-8 score,VAS score,ODI score or HAMD score at discharge of patients between the two groups(P>0.05).The VAS score,ODI score and HAMD score 6 months and 12 months after discharge in the observation group were lower than those in the control group(P<0.05),the MMAS-8 score in the observation group was higher than that in the control group(P<0.05),and the incidences of re-fracture and constipation in the observation group were lower than those in the control group(P<0.05).There was no statistically significant difference in the Cobb angle of injured vertebrae 12 months after discharge of patients between the two groups(P>0.05).The bone mineral density T-value 12 months after discharge in the observation group was higher than that in the control group(P<0.05).Conclusion The FLS mode can significantly improve the medication compliance of patients,relieve pain,depression and constipation,improve bone mineral density,and significantly reduce the incidence of vertebral re-fracture in patients after vertebral augmentation surgery;however,it has no significant effect on the Cobb angle of injured vertebrae.

Using four Uncariae Cum Uncis materials including Uncaria sinensis (HGT), U. hirsutea (MGT), Jianhe U. rhynchophylla (JHGT) and U. rhynchophylla(GT) as the research objects, the correlations between medicinal materials' yield and photosynthetic ecophysiology-factors in the plant exuberant growth period were studied. Results showed that the Uncaria plants net photosynthetic rate (Pn) changed by unimodal curve. There was not "midday depression" phenomenon. There was a different relationship among the photosynthetic ecophysiology-factors and between photosynthetic ecophysiology-factors and medicinal materials' yield. Pn,Tl,Gs had a significant correlation with medicinal materials' yield（M）and were the most important factors of growth.

OBJECTIVETo investigate the efficacy of 2-month course of sleeping position correction in the treatment of positional plagiocephaly in infants aged <8 months.

METHODSA total of 73 infants with positional plagiocephaly between January 2015 and June 2016 were divided into treatment group (n=46) and control group (n=27) according to parents' wishes. The treatment group received sleeping position correction, while the control group received sleep curve mattress. The oblique diameters A and B in the two groups were measured and the cranial vault asymmetry (CVA) was calculated before and after treatment. The severity of positional plagiocephaly based on CVA was compared between the two groups before and after treatment. The Gesell Developmental Scale was used to determine the developmental quotients (DQs) in the motor, adaptive, language, and social domains in the two groups before and after treatment.

RESULTSBefore treatment, there were no significant differences in oblique diameters A and B, CVA, and DQs in the four specific domains between the two groups (P>0.05). After 2 months of treatment, the treatment group had a significantly greater oblique diameter B and a significantly smaller CVA than the control group (P<0.05); there were no significant differences in DQs in the four specific domains between the two groups (P>0.05). After treatment, both groups had significant improvements in oblique diameters A and B, CVA, and DQs in the motor and adaptive domains (P<0.01); moreover, the treatment group showed a significant improvement in the DQs in the social domain (P<0.01). There was no significant difference in the severity of positional plagiocephaly between the two groups before and after treatment (P>0.05).

CONCLUSIONSFor infants with positional plagiocephaly, sleeping position correction has better efficacy and is more convenient and economical than the sleep curve mattress, so it holds promise for clinical application.

Female ; Humans ; Infant ; Male ; Plagiocephaly, Nonsynostotic ; etiology ; therapy ; Posture ; Severity of Illness Index ; Sleep

Objective:To compare the surgical procedures and postoperative effects of PFNA and DHS in the treatment of intertrochanteric fracture in elderly patients.Methods:The clinical data of 30 elderly patients with intertrochanteric fracture treated in our department from March 2013 to March 2017 were retrospectively analyzed.15 cases were treated with PFNA internal fixation and 15 cases with DHS internal fixation.The average length of operation,the amount of bleeding during operation,the time of hospitalization and the difference of postoperative functional recovery were compared between the two surgical procedures.Results:The intraoperative bleeding of the DHS group was more than that of the PFNA group,and the difference was statistically significant (P＜0.05).There was no significant difference in length of operation,time of hospitalization or postoperative hip function between the two groups.Conclusions:DHS is similar in clinical efficacy to PFNA in the treatment of intertrochanteric fracture in elderly patients,especially for intertrochanteric fractures with simple fracture types and intact lateral wall of the femur.DHS has the advantages of anatomical reduction and simple operation,which is worthy of clinical promotion.

BACKGROUNDVentricular septal rupture (VSR) remains an infrequent but devastating complication of acute myocardial infarction (AMI). The best time to undergo surgical repair is controversial and there is currently no risk stratification for patients with VSR to guide treatment. The purpose of this study was to review the clinical outcomes of 70 patients with VSR, to analyze the short-term prognosis factors of VSR following AMI, and to make a risk stratification for patients with VSR.

METHODSA total of 70 consecutive VSR patients following AMI treated in our hospital from January 2002 to October 2010 were enrolled in this study retrospectively. The difference of clinical characteristics were observed between patients with VSR who survived ≤30 days and survived >30 days. We analyzed the short-term prognosis factors of VSR and established the short-term prognosis index of VSR (SPIV) based on the Logistic regression analysis to stratify patients with VSR.

RESULTSAmong 12 354 patients with acute ST-segment elevation myocardial infarction, 70 (0.57%) patients (33 males and 37 females) were found to have VSR. The average age was (68.1±8.5) years. Fifty-four (77.1%) patients were diagnosed with an acute anterior infarction. Patients with VSR selected for surgical repair had better outcomes than patients treated conservatively; 1-year mortality 9.5% versus 87.8%, P < 0.005. Logistic regression analysis revealed that female (P = 0.013), anterior AMI (P = 0.023), non-ventricular aneurysm (P = 0.023), non-diabetes (P = 0.009), Killip class 3 or 4 (P = 0.022) and time from AMI to VSR less than 4 days (P = 0.027) were independent risk determinants for shortterm mortality. SPIV ≥9 indicates a high risk as the 30-day mortality is 77.4%; SPIV <8 indicates a low risk as the 30-day mortality is 28.6%; SPIV between 8 and 9 indicates a moderate risk.

CONCLUSIONSVSR remains a rare but devastating complication of AMI. The independent risk determinants for short-term mortality of VSR were female gender, anterior AMI, non-ventricular aneurysm, non-diabetes, Killip class 3 or 4, and the time from AMI to VSR less than 4 days. It is reasonable to take more active treatments for the patients at high risk to save more lives.

Aged ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications ; physiopathology ; Ventricular Septal Rupture ; diagnosis ; etiology

OBJECTIVETo investigate clinical characteristics and predictive factors of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children so as to recognize and treat the disease earlier.

METHODThe data including febrile time, inflammatory markers (WBC, neutrophil, CRP) and radiological features of 213 children hospitalized with Mycoplasma pneumoniae pneumonia (MPP) (72 with refractory MPP and 141 with mild MPP were retrospectively analyzed). The primary diagnostic criteria of refractory MPP: the patient's condition still deteriorates after treatment with macrolides for more than 5 days. The independent variables which had significant difference in univariate analysis was analyzed by multivariate logistic regression analysis. The predictive criteria of RMPP were further applied in 100 other patients prospectively. Kappa test was used to evaluate the accuracy rate.

RESULTRefractory MPP patients: febrile time was more than 10 days, white blood cell (WBC) count was (3.8 - 18.5)×10(9)/L in peripheral blood routine test, CRP was 38 mg/L - > 160 mg/L, large lobar consolidation with high density (> 2/3 pulmonary lobe, CT value 40 - 50 HU, without air bronchogram). Mild MPP patients: febrile time was less than 10 days, CRP was often less than 40 mg/L. Independent risk factors for RMPP were febrile time, CRP, large consolidation area with high density in lungs with or without pleural effusion (OR = 1.586, P = 0.017; OR = 4.344, P = 0.001; OR = 2.660, P = 0.012), CT value 40 - 50 HU which were demonstrated by logistic regression analysis. The specificity, sensitivity and Youden index for this diagnostic test were respectively 0.96, 0.94 and 0.90 at a CRP cut off of 40 mg/L. The sensitivity, specificity, and Kappa value for the above criteria to diagnose RMPP were respectively 0.96, 0.94 and 0.9.

CONCLUSIONThe predictive factors for RMPP are febrile time (> 10 days), CRP (> 40 mg/L), large lobar consolidation with high density (> 2/3 pulmonary lobe, CT value > 40 HU with or without pleural effusion) for the purpose of treating earlier.

Adolescent ; C-Reactive Protein ; analysis ; Child ; Child, Preschool ; Female ; Fever ; Humans ; Infant ; Leukocyte Count ; Lung ; diagnostic imaging ; pathology ; Male ; Pneumonia, Mycoplasma ; diagnosis ; pathology ; Predictive Value of Tests ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed

OBJECTIVETo investigate the oxidative damage to lung tissue and peripherial blood in PM2.5-treated rats.

METHODSPM2.5 samples were collected using an auto-sampling instrument in summer and winter. Treated samples were endotracheally instilled into rats. Activity of reduced glutathione peroxidase (GSH-Px) and concentration of malondialdehyde (MDA) were used as oxidative damage biomarkers of lung tissue and peripheral blood detected with the biochemical method. DNA migration length (microm) and rate of tail were used as DNA damage biomarkers of lung tissue and peripheral blood detected with the biochemical method.

RESULTSThe activity of GSH-Px and the concentration of MDA in lung tissue significantly decreased after exposure to PM2.5 for 7-14 days. In peripheral blood, the concentration of MDA decreased, but the activity of GSH-Px increased 7 and 14 days after experiments. The two indicators had a dose-effect relation and similar changing tendency in lung tissue and peripheral blood. The DNA migration length (microm) and rate of tail in lung tissue and peripheral blood significantly increased 7 and 14 days after exposure to PM2.5. The two indicators had a dose-effect relation and similar changing tendency in lung tissue and peripheral blood.

CONCLUSIONPM2.5 has a definite oxidative effect on lung tissue and peripheral blood. The activity of GSH-Px and the concentration of MDA are valuable biomarkers of oxidative lung tissue damage induced by PM2.5. The DNA migration length (microm) and rate of tail are simple and valuable biomarkers of PM2.5-induced DNA damage in lung tissues and peripheral blood. The degree of DNA damage in peripheral blood can predict the degree of DNA damage in lung tissue.

Animals ; DNA Damage ; drug effects ; Drug Administration Routes ; Drug Administration Schedule ; Lung ; drug effects ; pathology ; Lung Diseases ; blood ; chemically induced ; pathology ; Male ; Oxidative Stress ; Particle Size ; Particulate Matter ; administration & dosage ; toxicity ; Rats ; Rats, Wistar ; Seasons

Child ; Chronic Disease ; Cough ; diagnosis ; etiology ; therapy ; Humans ; Practice Guidelines as Topic

BACKGROUNDThe main therapeutic treatments for hepatic artery complications after orthotopic liver transplantation (OLT) include thrombolysis, percutaneous transluminal angioplasty, stent placement, and liver retransplantation. The prognosis of hepatic artery complications after OLT is not only related to the type, extent, and timing but also closely associated with the selection and timing of the therapeutic methods. However, there is no consensus of opinion regarding the treatment of these complications. The aim of this study was to determine optimal treatment for hepatic artery complications after OLT.

METHODSThe clinical data of 25 patients diagnosed with hepatic artery thrombosis (HAT) and hepatic artery stenosis (HAS) between October 2003 and March 2007 were retrospectively reviewed. Treatments included liver retransplantation and interventions which contain thrombolysis, percutaneous transluminal angioplasty and stent placement.

RESULTSAmong five patients with HAT, 3 were treated with thrombolysis. One recovered, one died after thrombolysis and another one died of multi-organ failure after retransplantation because of recurrent HAT. The remaining 2 patients underwent successful retransplantation and have survived after that. Among 12 patients presented with HAS within 1 month postoperatively, 2 patients underwent retransplantation due to irreversible liver failure and another 10 patients were treated with interventions. The liver function failed to improve in 3 patients and retransplantations were performed in 4 patients after stent placement because of ischemic cholangitis. Among 6 patients undergoing liver retransplantations, two died of intracranial hemorrhage and infection respectively. Eight patients presented with HAS after 1 month postoperatively, 5 patients were treated with interventional management and recovered after stent placement. Among another 3 patients presented with HAS, 2 patients' liver function was stable and one patient received late liver retransplantation due to ischemic bile duct lesion.

CONCLUSIONSIndividualized therapeutic regimens should be adopted in treating hepatic artery complications after OLT, according to postoperative periods, types and whether ischemic bile duct lesion exists or not. Liver retransplantation is the best treatment for patients with hepatic artery thrombosis. Interventional treatments of late HAS without irreversible liver failure or bile duct ischemia are appropriate, whereas retransplantation is recommended for early HAS.

Adult ; Aged ; Constriction, Pathologic ; Female ; Hepatic Artery ; pathology ; Humans ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Reoperation ; Retrospective Studies ; Thrombosis ; therapy

Objective To find out the status of brick-tea type fluorosis in the epidemic areas.Methods Based on "Scheme for Epidemiological Brick-tea Type Fluorosis in Sichuan Province",ten counties were selected in Sichuan brick-tea areas and ten towns were selected in every county,then the epidemicologic survey was performed in children of 8～12 year-old and adults aged above 20 years old.Results 5044 children and 4053 adults were selected from brick-tea areas.The rates of dental fluorosis in children and adults were 55.69%(2809/5044)and 60.41%(4053/6709)respectively.The dental fluorosis was mainly of mild damage.The skeletal fluorosis found in X-ray film was 44.64%(167/1241)and in clinical examination,38.94%(3883/9973).The levels of urine fluoride in children and adults were 1.88 and 2.78 mg/L.The level of urine fluoride was not differenet among children of different age,but in adults it was higher in the elder than the younger.The level of fluoride in urine was related to the severeness of skeletal fluorosis(r=0.74).The detective rates of skeletal fluorosis in agricuIture,pasturing,and agriculture-pasturing areaswere 31.70%(1369/4318),50.04%(1228/2454),and 40.17%(1286/3201),respectively.The X-ray detecting rates of skeletal fluorosis in men and wonlen were 49.57%(229/462)and 41.72%(325/779) respectively(χ2=11.72,P＜0.05).Conclusion The prevalence of brick-tea type fluorosis is very serious in the regions studied.