Clinical outcomes of proximal femoral reconstruction technique combined with THA in the treatment of high dislocation secondary to septic arthritis: a retrospective single-center study.

PURPOSE: The aim of this retrospective study was to examine the clinical outcomes and complications of proximal femur reconstruction (PFR) combined with total hip arthroplasty (THA) in patients with high hip dislocation secondary to septic arthritis (SA). METHODS: Between September 2016 to September 2021, we performed a series of 15 consecutive PFR combined with THA on patients with high dislocation of the hip secondary to SA, of these,12 hips were reviewed retrospectively, with a mean follow-up of 2.5 years (range, 1.5-6 years). The mean age of the patients at the time of surgery was 52 years (range, 40-70 years). RESULTS: All patients were followed up. At 1-year postoperative follow-up, the median HHS increased from 32.50 preoperatively to 79.50 postoperatively. The median VAS decreased from 7 before surgery to 2 at 1 year after surgery. The median LLD reduced from 45 mm preoperatively to 8 mm at 1 year after surgery. The mean operative time 125 ± 15 min (range 103-195 min). Mean estimated blood loss was500 ± 105ml (range 450-870 ml). Mean hospital days 9.5 days (range 6-15 days). Two patients developed nerve injuries that improved after nutritional nerve treatment. One patient had recurrent postoperative dislocation and underwent reoperation, with no recurrence dislocation during the follow-up. There were no cases of prosthesis loosening during the follow-up period. One patient developed acute postoperative periprosthetic joint infection (PJI) that was treated with Debridement, Antibiotics and Implant Retention (DAIR) plus anti-infective therapy, with no recurrence during 2 years of follow-up. CONCLUSION: This study indicates PFR combined with THA shows promise as a technique to manage high hip dislocation secondary to SA, improving early outcomes related to pain, function, and limb length discrepancy.

Towards Exploring Large Molecular Space: An Efficient Chemical Genetic Algorithm.

Generating molecules with desired properties is an important task in chemistry and pharmacy. An efficient method may have a positive impact on finding drugs to treat diseases like COVID-19. Data mining and artificial intelligence may be good ways to find an efficient method. Recently, both the generative models based on deep learning and the work based on genetic algorithms have made some progress in generating molecules and optimizing the molecule's properties. However, existing methods need to be improved in efficiency and performance. To solve these problems, we propose a method named the Chemical Genetic Algorithm for Large Molecular Space (CALM). Specifically, CALM employs a scalable and efficient molecular representation called molecular matrix. Then, we design corresponding crossover, mutation, and mask operators inspired by domain knowledge and previous studies. We apply our genetic algorithm to several tasks related to molecular property optimization and constraint molecular optimization. The results of these tasks show that our approach outperforms the other state-of-the-art deep learning and genetic algorithm methods, where the z tests performed on the results of several experiments show that our method is more than 99% likely to be significant. At the same time, based on the experimental results, we point out the insufficiency in the experimental evaluation standard which affects the fair evaluation of previous work. Supplementary Information: The online version contains supplementary material available at 10.1007/s11390-021-0970-3.

[Association between tea drinking and the risk of type 2 diabetes mellitus among rural adults in Deqing County:a prospective cohort study].

OBJECTIVE: To explore the associations between tea drinking and the incident risk of type 2 diabetes mellitus(T2 DM). METHODS: A dynamic prospective cohort study among a total of 27 841 diabetes-free permanent adult residents randomly selected from 2, 6 and 7 rural communities between 2006-2008, 2011-2012 and 2013-2014, respectively. Questionnaire survey, physical examination, and laboratory test were carried out among the participants. In 2018, we conducted a follow-up through the electronic health records of residents. Cox regression model were applied to explore the association between tea drinking and the incident risk of T2 DM and estimate the hazard ratio(HR), and its 95%CI. RESULTS: Among the 27 841 rural community residents in Deqing County, there were 10 726(38.53%) were tea drinkers, 8215 of which were green tea drinkers, accounting for 76.59%. Totally 883 new T2 DM incidents were identified until December 31, 2018, and the incidence density was 4.43 per 1000 person years(PYs). The incidence density was 4.07/1000 PYs in those with tea drinking habits and 4.71/1000 PYs in those without tea drinking habits, among which the incidence density was 3.79/1000 PYs in those with green tea drinking habits. After controlling for sex, age, education, farming, smoking, alcohol consumption, dietary preference, body mass index, hypertension, impaired fasting glucose, family history of diabetes, the risk of T2 DM among rural residents with tea drinking habits in Deqing County was 0.79 times higher than that among residents without tea drinking habits(HR=0.79, 95%CI 0.65-0.96), and the risk of T2 DM among residents with green tea drinking habits was 0.72 times higher than that among residents without tea drinking habits(HR=0.72, 95%CI 0.58-0.89). However, no significant associations were found between other kinds of tea and the risk of T2 DM, nor the amount of green tea to drink. CONCLUSION: Drinking green tea may reduce the risk of T2 DM among adult population in rural China.

Quality of life during the epidemic of COVID-19 and its associated factors among enterprise workers in East China.

BACKGROUND: The COVID-19 related lockdown and home confinement might have an important impact on the quality of life in enterprise workers. We investigated the quality of life during the epidemic in enterprise workers who just returned to work, and assessed its potential influencing factors to have a better understanding of the impact of COVID-19 epidemic lockdown and home confinement. METHODS: This was a cross-sectional study of enterprise workers conducted in Deqing and Taizhou, Zhejiang Province, China. The Chinese version of EQ5D was used to assess life quality, and information about general characteristics and COVID-19 related factors was collected by a structured questionnaire, which was distributed through the social application "WeChat". Multiple liner regression was used to investigate potential influencing factors. RESULTS: A total of 2420 participants were enrolled, 59.5% of which worked in Deqing. About 50% of the participants reported worries about the COVID-2019 epidemic and 40.2% had a centralized or home quarantine during the epidemic. The mean EQ-5D score and VAS were 0.990 and 93.5. Multiple liner regression showed that the quality of life measures was related to physical activities (ß = 0.006) and keeping home ventilation (ß = 0.063) in Deqing, and were related to wearing a mask when going out (ß = 0.014), keeping home ventilation (ß = 0.061), other marital status (ß = - 0.011), worry about the epidemic (ß = - 0.005) and having a centralized or home quarantine (ß = - 0.005) in Taizhou. CONCLUSIONS: The quality of life for returning enterprise workers in areas with different risks of COVID-19 was affected by different factors. Associated factors identified from this study would help develop proper intervention measures for enterprise workers to reduce the impact of large-scale public health events like the COVID-19 on their quality of life.

Peripheral artery disease and clinical outcomes in patients with atrial fibrillation: A systematic review and meta-analysis.

BACKGROUND: Atrial fibrillation (AF) is the most common cardiac rhythm disturbance and leads to morbidity and mortality. Peripheral artery disease (PAD) is associated with atherosclerotic risk factors and always classified as a vascular disease and deemed to be a bad complication of AF. In patients with AF, the risk and prognostic value of PAD have not been estimated comprehensively. HYPOTHESIS: PAD is associated with all-cause mortality, cardiovascular (CV) mortality, and other outcomes in patients with AF. METHODS: We searched PubMed, Embase, and Cochrane Library databases for prospective studies published before April 2021 that provided outcomes data on PAD in confirmed patients with AF. Heterogeneity was estimated using the I2 statistic. The fixed-effects model was used for low to moderate heterogeneity studies, and the random-effects model was used for high heterogeneity studies. RESULTS: Eight prospective studies (Newcastle-Ottawa score range, 7-8) with 39 654 patients were enrolled. We found a significant association between PAD and all-cause mortality (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.25-1.62; p < .001), CV mortality (HR, 1.64; 95% CI, 1.32-2.05; p < .001) and MACE (HR, 1.75; 95% CI, 1.38-2.22; p < .001) in patients with AF. No significant relationship was found in major bleeding (HR, 1.22; 95% CI, 0.95-1.57; p = 0.118), myocardial infarction (MI) (HR, 2.07; 95% CI, 1.17-3.67; p = .038), and stroke (HR, 1.14; 95% CI, 0.87-1.50, p = 0.351). CONCLUSIONS: PAD is associated with an increased risk of all-cause mortality, CV mortality, and MACE in patients with AF. However, no significant association was found with major bleeding, MI, and stroke.

The prospective effects of long-term exposure to ambient PM2.5 and constituents on mortality in rural East China.

Few cohort studies explored the associations of long-term exposure to ambient fine particulate matter with an aerodynamic diameter of 2.5 µm or less (PM2.5) and its chemical constituents with mortality risk in rural China. We conducted a 12-year prospective study of 28,793 adults in rural Deqing, China from 2006 to 2018. Annual mean PM2.5 and its constituents, including black carbon (BC), organic carbon (OC), ammonium (NH4+), nitrate (NO3-), sulfate (SO42-), and soil dust were measured at participants' addresses at enrollment from a satellite-based exposure predicting model. Cox proportional hazard model was used to estimate hazard ratios (HRs) and 95% confidence intervals (95%CIs) of long-term exposure to PM2.5 for mortality. A total of 1960 deaths were identified during the follow-up. We found PM2.5, BC, OC, NH4+, NO3-, and SO42- were significantly associated with an increased risk of non-accidental mortality. The HR for non-accidental mortality was 1.17 (95%CI: 1.07, 1.28) for each 10 µg/m3 increase in PM2.5. As for constituents, the strongest association was found for BC (HR = 1.21, 95%CI: 1.11, 1.33), followed by NO3-, NH4+, SO42-, and OC (HR = 1.14-1.17 per interquartile range). A non-linear relationship was found between PM2.5 and non-accidental mortality. Similar associations were found for cardio-cerebrovascular and cancer mortality. Associations were stronger among men and ever smokers. Conclusively, we found long-term exposure to ambient PM2.5 and its chemical constituents (especially BC and NO3-) increased mortality risk. Our results suggested the importance of adopting effective targeted emission control to improve air quality for health protection in rural East China.

Associations between serum amino acids and incident type 2 diabetes in Chinese rural adults.

BACKGROUND AND AIMS: Some amino acids (AAs) may be associated with type 2 diabetes (T2DM). This study aimed to determine the associations of individual AAs with the development of T2DM in rural Chinese adults. METHODS AND RESULTS: A cohort study of 1199 individuals aged 18 years or older was conducted from 2006 to 2008 in a rural community of Deqing, China, a repeated survey was done in 2015 and data linkage with the electronic health records system was performed each year for identifying new T2DM cases. A high-performance liquid chromatography approach was used to measure the baseline serum concentrations of 15 AAs. Cox proportional hazards models were used to examine the associations between AAs and the risk of incident T2DM. A total of 98 new T2DM cases were identified during the follow-up of 12 years on average. Among 15 AAs, proline was associated with an increased risk of incident T2DM after adjusted for age, sex, body mass index, fasting plasma glucose, family history of T2DM, smoking status, alcohol use, and history of hypertension, the adjusted hazard ratio for 1-standard deviation increment was 1.20 (95% confidence interval: 1.00, 1.43). The association tended to be more marked in subjects younger than 60 years and overweight/obese subjects. Among participants without hypertension, proline and phenylalanine were associated with an increased risk of incident T2DM, while aspartic acid was associated with a decreased risk. CONCLUSION: Serum proline was associated with the risk of incident T2DM in rural Chinese adults and might be a potential predictor.

Underweight rather than adiposity is an important predictor of death in rural Chinese adults: a cohort study.

BACKGROUND: To assess the associations of body mass index (BMI) with all-cause and cause-specific mortalities among rural Chinese. METHODS: A prospective study of 28 895 individuals was conducted from 2006 to 2014 in rural Deqing, China. Height and weight were measured. The association of BMI with mortality was assessed by using Cox proportional hazards model and restricted cubic spline regression. RESULTS: There were a total of 2062 deaths during an average follow-up of 7 years. As compared with those with BMI of 22.0-24.9 kg/m2, an increased risk of all-cause mortality was found for both underweight men (BMI <18.5 kg/m2) (adjusted HR (aHR): 1.45, 95% CI: 1.18 to 1.79) and low normal weight men (BMI of 18.5-21.9 kg/m2) (aHR: 1.20, 95% CI: 1.03 to 1.38). A J-shaped association was observed between BMI and all-cause mortality in men. Underweight also had an increased risk of cardiovascular disease and cancer mortalities in men. The association of underweight with all-cause mortality was more pronounced in ever smokers and older men (60+ years). The results remained after excluding participants who were followed up less than 1 year. CONCLUSION: The present study suggests that underweight is an important predictor of mortality, especially for elderly men in the rural community of China.

Investigation of the Association between 45 Tag SNPs and Type 2 Diabetes Mellitus in Han Chinese Adults: A Prospective Cohort Study.

INTRODUCTION: The objective of this study was to examine the association between type 2 diabetes mellitus (T2DM) and genes identified in previous genome-wide association studies (GWASs) in rural Han Chinese adults. METHODS: This prospective study included 1,832 adults aged ≥18 years in Deqing without diabetes at baseline. The subjects were followed up for 8.7 years on average. We selected 45 susceptible tag single-nucleotide polymorphisms (SNPs) for T2DM that have been identified in GWASs and genotyped. A Cox model was constructed to calculate the adjusted hazard ratios (aHRs) for the association between SNPs and incident T2DM. RESULTS: The incidence rate of T2DM was 12.0 per 1,000 person-years. After adjustment for covariates and a Bonferroni correction, rs17584499 of protein tyrosine phosphatase, receptor-type D (PTPRD), rs11257655 and rs10906115 of cell division cycle 123 gene (CDC123), and rs12970134 of melanocortin-4 receptor (MC4R) were significantly associated with incident T2DM. The aHRs for incident T2DM were 1.75 (95% confidence interval [CI]: 1.28-2.40) and 1.61 (95% CI: 1.27-2.04) in association with an increasing number of T alleles in rs17584499 and rs11257655 under an additive genetic model, and the aHR was 1.72 (95% CI: 1.33-2.22) with an increasing number of A alleles in rs10906115. The aHRs under the dominant model were 1.82 (95% CI: 1.25-2.66) for TT + CT versus CC of rs17584499 and 2.04 (95% CI: 1.47-2.86) for AA + AG versus GG of rs10966115. The aHRs under the recessive model were 2.99 (95% CI: 1.30-6.89) for TT versus CT + CC of rs17584499, 1.92 (95% CI: 1.39-2.70) for TT versus CT + CC of rs11257655, and 2.54 (95% CI:1.22-5.29) for AA versus AG + GG of rs12970134. In addition, an increased incidence of T2DM was significantly associated with the TA haplotype of rs11257655 and rs10906115 (aHR = 1.81, 95% CI: 1.12-2.92), while a decreased incidence was associated with the CG haplotype (aHR = 0.49, 95% CI: 0.35-0.68) and the CT haplotype of rs1111875 and rs5015480 (aHR = 0.61, 95% CI: 0.37-0.98). CONCLUSION: Variants of the PTPRD, CDC123, and MC4R genes were associated with the T2DM incidence in a rural Han Chinese population.

Depression and anxiety symptoms among returning workers during the COVID-19 period in East China.

PURPOSE: To determine the prevalence of depression and anxiety and associated factors among returning workers with different epidemic experience in East China. METHODS: A cross-sectional study was conducted among 2435 employees from the enterprises located in Deqing (low-risk epidemic area) and Taizhou (high-risk epidemic area) of East China in March 2020. An online questionnaire covered information on sociodemographic and lifestyle factors as well as knowledge, attitude, behavior and experience about COVID-19. The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) were applied to assess depression and anxiety symptoms, respectively. Logistic regression model was used to estimate adjusted odds ratios (aORs) and their 95% confidence intervals (CIs) for depression and anxiety symptoms associated with risk factors. RESULTS: The participants were aged 36.3 ± 9.2 years on average, and nearly half of them were female. Overall, the prevalence of depression, anxiety and both were 19.4%, 12.3% and 9.8%, and decreased with age. After adjustment for covariates, 16 or more years of education, being a white-collar worker or working in the high-risk epidemic area were significantly associated with increased risks of both depression and anxiety, in contract regular physical exercise was associated with decreased risks of both mental disorders. CONCLUSION: The depression and anxiety problems were prevalent among returning workers during the COVID-19 period. Targeted psychological interventions should be developed and implemented to improve their mental health.

Prevalence and associated factors of poor sleep quality among Chinese returning workers during the COVID-19 pandemic.

OBJECTIVES: The 2019 novel coronavirus (COVID-19) pandemic is a severe global crisis which has resulted in many public health problems. This study aimed to investigate the prevalence of poor sleep quality and its related factors among employees who returned to work during the COVID-19 pandemic. METHODS: Our online cross-sectional study included 2,410 participants aged ≥17 years in Deqing and Taizhou, Zhejiang Province, China from 5th to 14th March 2020. The questionnaire covered information on demographic characteristics, health status, workplace, lifestyle, attitude towards COVID-19, assessment of anxiety, depression and sleep quality. The Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) was administered to measure the poor sleep quality. Poor sleep quality was defined as a global PSQI score>5. Factors associated with sleep quality were analyzed by logistic regression models. RESULTS: In sum near half (49.2%) of 2,410 returning workers were females and the average year of subjects was 36.3 ± 9.1 years. The overall prevalence of poor sleep quality was 14.9% (95%CI: 13.5%-16.3%). The average score of PSQI was 3.0 ± 2.5 and average sleep duration was 7.6 ± 1.2 h. Independent related factors of poor sleep quality included age older than 24 years, higher education level, negative attitude towards COVID-19 control measures, anxiety and depression. CONCLUSIONS: Poor sleep quality was common and there was a shorter sleep duration among returning workers during the COVID-19 pandemic. Possible risk factors identified from this study may be of great importance in developing proper intervention for the targeted population to improve the sleep health during the COVID-19 public health emergency.

Poor sleep quality and influencing factors among rural adults in Deqing, China.

BACKGROUND: Poor sleep quality is prevalent and is associated with cognitive decline, impaired health, and reduced quality of life. There is a lack of studies about sleep quality and its potential risk factors among rural adults aged 45 years or above under rapid urbanization in China. METHODS: In a cross-sectional survey conducted in Deqing County, China in 2015, we included 1584 adults 45+ years of age. Sleep quality was measured by using the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI). Poor sleep quality was defined by a CPSQI global score > 5. Other data collected included sociodemographic and lifestyle factors as well as physical health. Logistic regression model was applied to assess factors influencing sleep quality by calculating crude odds ratio (cOR), adjusted OR (aOR), and their 95% confident intervals (CI). RESULTS: Of 1584 subjects, more than half were female with an average age of 58.9 ± 8.1 years. Their night sleep duration was 7.7 ± 1.2 h, sleep latency was 31.9 ± 32.0 min, and 17% of them could not fall asleep within half hour, averagely. The mean score of CPSQI was 4.4 ± 2.7. The prevalence of poor sleep quality was 27.7% (95% CI = 25.4-29.7%) overall, and there existed a significant sex difference-30.6% (95% CI = 27.7-33.7%) for women and 24.0% (95% CI = 20.9-27.2%) for men. Five domains of the CPSQI except for sleep efficiency and use of sleeping medication also showed a sex difference (p < 0.05). Logistic regression analysis indicated that unmarried status (aOR = 1.51, 95% CI = 1.03-2.22), lower monthly individual income (aOR = 2.09, 95% CI = 1.49-2.94), and chronic diseases (aOR = 1.95, 95% CI = 1.51-2.51) were significantly related to poor sleep quality. CONCLUSIONS: Sleep problems were prevalent among the rural Chinese adults aged 45+ years. People who were unmarried or had low personal income or any chronic diseases were more likely to have poor sleep quality.

[Prevalence and change of type 2 diabetes mellitus among rural adults in Deqing County, Zhejiang Province in China during 2006-2014].

OBJECTIVE: To describe the prevalence of type 2 diabetes mellitus( T2 DM) in rural Deqing County, Zhejiang Province, and explore its risk factors. METHODS: Random cluster sampling was used to select 8 rural communities in Deqing County, Zhejiang Province, and a cross-sectional survey was conducted in 2006-2008, 2011-2012 and 2013-2014, respectively. Totally, 6562 eligible subjects were investigated in 2006-2008, 11 763 eligible subjects in 2011-2012, and 10 904 eligible subjects in 2013-2014. Data on demography, life style and disease history, and physical examination such as height, weight and blood pressure were collected. Also, fasting plasma glucose was tested. T2 DM was defined as who having fasting plasma glucose ≥7. 0 mmol/L or was diagnosed by doctors or receiving diabetic treatment. RESULTS: In 2006-2008, 2011-2012 and 2013-2014, the standardized prevalences of T2 DM were 1. 2%, 1. 6% and 2. 1% and those of impaired fasting glucose( IFG) were 7. 2%, 18. 7% and22. 8%, respectively. There were increasing trends over years for both. After adjustment for other covariates in logistic regression, age( compared with age between 18 to 39. 9 years old: aOR_(40-59. 9)= 5. 20, 95% CI 2. 74-9. 89; aOR_(60-)= 8. 02, 95% CI 4. 19-15. 35), female( aOR = 1. 23, 95% CI 1. 02-1. 49), family history of T2 DM( aOR =4. 86, 95% CI 3. 49-6. 77), overweight/obesity( overweight: aOR = 1. 88, 95% CI1. 61-2. 20; obesity: aOR = 5. 10, 95% CI 4. 06-6. 41), hypertension( aOR = 2. 84, 95% CI 2. 44-3. 31), having meat mainly( aOR = 2. 25, 95% CI 1. 89-2. 69) and tea drinking( aOR = 0. 81, 95% CI 0. 68-0. 95) were significantly correlated with T2 DM. CONCLUSION: The prevalence of T2 DM increased over time in rural Deqing County, China. Age, gender, family history of T2 DM, overweight or obesity, hypertension, diet and drinking tea were significantly related to T2 DM.

Increased prevalence and incidence of anemia among adults in transforming rural China: two cross-sectional surveys.

BACKGROUND: Anemia remains one of the serious nutrition-related diseases in China, but data on incidence of anemia were less available, especially in rural area which are experiencing rapid urbanization. Out study aimed to estimate both the prevalence and incidence of anemia in transforming rural China. METHODS: We conducted a combined study of rural adults 18-64 years of age with a repeated cross-sectional component (4456 in 2006 and 2184 in 2008) and a cohort component (1424) in rural Deqing, China. Anemia was diagnosed based on blood hemoglobin levels using the hemiglobincyanide (HiCN) method according to both the World Health Organization (WHO) and Chinese criteria. The prevalence and incidence of anemia and their 95% confidential intervals (95% CI) were calculated. RESULTS: The prevalence of anemia based on the WHO criteria was 51.5% in 2006 and 53.7% in 2008, and the 2-year cumulative incidence was 42.1%. Of the cases, over 95% had mild anemia. The prevalence was much lower when the Chinese criteria was used. Both the prevalence and incidence were higher in women than in men and significantly increased with age in men. In both sexes, the incidence sharply increased after 45 years of age. CONCLUSION: Our study showed a high prevalence and incidence of anemia among adults in rural Deqing, China. Monitoring and intervention were needed urgently, especially among individuals over 45 years of age.

[Study on the prevalence and genotype of hepatitis E virus among commercial swine population in Eastern and Southern China].

OBJECTIVE: To determine the prevalence and genotype of hepatitis E virus (HEV) among commercial swine population in Eastern and Southern China. METHODS: Six hundred specimens of swine bile collected from 5 slaughterhouses in Eastern and Southern China from 2007 to 2009 were tested for HEV RNA using nested RT-PCR. PCR products were sequenced for phylogenetic analysis. RESULTS: Forty-seven out of the 600 samples (7.83%) were positive for HEV RNA. Based on the 150 nt fragment within HEV ORF2, data from phylogenetic analysis revealed that all the 47 HEV isolates were identified to be genotype IV, sharing 75.0% - 83.4%, 75.0% - 84.6%, 71.9% - 80.7% and 88.1% - 91.5% nucleotide identities with prototype I, II, III and IV HEV strains respectively while majority of the isolates clustered within their respective isolation sites. CONCLUSION: HEV was widespread in commercial swine population in Eastern and Southern China that raised a serious concern about the safety regarding the consumption of pork products.

Factors influencing the treatment of severe gluteal muscle contracture in children.

Usually the treatment of severe gluteal muscle contracture in children does not achieve a satisfactory clinical result and the disease is prone to recurrence after surgery. The aim of this study was to analyze the factors influencing the recovery of children with severe gluteal muscle contracture. Between 1997 and 2008, 428 children (mean age: 8 years) were subjected to surgical operations combined with functional exercises and physical therapy and were followed for 12-24 months with satisfactory clinical outcomes. In this series, the outcomes were found to be excellent in 400 cases, good in 22 cases, and fair in six cases with no patient having a poor result. No serious complications, such as sciatic nerve injury, dislocation, or osteonecrosis of the femoral head were found in the patients. Unsteadiness in walking and positive Trendelenburg sign were found in postoperative functional exercises in 16 patients, which may be the result of excessive resection of the gluteus medius and the gluteus minimus. However, the symptoms in all the cases disappeared within 3 months by rigorous functional exercise. We evaluated the factors that potentially influence the clinical outcome retrospectively and it was concluded that the surgery was highly beneficial for the treatment of the patients. Postoperative functional exercise and physical therapy could reduce the complications and maintain the favorable effects of surgery. In addition, the identification of the disease, the age of patients, and the rehabilitation procedures after hospital discharge were found to be very important for the successful treatment of this condition.

[Phylogenetic analysis of sporadic hepatitis E virus in Eastern China].

OBJECTIVE: To understand phylogenetic characteristics of sporadic hepatitis E virus (HEV) in eastern China. METHODS: Four hundred and thirteen sera were collected from sporadic hepatitis E cases in 14 second- or first-class hospitals in Eastern China from 2005 to 2008 and detected with a nested RT-PCR assay. Partial nucleotide sequences of the HEV isolates were determined for phylogenetic analysis with prototype sequences in the GenBank. RESULTS: The male-to-female sex ratio of the patients was 1.75:1 with 61.5% of them aged 40 - 69 years old. HEV RNA was detected in 140 out of 413(34%)serum samples. Phylogenetic analysis revealed that all the 140 HEV isolates belonged to genotype IV, sharing 77.9% - 88.3%, 80.8% - 90.6%, 73.4% - 85.2% and 91.0% - 95.4% nucleotide sequence identities with prototype I, II, III and IV HEV isolates respectively. CONCLUSION: It was evident that genotype IV HEV served as the main causative agent of sporadic HEV infection in Eastern China. However the viral origin and evolution needs further clarification.

[Relationship between tea-drinking and anaemia of rural reproductive married women in a community-based cross-sectional study in China].

OBJECTIVE: To determine the prevalence of anaemia and the relationship between tea-drinking and anaemia in reproductive married women in rural China. METHOD: A cross-sectional study was carried out in four rural communities in Deqing County, Zhejiang Province, China. A total of 1425 reproductive married women at the ages of 20 to 49 years participated in this study and had a satisfactory measure of hemoglobin. Their general information, health status and lifestyle behaviors were collected. Hemoglobin was tested by Drabkin Method. Chi-square test, and binary and multinomial Logistic regression models were used for statistical analysis in SPSS 11.0. RESULT: Among 1425 subjects, the average concentration of hemoglobin were 114.7 +/- 17.0 g/L, the prevalences of anaemia were 63.3%, and most were mild and moderate anaemia (Such prevalence were 63.5%, 63.2% and 63.4% respectively at the ages of 20-30 years, 31-40 years, and 41-49 years.). Subjects with tea-drinking were higher in average concentration of hemoglobin than those of no tea-drinking (t = 3.33, P = 0.001). There were significant associations between tea-drinking and anaemia OR was 0.56 (95% CI: 0.45, 0.73). Further, such protective effects of tea-drinking were observed among subjects with different anaemia [ORs were 0.57 (95% CI: 0.43, 0.75), 0.57 (95% CI: 0.43, 0.75), and 0.28 (95% CI: 0.11, 0.70)] in mild, moderate and severe anaemia, respectively. CONCLUSION: The prevalence of anaemia in reproductive married women in rural of China could be higher and tea-drinking could be a possible protective factor.

[Seasonal pattern and phylogenetic analysis with human isolates of genotype-IV hepatitis E virus in swine herds, eastern China].

OBJECTIVE: To determine the seasonal prevalence of genotype-IV hepatitis E virus (HEV) in swine herds in Eastern China and explore the phylogenetic relationship between swine HEV and human HEV in the situation that zoonotic features of HEV had been confirmed. METHODS: From September 2007 to June 2008, a total of 1200 swine bile specimens were collected from three slaughter houses located in Zhejiang, Anhui and Jiangsu, the Eastern China, and detected for HEV RNA by using nested RT-PCR. The positive PCR products were sequenced. Then the swine HEV were phylogenetically determined with human HEV isolated in Eastern China. RESULTS: The positive rate for HEV RNA in swine herds was 4.5% totally. Significant differences of HEV detection were not observed among seasonal pattern (Sep - Oct: 6%, Dec - Jan: 4.33%, Mar - Apr: 4.33%, May - Jun: 3.33%) but in geographic distribution (Jiangsu: 6%, Anhui: 5%, Zhejiang: 2.5%). Regardless of isolation from different areas,swine and human genotype-IV HEV shared a high similarity. Phylogenetically, there were 80% - 100% and 96% - 100% identities within swine genotype-lV HEV at the nucleotide and amino acid levels respectively. Between swine HEV and human HEV, there were also similarities of 76% -99% and 95% - 100%. It was noted that some human and swine isolates were clustered with bootstrap values of > 90%. CONCLUSION: Genotype-IV HEV is widely prevalent in swine herds in Eastern China and original common ancestor of evolution and transmission was implied. The sustaining prevalence within swine herds should have a probable influence on the epidemic situation of hepatitis E in human beings.

[A cost-effectiveness study on a case-finding program of tuberculosis through screening those suspects with chronic cough symptoms in the rich rural areas].

OBJECTIVE: To study the feasibility and cost-effectiveness of a case-finding program on tuberculosis (TB) in richer rural areas. METHODS: Screening was implemented every three months for a total period of 9 months, in rural areas with high case notification rates. Three villages, each with ten thousand population, were selected to carry out a household screening program. A suspect was defined as who coughed for more than 3 weeks. The suspect was then referred to further diagnosis in county TB dispensary to undergo chest X-ray and sputum test. RESULTS: Of the 86,168 community population screened, 26 TB patients were identified with 7 of them were smear positive. The ratio of effectiveness vs. cost decreased on the second but slightly increased on the third screening program. The direct costs for the 3 screening programs were 6,312,397 and 1637 RMB respectively. Of total direct cost, 5.9% was paid by TB patients, whereas 35.9% was through financing of the county itself. CONCLUSION: The community household screening program could achieve higher case detection rate than passive case-finding approach which could be used in richer areas with low case detection rate in China.