Relations between high risk sexual behavior and HIV infection among men who have sex with men in ways of meeting male partners / 中华流行病学杂志

Objective@#To understand the relations between high risk sexual behavior and HIV infection among MSM in ways of finding male partners in Ningbo.@*Methods@#A cross-sectional study was conducted in Ningbo between April and November in 2018. Data related to socio-demographics, ways of finding male partners, adoption of gay apps and sexual behaviors were collected by snowball method. Blood samples were drawn for HIV antibody testing. Classified data was evaluated by chi-square test. Related factors on HIV infection were analyzed by multivariate logistic regression.@*Results@#A total of 735 participants were included in this study. Ways of finding male partners would through gay apps (60.8%, 447/735), QQ/Wechat (32.3%, 237/735) and gay-places (6.9%, 51/735). Related information on high risk sexual behavior and HIV infection among gay apps users were found as: 16.8%(75) had sexual behavior once per week in the past 6 months, 41.8% (187/447) had multiple sexual partners, 12.1% (54/447) had unprotected anal intercourse in the last time, 52.3% (234/447) having had unprotected anal intercourse in the past 6 months. The overall HIV prevalence rate was 12.1%(54/447). Among the HIV cases who got infected within the two years, 68.6%(24/35) of them had used gay apps for less than two years. Results from the, multivariate logistic regression analysis showed that gay apps users were more susceptible to infected HIV than those who used the QQ/Wechat (OR=3.03, 95%CI: 1.30-7.07).@*Conclusions@#Gay apps was popularly known among the Ningbo MSM, and was associated with the high risk sexual behaviors and HIV infection. HIV control and prevention programs should be strengthened in the MSM population who used the gay apps. Related surveillance and intervention programs for MSM, who use the gay apps, need to be further reinforced.

Efficacy comparison between plate fixation with in situ reinforcing ulnar nerve and anterior transposition for humeral intercondylar fracture / 中华创伤杂志

Objective To investigate the clinical efficacy of plate fixation with in situ reinforcing ulnar nerve and anterior transposition by olecranon osteotomy approach in the treatment of type C2 and C3 humeral intercondylar fractures.Methods A retrospective case control study was conducted to analyze the clinical data of 23 patients with humeral intercondylar fractures admitted to the Affiliated Hospital of Hangzhou Normal University from June 2014 to January 2017.There were 17 males and six females,aged 19-56 years,with an average of 41.2 years.According to AO classification,there were 15 patients with type C2 and eight with type C3.All patients were treated with plate internal fixation by olecranon osteotomy approach.The patients were divided into anterior group (11 patients) which was treated with ulnar nerve release anterior transposition and in situ reinforcing group (12 patients) which was treated with ulnar nerve release in situ.The operation time,intraoperative blood loss,fracture healing time,elbow flexion and extension range,elbow joint Mayo score,and excellent and good rate were compared between the two groups.Postoperative complications were recorded.Results All patients were followed up for 15-43 months,with an average of 26.7 months.All patients had no need of blood transfusion.There were no significant differences between anterior group and in situ reinforcing group in operation time [(219.1 15.1) minutes vs.(211.2 ± 17.1) minutes],intraoperative blood loss [(263.6 ± 35.3) ml vs.(237.5 ±25.6)ml] and fracture healing time [(18.2±2.4)weeksvs.(18.9±1.7)weeks] (P＞0.05).Nosignificant differences were found between the two groups in elbow flexion [(120.3 ±7.1) ° vs.(120.3 ±4.1)°],straightness [(3.7±2.7)° vs.(4.1 2.4)°],Mayo score [(89.09 ±9.17)points vs.(86.67 ±10.29)points] and excellent and good rate [91％ (10/12) vs.83％ (10/12)] (P ＞0.05).After operation,no complications such as infection,heterotopic ossification,ulnar neuritis,elbow valgus deformity,or internal fixation failure occurred.Conclusions For humeral intercondylar fracture,the plate fixation with in situ reinforcing ulnar nerve and anterior transposition by olecranon osteotomy approach both have advantages such as small surgical trauma,strong fixation,fewer complications,satisfactory recovery of elbow function.Ulnar nerve anterior transposition or not does not affect the occurrence of ulnar neuritis,and both can obtain satisfactory clinical efficacy.

The application of multifunctional inflatable pelvis and hip-joint fixator (MIPHF) in damage control in patients with pelvic fracture / 中华骨科杂志

Objective To discuss the safety and the application of the self-designed multifunctional inflatable pelvis and hip-joint fixator (MIPHF) in damage control in pelvic fracture patients.Methods The MIPHF was subjected to pressure test and quality inspection.From September 2016 to June 2017,61 pelvic-fracture patients were treated with our self-designed MIPHF as pre-hospital first-aid care according to the concept of damage control orthopedics (DCO) (MIPHF group).The control group consisted of 69 pelvic-fracture patients who had not received pre-hospital first-aid care with the self-designed MIPHF from December 2015 to August 2016.There were no statistically significant differences between the two groups in gender,age,types of pelvic fracture,and preoperative injure severity score (ISS).The study compared the two groups for the case fatality rate,volume of blood transfused during surgeries,early complication rates,fracture reduction (Matta standards),and long-term efficacy (Cole scores).Results The pressure test showed that the MIPHF had a good fixation effect on the pelvis.And the quality inspection showed that the material used for the MIPHF was in line with national standards and the safety was guaranteed.The MIPHF group had 1 death (1.6％) and the control group had 8 deaths (11.6％),which was a significant difference (x2=4.979,P=0.026).All survival patients in both groups were followed up.The MIPHF group (61 cases) received 3.0 to 18.0 months follow-up,with an average of 9.0 months.And the control group (69 cases) had 18.0 to 30.0 months follow-up,with an average of 21.9 months.In the MIPHF group,23 cases were treated conservatively,and 37 cases were treated with surgery.Among them,3 cases were fixed with external fixator,20 cases with anterior open reduction and internal fixation,9 cases with posterior open reduction and internal fixation,and 5 cases with combined anterior and posterior fixation.The timing of surgery was 1 to 20 days after injury,with an average of 4.1 days.The volume of blood transfused in the MIPHF group during surgery was 200 to 1500 ml,with an average of 628.6 ml.In the control group,27 patients were treated conservatively,and 42 patients were treated with surgery.Among them,2 cases were fixed with external fixator,24 cases with anterior open reduction and internal fixation,10 cases with posterior open reduction and internal fixation,and 6 cases with combined anterior and posterior fixation.The timing of surgery was 1 to 15 days after injury,with an average of 3.l days.The volume of blood transfused in the control group during surgery was 200 to 4000 ml,with an average of 1 707.1 ml.There was a significant difference between the two groups in intraoperative blood transfusion(Z=-2.330,P=0.020).The MIPHF group had 10 (16.4％) cases of early serious complications and the control group had 22 (31.9％) cases,which had a significant difference (x2=4.187,P=0.041).According to the criteria proposed by Matta et al.,the good rate of results for treating fractures was 82.0％ in the MIPHF group and 60.9％ in the control group,which got a significant difference (x2=6.967,P=0.008).The MIPHF group and the control group also differed significantly in their mean long-term Cole scores (27.2±4.0 versus 25.1 ±5.6,t=2.457,P=0.015).Conclusion MIPHF,which reflects the DCO concept,may be recommended as pre-hospital first-aid care for patients with pelvic fracture because it can lessen bleeding and prevent secondary pelvic injury,thus reduce case fatality rate and the incidence of complications.It can also improve the success rate of treating pelvic fracture,which will positively affect long-term outcomes.

Research progress in the treatment of sternoclavicular joint dislocation / 中国综合临床

The incidence of sternoclavicular joint dislocation is rare due to its specially physiological anatomy. At present, the main therapy of sternoclavicular joint dislocation is operation, including the sternoclavicular joint reconstruction, internal clavicle resection and internal fixation with thoracoclavicular joint. Overall,surgical treatment is difficult to operate and has high risk. The article summarized the relevant literature and reviewed the treatment of sternoclavicular joint dislocation as follows.

Effect of zoledronic acid combined with Jintiange capsule on treatment of postmenopausal osteoporosis / 中华内分泌外科杂志

Objective To explore the effect of Jintiange capsule on treatment of postmenopausal osteoporosis (PMOP) and its mechanism.Method 133 patients diagnosed as PMOP and meeting the standard were collected from Oct.2011 to Aug.2015 in our hospital.They were randomly divided into two groups:treatment group and the control group.The control group received calcium and alendronate,while the treatment group received 3 Jintiange capsules 3 times daily on the basis of the control group.The lumbar bone densit (BMD),greater trochanter BMD,femoral neck BMD,Ward triangle BMD,visual analogue score (VAS) of knee and back,the serum levels of bone glaprotein (BGP),alkaline phosphatase (ALP),β-C-terminal telopeptide of type Ⅰ collagen (β-CTX),N-terminal propeptide of type Ⅰ procollagen (PINP) and adverse reactions were recorded before and after treatment.Results The lumbar BMD,greater trochanter BMD,femoral neck BMD,ward triangle BMD of treatment group after treatment were higher than those before treatment and those of the control group (P＜0.05).VAS score of knee and back of treatment group were lower than those of the control group (P＜0.05).The serum levels of BGP,ALP,β-CTX,PINP of treatment group were lower than those of the control group (P＜0.05).The adverse reactions rate of two groups had no significant difference (P＞0.05).Conclusion Jintiange capsule can significantly reduce bone metabolism level,increasing BMD,reducing bone loss,relieving knee and back pain of PMOP,without increasing complication rates,which is worthy to be promoted due to high safety and efficacy.

Biomechanics of lumbar spondylolysis: Finite element modeling and validation / 医用生物力学

Objective To construct three-dimensional finite element model of lumbar spondylolysis,then to verify its validity by comparison of biomechanics in vitro.Method According to the radiological data of a patient with lumbar spondylolysis,the bone and intervertebral disc of L4-S1 were reconstructed by Simpleware software.The lumbar attaching ligaments and articular capsule were added into simulating model by Ansys software.The three-dimensional finite element model of lumbar spondylolysis was finally simulated successfully,and validated by lumbar spondylolysis biomechanical experiment in vitro.Results The reconstruction of digital model contained the bones of lumbar spine which include vertebral cortical bone,cancellous bone,facet joint,pedicle,lamina,transverse process and spinous process,as well as the annulus fibrosus,nucleus pulposus,superior and inferior end-plates.Besides,anterior and posterior longitudinal ligaments,flavum ligament,supraspinal and interspinal ligaments and articular capsule of facet joint are also attached.The model consisted of 281,261 nodes and 661,150 elements.Imitation of spondylolysis is well done in this model.The validity of the model was verified by comparison of the results of biomechanics in vitro which involved in the trends under loading of stress/strain of L4 inferior facet process,L5 superior and inferior facet process,S1 superior facet process and the trends of stress/strain of lateral and medial L4 inferior facet process.Conclusions Three-dimensional model of lumbar spondylolysis is reconstructed using finite element analysis,and can be further used in the research in biomechanics of lumbar spondylolysis.

How to determine whether adhesion between posterior longitudinal ligament and spinal dura mater exists or not / 中华骨科杂志

Objective To evaluate retrospectively whether posterior longitudinal ligament(PLL)adhere to dura mater in the patients with cervical spondylotie myelopathy(CSM)or not before the anterior cervical operation.Methods From December 2005 to January 2007,of 18 patients with CSM the adhesion between PLL and dura mater was found in the anterior cervical operation.The patients included of 11 males and 7 females,with mean age of 65.4 years (range 55-72 years).All the patients were measured by CT and MRI before operation.There were 12 cases of dual-segmental cervical intervertebral disc herniation,6 of tri-segmental disc herniation.The former cases were treated with one level corpectomy and titanium mesh or iliac grafting and cervical anterior plate,and the latter with an additional cervical cage in the intervertebralspace.The floatation method was used to deal with the adhesion.The fitness between the two radiological methods was analyzed by matched-pairs Kappa eoemcient test.Results The nerve functions of all the patients were improved after anterior cervieal decompression.The mean score of JOA was increased from 9.6 of pre-operation to 12.1 of post-operation.There were 4 cases with injury in dura mater,which healed after appropriate dealing with the leakage of cerebrospinal fluid.None of lacerated dura was directly repaired during the operation.The condition of the coarse touch and bur between intervertebral disc and dura mater were found in CT transverse scanning.The thickening of the PLL and the unsymmetrical space between inferior and superior subdural cavity was found in MRI.The coefficient test proved that the difference of the CT and MRI was significant in finding the adhesion.Conclusion MRI iS better than CT in finding the adhesion between the PLL and dura mater in CSM before operation,besides the floatation method should be good to deal with the adhesion.

Treatment of lumbar spondylolisthesis with spinal bifida occulta / 中国矫形外科杂志

Objective To approach the treatment principle of lumbar spondylolisthesis with spina bifida occulta. Methods Twenty-six patients(male19,female 7,average 23.2 years old)with spondylolisthesis and spina bifida occulta were analyzed retrospectively.All cases were evaluated by radiological examinations including X-rays,computed tomography,magnetic resonance image.Based on the radiological results,the degeneration of intervertebual disc were varied by Ⅰ~Ⅴ types.Meyerdin’s score was used to evaluate the severe slip of the body of spondylolysis.At same time spina bifida occulta was divided into 4 models as follows,type A meant that the semi-lamina of sacrum was hypoplasia and still linked with spinous process;type B meant that the both sides of the lamina of sacrum was hypoplasia and the spinous process was free;type C meant that the lamina of sacrum was absent;type D meant that the spina bifida occulta was companied by other deformities such as the round formation of the end-plate of sacrum,the deformity of the transverse process of L5. Results The modality of the operations included 9 cases in single-vertabra fixation,13 cases in single-segment fixation,4 cases in two-segment fixation.All patients had been follow-up for 6~37 months(average 11.2 months).The effect of treatment was also obtained(8 in excellent,13 in good,5 in fair). Conclusions As for how to do with spondylolisthesis with spina bifida occulta(SBO),the type of SBO,degeneration scores of the disc and the degree of the slip of spondylolysis should be taken into consideration.

Clinic feature and treatment of ossification of cervical posterior longitudinal ligament associated with developmental spinal stenosis / 中国矫形外科杂志

DSS group,although without statistical significance.JOA score of two groups before and after surgery without statistical significance.[Conclusion]Developmental spinal stenosis is pathology found,which influences course of ossification of cervical posterior longitudinal ligament.The principal factor is trauma,which induces ossification of cervical posterior longitudinal ligament.Decompressed from a posterior approach is a reasonable treatment way.

Clinic studies on the change of cervical curvature after cervical anterior segmental decompression / 中国矫形外科杂志

[Objective]To evaluate the restoration of the cervical curvature after segmental anterior cervical decompression.[Method]Thirty-seven patients(male 31,female 6,mean age 57.8)with cervical spondylotic myelopathy were treated by segmentai anterior decompression,JOA(17 scores)was used to evaluate the improvement of nerve function of the patients.The measurement of the lordosis was according to the Harrion posterior tangent angle which is presented on the tangent of posterior vertebral body margins of C2 and C7 in the cervical spine.E-film software was used to measure the tangent angles which were obtained by pre operation and post operation.All patients were divided into two groups in terms of the fifteen degree of lordosis of the cervical spine before the operation.[Result]All of the cases were obtained the improvement of the nerve function of the extremities.The mean JOA scores was 10.6 in pre-operation,and was 12.8 in post-operation(P