Changes and health equity of low vision among children and adolescents in Chongqing during 2018 to 2021 / 中国学校卫生

Objective@#To understand changes and health equity of low vision in children and adolescents in Chongqing, and to provide reference for student myopia prevention and control.@*Methods@#Using longitudinal studies, all school students in grades 1 to grade 12 in Chongqing were examined for visual acuity during 2018 to 2021, and the prevalence as well as changes of low vision were analyzed. In 2021, stratified random sampling was used to evaluate the health equity of uncorrected visual acuity and diopter(spherical equivalent, SE).@*Results@#The prevalence of low vision for children and adolescents in Chongqing from 2018 to 2021 was 54.12%, 58.17%, 60.03% and 58.20% respectively. Low vision showed an increasing trend in the first three years and decreased by 1.83% in 2021 as compared with 2020( χ 2 trend =13 870.45, P <0.01). The difference in the detection rate of poor vision among students in different grades was statistically significant( χ 2=17 396.36, 2 093.95, 771.87, P <0.01). From 2018 to 2021, the detection rate of low vision in girls was higher than that of boys( P <0.01). The Gini coefficient was 0.054 57 for uncorrected visual acuity in urban area, higher than in rural areas (0.035 94). Meanwhile, the Gini coefficient of urban and rural SE was 0.065 82, higher than the country (0.049 30). The results showed that myopia in children and adolescents was more uneven in urban areas.@*Conclusion@#The adjustment of myopia prevention and control strategies in the late stage of the novel coronavirus pneumonia epidemic is related to the reduction of the detection rate of poor vision in children and adolescents in Chongqing. Low vision varied by grade and gender, suggesting tailored myopia prevention and control strategy. The detection rate of poor vision in cities is more uneven than in rural areas, and different myopia prevention and control measures need to be implemented according to regional characteristics.

Treatment of patella inferior pole fracture with non excitation tension band technique / 中华骨科杂志

Objective:To explore the experience of the treatment of patella inferior pole fracture with non excitation tension band technique.Methods:From April 2009 to December 2019, 76 patients with inferior patellar fracture were treated with non excitation tension band technique. There were 42 males and 34 females; The age was 35.48 ± 18.12 years (17-66 years), with an average of 35 years. There were 45 cases on the left and 31 cases on the right. Causes of injury: fall injury in 46 cases, bicycle injury in 16 cases and traffic accident injury in 14 cases. The time from injury to operation was 0.25-5 d, with an average of 3.2 d. There were 18 cases of open fractures, 64 cases of articular surface fractures and 52 cases of comminuted fractures. Open fracture patients were debridement first, and all cases were fixed with non excitation tension band technique. The intraoperative fracture reduction, postoperative fracture healing and internal fixation were observed. The knee function was evaluated according to the degree of claudication, the use of supports, the feeling of joint strangulation, joint instability, pain, swelling, stair climbing and squatting.Results:All 76 patients successfully completed the operation and were followed up for 18.24 ± 6.18 months (range 12-24 months). There was no wire fracture during and after operation. All incisions healed in the first stage after operation, and there was no deep venous thrombosis of lower limbs. The X-ray film showed that there was no further fracture and fracture displacement after operation, and there was no Kirschner wire slip before the internal fixation was taken out. Only one case had steel wire relaxation due to buckle (which did not affect fracture healing). All fractures healed well, with an average of 7.5 weeks, and the fracture line basically disappeared. 12 months after operation, according to Lysholm knee score standard, the knee function of patients was evaluated. The score of 76 cases was 95.40±4.60 points (range 82-100 points): excellent in 54 cases, good in 21 cases and fair in 1 case. The excellent and good rate was 98.7%. According to the visual analogue scale (VAS) pain score standard, the patients were scored for postoperative pain. The score of 76 cases was 0.09±2.05 points (range 0-3 points): 4 cases had mild pain, with an average score of 0.09.Conclusion:The results of the treatment of patellar inferior pole fracture with tension free band technique are satisfactory, the pain caused by tissue irritation by the internal fixation was lower, clinical application can be popularized.

Effects of enoxaparin on osteogenic differentiation of bone marrow stem cells and their exosomes / 中华创伤骨科杂志

Objective:To study the effects of enoxaparin on osteogenic differentiation of bone marrow stem cells (BMSCs) and the exosomes derived from BMSCs.Methods:After the BMSCs from 4-week old male SD rats were cultured, their surface antigen and multilineage differentiation potentials were identified. Subsequently, the BMSCs were incubated with osteogenic differentiation medium containing 10 IU/mL enoxaparin for 14 days. After the exosomes derived from BMSCs (BMSC-Exos) were extracted by the kit method, their structure was observed by transmission electron microscopy and their surface antigen CD63 detected by Western blot. Alizarin red staining was used to analyze the osteogenic differentiation of BMSCs. Osteogenic proteins including OCN and BMP-2 in BMSCs and exosomes were detected.Results:The spindle-shaped BMSCs isolated and cultured showed a uniform spiral pattern. They expressed highly the surface markers CD29 and CD44 but lowly CD34 and CD45, indicating that the majority of the cells were BMSCs. BMSC-Exos, in an oval shape with a diameter of about 30 to 80 nm, expressed CD63. Alizarin red staining showed that the number of mineralized nodules in the enoxaparin treatment group was significantly lower than that in the control group. Western blot analysis indicated that enoxaparin inhibited the expression of osteocalcin (OCN) and BMP-2 in BMSCs. ELISA results showed that the protein levels of OCN(48.81 ng/mL ± 8.23 ng/mL) and BMP-2 (311.45 pg/mL ± 27.59 pg/mL) in the BMSCs treated with enoxaparin were significantly lower than those of OCN (80.43 ng/mL ± 10.74 ng/mL) and BMP-2 (399.23 pg/mL ± 32.25 pg/mL) in the control BMSCs ( P<0.05). The contents of OCN (1.45 ng/mL±0.15 ng/mL) and BMP-2 (18.47 pg/mL ± 0.54 pg/mL) in the exosomes from BMSCs treated with enoxaparin were significantly higher than those of OCN (1.00 ng/mL ± 0.12 ng/mL) and BMP-2 (9.07 ng/mL ± 0.36 pg/mL) in the exosomes from control BMSCs ( P<0.05). Conclusions:Enoxaparin may inhibit the osteogenic differentiation of BMSCs. The mechanism of this might be related to its direct inhibition against the expression of OCN and BMP-2 in BMSCs and its indirect reduction of OCN and BMP-2 in BMSCs through the exhaust of the above proteins in the form of exosomes.

Reduction assisted by a double-needle repositor for femoral neck fractures of Garden types Ⅲ-Ⅳ / 中华创伤骨科杂志

Objective@#To compare the efficacy between reduction assisted by a double-needle repositor and manual reduction in the treatment of femoral neck fractures of Garden types Ⅲ-Ⅳ.@*Methods@#From May 2015 to October 2017, 67 patients with femoral neck fracture of Garden type Ⅲ or Ⅳ were treated by hollow screw fixation at Department of Orthopaedics, The Second Affiliated Hospital to Shanxi Medical University. They were divided into 2 groups according to the different reduction methods. The reduction was assisted by a double-needle repositor in 37 cases (group A); they were 21 males and 16 females with an age of 46.2±8.1 years and there were 13 cases of Garden type Ⅲ and 24 cases of Garden type Ⅳ. The reduction was conducted manually in another 30 cases (group B); they were 18 males and 12 females with an age of 48.8±9.1 years and there were 13 cases of Garden type Ⅲ and 17 cases of Garden type Ⅳ. The 2 groups were compared in terms of reduction time, anatomical reduction rate, operation time, intraoperative bleeding volume, fracture healing time, postoperative complications and Harris hip scores at the last follow-up.@*Results@#There were no significant differences between the 2 groups of patients in their preoperative general data, indicating they were compatible(P>0.05). All the 67 patients were followed up for 20 to 30 months (average, 24 months). The anatomic reduction rate in group A [94.6% (35/37)] was significantly higher than that in group B [83.3% (25/30)]; the reduction time, operation time and fracture healing time in group A (33.2±4.6 min, 70.2±5.0 min and 4.6±0.7 months) were significantly shorter than those in group B (45.8±8.6 min, 90.6±9.2 min and 5.6±0.6 months); the Harris hip scores at the last follow-up in group A (84.3±8.6 points) were significantly higher than in group B (81.2±7.8 points) (all P<0.05). There was no significant difference in intraoperative bleeding volume or postoperative complications between the 2 groups (P>0.05).@*Conclusion@#Reduction assisted by a double-needle repositor is fine for femoral neck fractures of Garden types of Ⅲ-Ⅳ, because it has advantages of limited invasion, simplicity, a high rate of anatomical reduction, quick reduction and good functional recovery.

Reduction assisted by a double-needle repositor for femoral neck fractures of Garden types Ⅲ-Ⅳ / 中华创伤骨科杂志

Objective To compare the efficacy between reduction assisted by a double-needle repositor and manual reduction in the treatment of femoral neck fractures of Garden types Ⅲ-Ⅳ.Methods From May 2015 to October 2017,67 patients with femoral neck fracture of Garden type Ⅲ or Ⅳ were treated by hollow screw fixation at Department of Orthopaedics,The Second Affiliated Hospital to Shanxi Medical University.They were divided into 2 groups according to the different reduction methods.The reduction was assisted by a double-needle repositor in 37 cases (group A);they were 21 males and 16 females with an age of 46.2 ± 8.1 years and there were 13 cases of Garden type Ⅲ and 24 cases of Garden type Ⅳ.The reduction was conducted manually in another 30 cases (group B);they were 18 males and 12 females with an age of 48.8 ± 9.1 years and there were 13 cases of Garden type Ⅲ and 17 cases of Garden type Ⅳ.The 2 groups were compared in terms of reduction time,anatomical reduction rate,operation time,intraoperative bleeding volume,fracture healing time,postoperative complications and Harris hip scores at the last follow-up.Results There were no significant differences between the 2 groups of patients in their preoperative general data,indicating they were compatible(P ＞ 0.05).All the 67 patients were followed up for 20 to 30 months (average,24 months).The anatomic reduction rate in group A [94.6％ (35/37)] was significantly higher than that in group B [83.3％ (25/30)];the reduction time,operation time and fracture healing time in group A (33.2 ±4.6 min,70.2 ±5.0 min and 4.6 ±0.7 months) were significantly shorter than those in group B (45.8 ±8.6 min,90.6 ± 9.2 min and 5.6 ± 0.6 months);the Harris hip scores at the last follow-up in group A (84.3 ± 8.6 points) were significantly higher than in group B (81.2 ±7.8 points) (all P ＜0.05).There was no significant difference in intraoperative bleeding volume or postoperative complications between the 2 groups (P ＞ 0.05).Conclusion Reduction assisted by a double-needle repositor is fine for femoral neck fractures of Garden types of Ⅲ-Ⅳ,because it has advantages of limited invasion,simplicity,a high rate of anatomical reduction,quick reduction and good functional recovery.

Experience of proximal femoral nail anti rotation intramedullary nail (PFNA)in the treatment of intertro-chanteric osteoporotic fracture in elderly patients / 中国基层医药

Objective To investigate the clinical effect of proximal femoral nail anti rotation intramedullary nail (PFNA)in the treatment of intertrochanteric osteoporotic fractures in elderly patients.Methods 42 cases of femoral intertrochanteric fracture were treated with proximal femoral nail anti rotation intramedullary nail (PFNA)in cases (AO type,A1 type 13 cases,A2 type 24 cases,type A3 5 cases).Results The group of 42 patients after 12 -36 months of follow -up,the average follow -up time of 18 months,all the patients were healed,1 case of deep venous thrombosis,1 case of mild coxa vara.According to the Harris evaluation standard:excellent 32 cases,good in 9 cases,fair in 1 case,the excellent rate was 97.6%.Conclusion The proximal femoral nail anti rotation (PFNA) anti tensile,anti sliding and anti rotation function is good,and has the advantages of simple operation,small trauma,for osteoporotic intertrochanteric fracture patients can be applied.

Influence of shift work in nursing on sleep and circadian blood pressure and rhythm / 心血管康复医学杂志

Objective: To explore influence of shift work in nursing on sleep and circadian blood pressure and rhythm. Methods: A total of 29 shift nurses, who worked in our hospital for a long period, were enrolled as shift nurse group. Another 32 day shift nurses were regarded as day shift nurse control group（control group）. Both groups received Pittsburgh sleep quality index (PSQI) assessment and 24h ambulatory blood pressure monitoring (ABPM). Results: Compared with control group, PSQI assessment showed that most factor scores and PSQI total score [(8.67±2.16) scores vs. (11.98±3.30) scores] significantly increased in shift nurse group（P<0.05~0.01）; 24h ABPM showed that mean nighttime SBP [(106.51±12.94) mmHg vs. (115.74±13.72) mmHg] and nighttime DBP [(71.23±9.76) mmHg vs. (74.96±10.68) mmHg] significantly rose in shift nurse group, P<0.05; Mean SBP decreasing rate [(7.84±1.52)% vs. (3.66±1.47)%] and mean DBP decreasing rate [(6.55±1.39)% vs. (2.83±0.51)%], SBP dipper percentage (59.38% vs. 31.03%) and DBP dipper percentage (68.75% vs. 27.59%) significantly reduced, SBP non-dipper percentage (40.63% vs. 68.97%) and DBP non-dipper percentage (31.25% vs. 72.41%) significantly rose in shift nurses group, P<0.05~0.01.Conclusions: There exists definite somnipathy and significant change of circadian blood pressure and rhythm in shift nurses.

Vascular histocompatiblity after implantation of an arsenic-coated stent / 中国组织工程研究

BACKGROUND:Arsenic trioxide is considered to inhibit the proliferation of vascular smooth muscle cel s and promote cel apoptosis. Therefore, we wondered whether the arsenic can inhibit the hyperplasia of vascular smooth muscle cel s, an arsenic-coated stent can be compatible with the vascular tissue, and a better vascular intimal coverage as early as possible can reduce intimal hyperplasia. OBJECTIVE:To observe the vascular histocompatibility of the arsenic-coated stent. METHODS:Fourteen white rabbits were randomized into two groups and respectively subject to the implantation of arsenic-coated 316 L stainless steel stents and bare 316 L stainless steel stents into the abdominal aorta. After 28 days, the distal and proximal parts of the vessel at the implantation site were ligated and the ligated vessel was taken for hematoxylin-eosin staining and light microscope observation. RESULTS AND CONCLUSION:(1) Gross observation:the vessel at the stent site was a little larger than the adjacent vessels in the outer diameter, which was expanded but had no visible thrombus. After cutting the stent, the neointima formed smoothly on the stent surface. (2) Light microscope observation:the stent was located in the middle of the vessel, the medial smooth muscle was pressed, and vascular intimal smooth muscle hyperplasia was found around the stent, thereby thickening the vascular intima. The vascular neointima formed and covered the stent, and there was a thin black layer between the stent and the vascular tissue, which consisted of arsenic and its compounds. These findings suggest that the arsenic-coated stents can be covered with vascular tissues, possessing good vascular histocompatibility.

Pathogen Epidemiology of Community-Acquired Pneumonia in Adults of Tangshan Area / 天津医药

Objective To investigate the distribution of pathogens in adult patients with community-acquired pneumonia (CAP) in Tangshan area. Methods The clinical data of 530 hospitalized patients with CAP were retrospectively collected in department of respiratory medicine from 6 hospitals in Tangshan area from October 2011 to September 2012. The sputum samples were isolated and cultured. Results A total of 195 strains were isolated from 530 patients with CAP. The most common types of pathogens included Klebsiella pneumoniae (64 strains,12.08%), Streptococcus pneumoniae (24 strains, 4.53%) and Bauman Acinetobacter (19 strain, 3.58%). The detective rates of Klebsiella pneumoniae and Pseudomonas aeruginosa were significantly higher in patients with basic diseases than those of patients without basic diseases (P0.05). Conclusion The gram-negative bacterial pathogens were the majority isolated from patients with CAP in Tangshan area. And Klebsiella pneumoniae was the primary bacteria. Patients with serious illness, above 60 years old, without antibiotic treatment before hospitalization, with basic diseases and above PORTⅢlevels should be given treatment of anti-gram-negative bacteria.

Combined transfer of the free second toe dorsal wrap around flap and fibula side flap of great toe to repair degloving injury of the single finger / 中华显微外科杂志

Objective To provide the new method for repairing degloving injury of the single finger.Methods From August 2007 to June 2010,eleven patients were repaired with the second free toe dorsal wrap around flap and fibula side flap of great toe.Patients including 9 men and 2 women.The mean age were 31 years(17-49 years).The finger including 6 index fingers,two middle fingers and 3 ring fingers,in which 4 patients were type I and 7 patients were type Ⅱ.All of them were emergency debridement VSD closed negative pressure attraction,surgical repair in 3-5 days after injury.The plantar digital nerve in the second free toe dorsal wrap around flap and fibula side flap of great toe with the digital nerve of the stump by end-to-end nerve anastomosis.The donor sites were covered with a free flap.Results All of 11 flaps survived,but 2 cases developed partial native second toe skin grafting necrosis,by dressing healed,one case of phalanges exposed through survival skin,the part of the exposed phalanx healed after surgical cut.All the 11 patients were followed up from 3 monthes to 3 years.The flaps survived completely with satisfactory cosmetic results and good sensibility.The sensation recovery was reached above S3.The great toe fibular flap for repair of finger pulp full,two-point discrimination was 6-9 mm,the mean was 7.0 mm.Finger flexion function by finger total activity (TAM) score assessment,excellent 9 cases,good 2 cases.Conclusion Transfer of the second free toe dorsal wrap around flap and fibula side flap of great toe to repair degloving injury of the single finger is an ideal method of treatment.

Involvement of VLA-5 and VLA-6 in facilitating endothelium-oriented transmigration of hematopoietic stem/progenitor cells / 吉林大学学报(医学版)

Objective:To investigate whether VLA-5 and VLA-6 are involved in facilitating en-dothelium-oriented transmigration of hematopoietic stem/progenitor cells. Methods:Purified hu-man CD34+ cells were subject to ex vivo transmigration assay and blocking experiments throughtranswell filter inserts coated with human umbilical vein endothelial cells (HUVECs). Four-colorfluorescence-activated cell sorting (FACS) analysis was applied to detect the expression profilesof adhesion molecules and chemokine receptor CXCR-4 on CD34bright cells. Results:Stromal cell-derived factor (SDF)-1-induced transmigrations of both mobilized peripheral blood (mPB)-(56.6±20. 1)% and bone marrow (BM)- (15. 6±1. 8)% derived CD34+ cells were significantlyfacilitated through HUVECs-coated transwell filter insters compared with noncoated ones, whichwere efficiently blocked by preincubation of CD34+ cells with neutralizing antibodies to VLA-5,or VLA-6, or both of them; meanwhile the proportions of migrating CD34+ cells through bothHUVECs-coated and noncoated transwell filter inserts in BM were significantly lower than thosein mPB; the different percentages of migrating CD34+ cells between in mPB and BM were corre-lated with their variable expressions of VLA-5 and VLA-6, but not for VLA-4 or chemokine re-ceptor CXCR-4. Conclusion:Facilitating HS/PCs transmigrations through HUVECs are involvedin both VLA-5 and VLA-6.

A new replantation method for the treatment of distal segment finger amputations with subcutaneous pocket / 中国医师杂志

Objective To explore a new way for the treatment of distal segment finger amputations.Methods From Aug 2001 to Feb 2005,the method of subcutaneous pocket was applied to 122 complete distal segment finger amputations in 70 patients.After the nail of amputated parts was removed,fractured bone segments fixed with K-wires and amputated part de-epithelialized to the middermal layer,the reattached parts were separately inserted into the subcutaneous pocket of chest,abdominal or ipsilateral palm.After 16 to 20 days,the reattached parts were removed from the subcutaneous pocket. Results One hundred and twenty-two finger amputations of 70 cases had recovered completely.The replanted fingers had satisfactory sensation and appearance.Conclusion It is a simple and effective method for the treatment of distal segment finger amputations,particularly for the finger amputations when the vascular anastomosis is not feasible.