Relationship between digital media use and anxiety in college students during the COVID-19 outbreak / 中国学校卫生

Objective@#To describe digital media use in college students during the coronavirus disease 2019(COVID-19) outbreak.@*Methods@#A structured self-administered electronic questionnaire was designed and admin istered during February 4 to 12, 2020, collecting information on the use time of digital media and anxiety symptoms of college students in China during the COVID-19 outbreak. Data was analyzed by Chi-square test, univariate and multivariate Logistic regression models.@*Results@#A total of 11 787 university students were recruited. The detection rate of anxiety symptoms was 17.8%. The percentages of screen time ≤2, >2-4 and >4 h/d were 21.3%, 31.4% and 47.3%. The proportions of mobile phone use time ≤2, >2-4 and >4 h/d were 14.6%, 33.2% and 52.3%. The proportion of browsing information regarding COVID-19 ≤1, 1-2 and >2 h/d were 66.6%, 19.4% and 13.9%. The results of Logistic regression analysis revealed that the detection rate of anxiety symptoms was lower among the students having 2-4 h/d of screen time(OR=0.70, 95%CI=0.61-0.81), but higher among the students having more than 4 h/d of screen time(OR=1.13, 95%CI=1.00-1.28) compared with those having ≤2 h/d of video usage time. Compared with the mobile phone usage ≤2 h/d group, the detection rate was lower among >2-4 h/d group(OR=0.78, 95%CI=0.66-0.91). However, anxiety symptoms were more likely to occur in the group of > 4 h/d(OR=1.20, 95%CI=1.04-1.39). The detection of anxiety symptoms was higher in the group with more browsing time. The OR for anxiety symptoms detection rate was 1.55(1.38-1.75) among the students with >1-2 h/d of browsing information regarding COVID-19 and 2.15(1.89-2.44) among the students with >2 h/d of browsing information regarding COVID-19 compared with those with ≤1 h/d of browsing information regarding COVID-19.@*Conclusion@#During the epidemic period, the use of >2-4 h/d digital media helps to reduce the occurrence of anxiety symptoms. But the use of computers and mobile phones for more than 4 h/d is associated with higher level of anxiety symptoms among college students. Less screen time spent on fact-checking on COVID-19 might help reduce anxiety sympotoms among college students.

Soft tissue defects around knee joints repaired with thigh distal perforator propeller flap: a report of 72 cases / 中华显微外科杂志

Objective:To evaluate the clinical effect of soft tissue defects around knee joints repaired with thigh distal perforator propeller flap.Methods:Clinical data of 72 patients with defects around knee joints from January, 2009 to October, 2019 were analyzed retrospectively, including 43 males and 29 females, aged from 17 to 83 years. The sizes of soft tissue defects ranged from 4.0 cm×3.0 cm to 22.0 cm×13.0 cm. Perforator propeller flaps were designed and harvested to repair the defects according to anatomical features of the origin, course, branches, distribution and anastomosis of vascular network of the perforator vessels and location as well as the size and shape of defects. Nine patients repaired with the lateral distal perforator propeller flaps (LDF), 53 with descending genicular artery perforator propeller flaps (DGF) and 10 with direct popliteal artery perforator propeller flaps (DPF). The size of flap was 4.5 cm×3.5 cm to 24.0 cm×14.0 cm. The donor sites were sutured directly or covered with free full-thickness skin. To evaluate the effect, the skin swelling rating in early and later stage were taken. Three to 72 months of followed-up was conducted through outpatient clinic (78%), telephone (15%) and WeChat (7%).Results:The flaps totally survived in 65 patients and 7 patients underwent partial necrosis at the distal end of the flaps ( 2 cases of LDF, 4 cases of DGF, 1 case of DPF) who were treated with dressing, and the donor sites were completely healed. The appearance and shape of the repaired knee joints was good, and the color and elasticity was close to surrounding normal skin, TPD of the flaps were 7-10 mm, and the scar was small after 3 to 72 months' follow-up. The efficacy was satisfactory in 48 cases ( 4 cases of LDF, 39 cases of DGF, 5 cases of DPF), general in 24 cases ( 5 cases of LDF, 14 cases of DGF, 5 cases of DPF). Degree of flap swelling: in early stage, I° in 40 cases ( 4 cases of LDF, 31 cases of DGF, 5 cases of DPF), II° in 20 cases ( 3 cases of LDF, 14 cases of DGF, 3 cases of DPF), III° in 10 cases ( 2 cases of LDF, 7 cases of DGF, 1 case of DPF), IV° in 2 cases(1 case of DGF, 1 case of DPF); in later stage: I° in 55 cases ( 6 cases of LDF, 41 cases of DGF, 8 cases of DPF), II° in 15 cases ( 2 cases of LDF, 12 cases of DGF, 1 case of DPF), III° in 2 cases ( 1 case of LDF, 1 case of DPF). The evaluation of knee joint function: excellent in 17 cases ( 2 cases of LDF, 12 cases of DGF, 3 cases of DPF), good in 35 cases( 4 cases of LDF, 27 cases of DGF, 4 cases of DPF), general in 20 cases( 3 cases of LDF, 14 cases of DGF, 3 cases of DPF). The good rate was about 73%. The range of motion and stability of the knee joint were basically normal and there was no pain found to affect study and life. All the patients were satisfied with the effect.Conclusion:Repairing soft tissue defect around knee joint with thigh distal perforator propeller flap is reliable and clinical applicable.

Correlation between Pr1 protease activity, Pr1 gene expression and strain virulence of Isaria fumosorosea / 生物工程学报

Serine elastic chymotrypsin Pr1 is an enzyme that efficiently degrades insect body wall protein through its connection with the virulence of entomogenous fungi. Therefore, it is important to explore the relationship between the Pr1 protease activity, the Pr1 gene expression and the virulence of different strains of entomogenous fungi. Specific peptide substrate Suc-Ala-Ala-Pro-Phe-pNA and fluorogenic quantitative PCR were used for detecting Pr1 protease activity and Pr1 gene expression, and the slope spray method was used for evaluating the virulence of the fungi on the Myzus persicae. The results indicated that the linear regression equation of the Pr1 protease activity and the virulence of different strains were: y=3.64x+0.62, R²=0.432. It was shown that there is a positive correlation between the Pr1 protease activity and virulence of different strains. Moreover, the result of the multiple linear regression analysis between Pr1 protease activity, Pr1 gene expression and the virulence of different strains was: y=0.236+10.833x₁-0.039x₂ (x₁ represents Pr1 protease activity while x₂ represents Pr1 gene expression), R²=0.568, which suggested that the raw data could be represented by a linear fitting equation. The serial correlation coefficient was high (D-W was 2.444), indicating that Pr1 protease activity and Pr1 gene expression have great effect on the virulence of the fungi. Additionally, VIF=12.705, which shows that moderate multiple collinear exists between Pr1 protease activity and Pr1 gene expression. Therefore, Pr1 protease activity and Pr1 gene expression could be recommended as important indicators for strain virulence selection.

Using the forearm proximal radial inferior cubital artery perforator flap to repair the wound defects of anterior elbow / 中华整形外科杂志

Objective@#To evaluate the design and clinical application of forearm proximal radial inferior cubital artery perforator flap.@*Methods@#The clinical data of 11 patients with defects of anterior elbow from June 2013 to June 2018 were analyzed retrospectively, in which including 8 male and 3 female, mean age is 51.5 years old, ranged from 48 to 76 years old. The sizes of soft tissue defects ranged from 7.5 cm×4.5 cm to 14 cm×7 cm. Forearm proximal inferior cubital artery perforator flaps were used to repair the defects according to flap their location, size and shape, in which the largest is 15 cm×10 cm and the smallest is 7 cm×5 cm. To evaluate the effect according to flap survival, infection control, elasticity and color, appearance, the scar of the donor site, cutaneous sense, and satisfaction of patients. The elbow efficacy and function were evaluated according to Mayo criteria and the swelling degree of flap was also evaluated.@*Results@#All the flaps survived in 11 cases, the incisions in donor and recipient site were primary healing. The survival of flaps is good and the appearance, color and elasticity are close to normal, on the other hand, the scar at the donor site is small after 6 to 36 months follow-up. The efficacy is satisfied in 8 cases, general in 3 cases and no dissatisfactory. The function of elbow is excellent in 4 cases, good in 6 cases and general in 1 case. Skin swelling rating in early stage is 1st degree in 6 cases, 2nd degree in 3 cases, 3rd degree in 2 cases; in later stage is 1st degree in 8 cases, 2nd degree in 2 cases, 3rd degree in 1 case.@*Conclusions@#The anatomic position of forearm proximal radial inferior cubital artery perforator flap is constant, the blood supply is good, and the operation method is simple and safe which could be a new supplementary method and be available for clinical selection to repair the soft tissue defects of elbow.

Clinical effects of dorsal perforator fascia pedicle flap of the deep palmar arch in the repair of skin and soft tissue defects of finger web area / 中华烧伤杂志

Objective@#To explore the clinical effects of dorsal perforator fascia pedicle flap of the deep palmar arch in the repair of skin and soft tissue defects of finger web area.@*Methods@#Eleven patients (7 males and 4 females, aged from 18 to 73 years) with soft tissue defects of finger web area in distal dorsal side were admitted to Xinhua Hospital (Chongming) of Shanghai Jiao Tong University School of Medicine from October 2010 to September 2018. The sizes of skin and soft tissue defects ranged from 2.5 cm×1.5 cm to 6.0 cm×2.5 cm. According to the origin, course, branches, and distribution of the dorsal perforator of deep palmar arch, and the anatomical characteristics with vascular network of dorsal carpal and dorsal metacarpal, dorsal perforator fascia pedicle flaps of the deep palmar arch from the back of the injured hands were designed and transferred to repair the wounds of finger web area in distal dorsal side. The sizes of the flaps of patients ranged from 3.5 cm×2.0 cm to 6.5 cm×3.0 cm. The donor sites were sutured directly or covered with free forearm full-thickness skin graft. The clinical effects and swelling degree of flaps in early and late stages were evaluated during the follow-up of 3 to 36 months post surgery.@*Results@#All the flaps survived in 11 patients, the incisions in donor and recipient sites were healed. During the follow-up of 3 to 36 months post surgery, the survival of flaps was good, and the appearance, color, and elasticity were close to normal skin, with two-point discrimination distance of 7 to 10 mm and sensory function recovery of grade S3. The wounds in donor site had small scar without infection. The efficacy was evaluated as satisfactory in 8 patients, general in 3 patients, and dissatisfactory in no patient. Flap swelling rating in early stage was 1st degree in 7 patients, 2nd degree in 2 patients, and 3rd degree in 2 patients. Flap swelling rating in late stage was 1st degree in 8 patients, 2nd degree in 2 patients, and 3rd degree in 1 patient. The extension and flexion of the metacarpal and interphalangeal joints were basically normal and the patients were satisfied with the outcomes.@*Conclusions@#Based on the dorsal perforator of deep palmar arch, dorsal perforator fascia pedicle flap of the deep palmar arch is reliable to transfer to repair skin and soft tissue defects of finger web area in distal dorsal side, which is worthy of promotion in clinic.

Abnormal Metabolic Connectivity in Rats at the Acute Stage of Ischemic Stroke / 神经科学通报·英文版

Stroke at the acute stage is a major cause of disability in adults, and is associated with dysfunction of brain networks. However, the mechanisms underlying changes in brain connectivity in stroke are far from fully elucidated. In the present study, we investigated brain metabolism and metabolic connectivity in a rat ischemic stroke model of middle cerebral artery occlusion (MCAO) at the acute stage using F-fluorodeoxyglucose positron emission tomography. Voxel-wise analysis showed decreased metabolism mainly in the ipsilesional hemisphere, and increased metabolism mainly in the contralesional cerebellum. We used further metabolic connectivity analysis to explore the brain metabolic network in MCAO. Compared to sham controls, rats with MCAO showed most significantly reduced nodal and local efficiency in the ipsilesional striatum. In addition, the MCAO group showed decreased metabolic central connection of the ipsilesional striatum with the ipsilesional cerebellum, ipsilesional hippocampus, and bilateral hypothalamus. Taken together, the present study demonstrated abnormal metabolic connectivity in rats at the acute stage of ischemic stroke, which might provide insight into clinical research.

An Automatic Method for Generating an Unbiased Intensity Normalizing Factor in Positron Emission Tomography Image Analysis After Stroke / 神经科学通报·英文版

Positron emission tomography (PET) imaging of functional metabolism has been widely used to investigate functional recovery and to evaluate therapeutic efficacy after stroke. The voxel intensity of a PET image is the most important indicator of cellular activity, but is affected by other factors such as the basal metabolic ratio of each subject. In order to locate dysfunctional regions accurately, intensity normalization by a scale factor is a prerequisite in the data analysis, for which the global mean value is most widely used. However, this is unsuitable for stroke studies. Alternatively, a specified scale factor calculated from a reference region is also used, comprising neither hyper- nor hypo-metabolic voxels. But there is no such recognized reference region for stroke studies. Therefore, we proposed a totally data-driven automatic method for unbiased scale factor generation. This factor was generated iteratively until the residual deviation of two adjacent scale factors was reduced by < 5%. Moreover, both simulated and real stroke data were used for evaluation, and these suggested that our proposed unbiased scale factor has better sensitivity and accuracy for stroke studies.

In situ suturing technique for severe amputation of facial composite tissues in 14 cases / 中华整形外科杂志

Objective@#To report the method and effect of in situ suturing technique for severe amputation of facial composite tissues.@*Methods@#We in situ sutured severely amputated composite tissues of facial region in 14 cases in emergency by vessels and nerves anastomosis from May 2004 to December 2017.@*Results@#All replanted composite tissues survived in 13 cases. Edge necrosis of auricle occurred in 1 case because of serious contusion and it was cured after dressing changed. The color and appearance of the replanted composite tissues were close to normal after 3 to 48 months′ follow-up.@*Conclusions@#In situ suturing technique in emergency is the ideal treatment for severe amputation of composite tissues of facial region.

Transferring perforator fascial flap to repair skin soft tissue defect around ankle joint in elderly patients / 中华创伤杂志

Objective To evaluate the clinical effect of the perforator fascial flap of the lower leg for the repair of large skin and soft tissue defects around the ankle in the elderly.Methods A retrospective case series study was conducted on the clinical data of 23 elderly patients with skin and soft tissue defect around the ankle joint admitted to Xinhua Hospital (Chongming) Affiliated to Medical College of Shanghai Jiaotong University,from November 2013 to December 2017.There were 13 males and 10 females,aged 65-78 years (mean,71 years).The wound areas around the ankle joint ranged from 13.5 cm × 5.5 cm to 16.0 cm × 8.5 cm.According to the position,size,and shape of the wound area around the ankle joint of the lower leg,the perforator fascia flap was designed and transferred for repairing.The maximum flap area was 17.0 cm × 9.5 cm while the minimum area was 14.0 cm ×6.5 cm.According to the conditions of survivals of the skin flap,elasticity,color,appearance,infection control,donor site scar,skin sensation,joint activity,patient satisfaction,etc.,the ankle and foot function was evaluated by referring to Tornetta and other standards.Besides,the swelling degree of the flap was graded.Results A total of 21 flaps survived and the wound at both donor site and recipient site obtained stage Ⅰ union.Two cases of skin edge necrosis occurred at the distal end of the flap,and the wounds at the donor and recipient sites were completely healed after dressing change.The patients were followed up for 6-48 months,with an average of 15 months.The flaps had good survival,satisfactory shape,and small scar at donor site,with similar elasticity and color with the surrounding normal skin.Twenty patients were satisfied with the efficacy and three were fine with the outcome.In terms of functional evaluation of the ankle and foot,the results were excellent in eight patients,good in 12,and fair in three.Flap swelling grading was as follows:degree Ⅰ in 16 patients,degree Ⅱ in 5,and degree Ⅲ in 2 at the early stage;degree Ⅰ in 20 patients,degree Ⅱ in 2,and degree Ⅲ in 1 at the later stage.Conclusion In repairing large skin and soft tissue defects around the ankle in the elderly,the perforator fascia flap of the lower leg transferring is a convenient,safe,and reliable method with less damage,which can promote the wound healing and functional recovery of ankle and foot.

Ankle anterior perforating flaps for reconstruction of soft tissue defects on dorsum of foot / 中华创伤杂志

Objective To explore the clinical effects of ankle anterior perforating flaps in reconstruction of the soft tissue defects on dorsum of foot.Methods A retrospective cases series study was done to analyze 11 patients with dorsal skin soft tissue defects:eight males and three females,with age ranging from 18-76 years (mean,43.5 years),treated from January 2009 to March 2017.The sizes of the soft tissues defects varied from 4.0 cm × 3.5 cm to 15.0 cm × 6.0 cm.According to the anatomical basis of ankle anterior perforating flaps,the sizes and shapes of the skin defects of the dorsal ankle,the flaps were designed and harvested in the anterior part of the lower leg to repair the dorsal skin soft tissue defects.The sizes of flaps ranged from 15.0 cm × 6.0 cm to 4.0 cm × 3.2 cm.The clinical effect was evaluated based on the flap survival,infection control,elasticity,color,appearance,scars of the donor sites,skin sensitivity and patient satisfaction.The extent of the flap swellings was also evaluated.Results All ten flaps survived after the surgery.Both the donor and recipient sites healed very well at Ⅰ stage.One case had flap distal phalanx necrosis.After changing the ointments on time,both the donor and recipient sites survived completely.Duration of follow-up was 3-24 months (mean,12 months).The flaps survived very well with good shape,and the color and elasticity were very close to the normal skin nearby.The scars of the donor sites were small and the functions of ankle and foot were satisfactory.Satisfaction extents of treatment efficacy were good in nine patients and general in two,with no unsatisfaction.Flap swelling classification were nine cases of degree Ⅱ and two cases of degree Ⅲ in early stage while 11 cases of degree Ⅰ in later stage.Conclusions The ankle anterior perforating flap has constant perforating blood vessels,reliable blood supply,high survival rate of flaps and hence is one of the simple,safe and optimal ways to repair the dorsal skin soft tissue defects.

Emergency repair method and its effect in treatment of large avulsion injury of lower extremity in elderly patients / 中华创伤杂志

Objective To evaluate the emergency repair method and its effect for treatment of extensive avulsion injury of the lower extremity in the elderly patients.Methods From May 2008 to February 2015,11 patients aged over 60 years sustaining large avulsion injury (across the knee or ankle joint) of the lower limb in traffic crushes were treated by emergency debridement and one-stage repair with the procedures of autologous skin replantation,arteriovenous anastomosis and vacuum sealing drainage (VSD).Two patients sustained injury to both lower limbs,and nine patients sustained a unilateral injury.Effect of wound repair was evaluated with skin flap survival area.Active and passive motility of the knee and ankle were recorded at postoperative 24 h.Results One patient with multiple fracture and extensive muscular inactivity due to severe crush injury to the lower limbs had poor blood supply after the replantation and was amputated at postoperative 24 h.The remaining ten patients with large skin avulsion showed 90％ of the avulsed skin survived after operation.At the follow-up of 3-24 months,the ten patients showed no obvious pigmentation or scar tissue,were satisfied with the function recovery in knee (106°-110° in flexion and 0°-5°in extension) and ankle joint (15°-20°in dorsiflexion and 30°-35° in plantar flexion),and could walk freely,including excellence outcomes in 3 patients and good outcomes in 6 patients.Conclusion The emergency repair methods including autologous skin replantation,arteriovenous anastomosis and VSD combined with one-stage in situ repair can attain satisfactory clinical effect.

Duodenal neuroendocrine carcinoma: a clinical analysis of 9 patients / 中华肝胆外科杂志

Objective To study the clinical manifestations,endoscopic features,pathological features,treatment and prognosis of patients with duodenal neuroendocrine carcinoma (DNEC).Methods The clinical data of 9 patients with duodenal neuroendocrine carcinoma who were admitted to our hospital from December 2006 to December 2014 were retrospectively analyzed.Results There were 6 males and 3 females.The mean age was 61.5 years (range 48 ～75 years).The clinical manifestations were abdominal pain (n =7),jaundice (n =4),melena (n =1) and asymptomatic (n =1).The DNEC was usually solitary in the duodenum.The operations included duodenopancreatectomy (n =5),surgical resection (n =2),subtotal gastrectomy (n =1),and 1 patient was palliated by common bile duct stenting using an endoscopic retrograde cholangio-pancreatographic (ERCP) approach.The patients were followed up for 3 ～ 40 months after operation.For the 5 patients who underwent radical excision 4 were alive.One patient died from liver metastasis.For the 4 patients who underwent palliative therapy,one was alive,two died and one lost to follow-up.Conclusions The clinical manifestations of duodenal neuroendocrine carcinoma were non-specific.Endoscopic,pathologic and immumohisotochemical tests were important in the diagnosis.Surgical resection improved the prognosis of these patients.

Digital anatomical analysis of drilling position of the clavicle in coracoclavicular ligament reconstruction / 中国组织工程研究

BACKGROUND:Coracoclavicular ligament reconstruction with transclavicular-transcoracoid driling is an effective surgical technique to treat acromioclavicular dislocation. A good driling in the clavicle leads to a perfect bony tunnel and a good surgery. OBJECTIVE: To observe the effects of different driling positions of the clavicle on the location of bony tunnels in coracoclavicular ligament reconstruction. METHODS:Sixty three-dimensional digital models of the clavicle and coracoid process were constructed by Mimics13.0. Virtual transclavicular-transcoracoid bony tunnels were established according to different surgical planes with different driling positions in the clavicle. Parameters of these bony tunnels were measured, and the safety was evaluated. Option 1: The driling was made 30 mm distal to the clavicle, located in the center of the front and rear edges of the clavicle surface. Option 2: The driling was made 40 mm distal to the clavicle, located in the center of the front and rear edges of the clavicle surface. Option 3: The driling was made at the straight line of tapered nodule tip and the midpoint of the base of the coracoid process, located at the rear edge of the clavicle upper surface. RESULTS AND CONCLUSION: Bony tunnels in option 1 were extremely on the inside of the coracoid. Bony tunnels in options 1 and 2 were not in the center of clavicle. Bony tunnels in option 3 were in the center of both clavicle and coracoid. The method of locating the driling position with a certain distance to the distal clavicle leads to different results in man’s and woman’s models. To ensure that the bony tunnel can pass through the center of clavicle and coracoid, it is suggested to dril at the straight line of tapered nodule tip and the midpoint of the base of the coracoid process and nearby the rear edge of the clavicle upper surface.

Clinical application of little finger ulnar palmar artery perforator flaps / 中华创伤杂志

Objective To investigate the feasibility of repairing soft-tissue defects of the fifth phalange and the back of hand with ulnar palmar artery perforator flaps from the little finger.Methods Based on anatomic dissection,the fifth phalange ulnar palmar artery perforator flaps were created and transferred to repair soft-tissue defects at the little finger and the back of hand in 15 cases.Types of injury were stamping injury in 5 cases,planer injury in 4 cases,mechanical crash injury in 3 cases,blast injury in 2 cases,and cicatrical contracture following electric burn in 1 case.Injury involved in the palmar aspect near the middle segment of fifth phalange in 4 cases,dorsal aspect near the middle segment of fifth phalange in 6 cases,ulnar mesiodistal of the back of hand in 3 cases,and distal ulnar palmar aspect of hands in 2 cases.There were 6 patients wounded in left hands and 9 patients wounded in right hands.Results All flaps survived and all wounds healed by first intention.At the follow-up of 2-18 months,the flaps resurfaced the soft-tissue defects with good color and texture match and the maintenance of contour and function of donor and recipient sites were satisfactory.Conclusion The fifth phalange ulnar palmar artery perforator flap,as it has advantages of constant perforator vessels,rich blood supply and good texture and can be operated safely and easily,is considered an ideal treatment choice in repairing softtissue defects of the fifth phalange and the back of hand.

Dynamic hip screw combined with trochanter stabilizing plate versus Gamma nail fixation in repair of intertrochanteric fracture / 中国组织工程研究

BACKGROUND:Intertrochanteric fracture can obtain good curative effects after active effective internal fixation in early stage. OBJECTIVE:To compare dynamic hip screw+trochanter stabilizing plate and Gamma nail fixation for treatment of Evans type IIIB and type IV intertrochanteric fracture. METHODS:A total of 67 patients with Evans type IIIB and type IV intertrochanteric fracture, including 28 cases undergoing dynamic hip screw+trochanter stabilizing plate and 39 cases undergoing Gamma nail, were selected from Chongming Branch, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from February 2009 to November 2012. Al patients received antibiotics and functional exercises after treatment. Time of therapy, intraoperative bleeding amount, fracture healing time and Harris Hip Score were retrospectively analyzed in patients of both groups. RESULTS AND CONCLUSION:Al patients were fol owed up for 6-45 months, averagely 21 months. (1) One patient affected infection in the dynamic hip screw+trochanter stabilizing plate group. He was healed after fixation removal half a year after drug exchange. One obese patient experienced injury again during out-of-bed activity at 3 weeks after treatment in the Gamma nail group. Fracture appeared at distal end of lock pin, and healed after replaced by Gamma nail. Trochanteric stabilizing plate was unstable in four patients of the Gamma nail group. They affected severe pneumonia after over 6 weeks of lying in bed, and healed after treatment in the medical department (2) Coxa vara appeared in two cases of the dynamic hip screw+trochanter stabilizing plate group, and three cases in the Gamma nail group. Fracture healing was achieved in al patients. (3) The time of therapy was longer, and intraoperative bleeding amount was significantly more in the dynamic hip screw+trochanter stabilizing plate group compared with the Gamma nail group (P0.05). Dynamic hip screw+trochanter stabilizing plate and Gamma nail are effective methods for treatment of Evans type IIIB and type IV intertrochanteric fracture. To choose a suitable fixator, we should aggregately analyze fracture stability, healing state and the degree of osteoporosis.

Effect of atorvastatin on serum ferritin levels in elderly male patients with acute coronary syndrome / 中国中西医结合急救杂志

Objective To explore the effect of atorvastatin application on serum ferritin(SF)levels in elderly male patients with acute coronary syndrome(ACS)and its clinical significance. Methods 120 elderly male patients treated in Department of Cardiology in Cangzhou People's Hospital were randomly divided into treatment group and control group(60 cases in each group). All the patients in the two groups took the standard treatment of coronary heart disease,and the patients in treatment group were additionally given atorvastatin 20 mg orally,once-daily for 1 month. After 1 month of treatment,the changes in SF and lipid levels before and after treatment were determined. Results The total cholesterol(TC),low density lipoprotein(LDL)and SF levels of the two groups after treatment were significantly decreased compared with those before treatment. After treatment,triacylglycerol (TG)was decreased,and high-density lipoprotein(HDL)was increased significantly in treatment group,while in the control group,after treatment TG was increased and HDL was decreased. Compared between treatment and control groups after treatment,the differences in SF,TC,TG,HDL and LDL levels were statistically significant〔SF(μg/L):174.33±99.87 vs. 255.66±100.34,TC(mmol/L):4.23±0.60 vs. 5.15±0.56,TG(mmol/L):1.98±0.64 vs. 2.00±1.03,HDL(mmol/L):1.13±0.14 vs. 1.09±0.22,LDL(mmol/L):2.45±0.33 vs. 3.35±0.50,P<0.05 or P<0.01〕. Conclusion In elderly male hospitalized patients with ACS,the level of SF is significantly higher than normal,after atorvastatin specification treatment,the blood fat and SF levels are significantly lower,thus the SF inducing myocardial damage may be reduced and the risk of recurrence of acute coronary events can be decreased.

Relationships between level of serum ferritin/blood lipid and coronary atherosclerotic cardiopathy in elderly patients with acute coronary syndrome / 中国中西医结合急救杂志

Objective To investigate the relationships between level of serum ferritin(SF)/blood lipid and the degree of coronary artery stenosis in elderly patients with acute coronary syndrome(ACS),and evaluate the value of SF in the diagnosis of coronary heart disease. Methods ①One hundred and twenty-five elderly patients with ACS(65 males,60 females)underwent coronary angiography examination,and the total cholesterol(TC), triglycerides(TG),high-density lipoprotein(HDL-C),low density lipoprotein(LDL-C)and SF were determined;according to the results of coronary angiography,the degree of coronary artery stenosis was obtained by using the Gensini score and the degrees of severity of stenosis were divided into three groups:light(42 cases),medium (45 cases)and severe(38 cases). The differences in levels of SF and blood lipids among the three groups were observed,and the relationships between the level of SF/blood lipids and various degrees of coronary artery stenoses were analyzed.②The elderly patients with ACS were divided into two groups,male and female,to compare the SF numerical value and Gensini score between the two groups. ③The SF numerical value and Gensini score of 65 senile male cases with ACS were compared to those of 60 middle aged male cases with the same disease. Results ①Variance analysis showed that SF,TC,LDL-C distribution had significant differences among light,medium and severe groups〔SF(μg/L):147.287±73.838,162.313±94.882,290.421±194.501;TC(mmol/L):4.423±0.900,4.998±0.740, 5.032±1.009;LDL-C(mmol/L):3.150±0.799,3.439±0.839,3.902±1.053,all P0.05);in elderly patients with ACS,SF was positively correlated with Gensini score(r=0.355,P=0.000),while there was no correlation between Gensini score and any one of the following lipids:TC,TG,LDL-C,HDL-C(r=0.090,-0.170,0.256,-0.060,P=0.532,0.092,0.089,0.537).②The comparisons of SF value and Gensini score between senile male and senile female patients with ACS showed no significant differences(all P>0.05).③The comparisons of SF value and Gensini score between senile and middle aged male patients with ACS also showed no significant differences(all P>0.05). Conclusion The occurrence of ACS has certain correlation with SF and lipids,the degree of severity in coronary artery lesion is associated with SF,and there are no differences in age and sex in relation to the value of SF in the diagnosis of ACS.

Determination of Active Components in Whitening and Freckle-removing Cosmetics by High Performance Liquid Chromatography / 环境与健康杂志

Objective To develop a high performance liquid chromatography(HPLC)method for the determination of active components,sodium ascorbic phosphate,?-arbutin,hydroquinone,niacinamide,brillian-280 and phenol,in the whitening and Freckle-removing cosmetics.Methods Whitening and freckle-removing active components were separated on a C8 column(250 mm?4.6 mm,5 ?m)by using triethanolamine solution(11.15g triethanolamine dissolved in 1 L water,pH=7.7 adjusted with 1.75 ml H3PO4)+methanol=70+30 as the mobile phase at a flow rate of 1.2 ml/min,using diode array detector(DAD)with the detection wavelengh of 273 nm and the column temperature of 25℃.Results The coefficient of variation was less than 4.7% and the recovery rates were 87.3%-112.9%.Conclusion The method introduced in this paper is simple,rapid,accurate and is suitable for the analysis of various cosmetic samples.