Complicated Bosworth fracture-dislocation: A case report and review of the literature / 中华创伤杂志(英文版)

Bosworth fracture and dislocation is relatively rare, accounting for about 1% of ankle fractures. It is characterized by the proximal fibula fracture embedded in the posterolateral distal tibia. Due to an insufficient understanding of this fracture, it is easy to cause missed diagnosis and misdiagnosis in clinical practice. Due to the insertion of the fracture, it is challenging to perform closed reduction, and improper treatment is easy to cause complications. Surgical treatment is recommended for this type of fracture. In order to improve the understanding of orthopedic surgeons about Bosworth fracture and dislocation, this paper reports the diagnosis and treatment of 2 cases of Bosworth fracture and dislocation, and reviews the literature on Bosworth fracture's mechanism, diagnosis, classification, complications, and treatment options in recent years.

Progress on knee cartilage repair by knee joint distraction / 中国骨伤

Knee joint distraction is a new technology for the treatment of knee osteoarthritis in recent years. It could reduce knee pain and improve knee function, which is inseparable from the role of cartilage repair. The mechanism and influencing factors of knee joint distraction in repairing cartilage are the focus of current research. In this paper, the author reviewed literature and found that knee joint distraction could reduce knee joint load and provide a appropriate mechanical environment for cartilage repair, and it is resulting hydrostatic pressure fluctuation in the knee joint not only helps cartilage to absorb nutrients, but also promotes cartilage formation genes and inhibits cartilage matrix degrading enzyme gene expression. In addition, knee joint distraction creates conditions for synovial mesenchymal stem cells to be collected to cartilage injury, and improves ability of synovial mesenchymal stem cells to proliferate and differentiate into a chondrogenic lineage. Knee joint distraction could reduce inflammatory reaction and cartilage injury of knee joint by reducing content of inflammatory factors and inhibiting expression of inflammatory genes. At present, it is known that the factors affect repair of cartilage by knee joint distraction include, increasing weight-bearing activity and height and time of distraction is helpful for cartilage repair, male patients and patients with higher severity of knee osteoarthritis have better cartilage repair effect after knee joint distraction.The better efficacy of cartilage repair on the first year after knee joint distraction predicts a higher long-term survival rate of knee joint distraction with knee preservation. However, the research on the above hot spots is only at the initial stage and further exploration is still needed, in order to better guide clinical application of knee joint distraction.

Analysis of drug resistance gene in Mycoplasma pneumoniae and 13 pathogens in bronchoalveolar lavage fluid of children with Mycoplasma pneumoniae pneumonia / 中华实用儿科临床杂志

Objective:To investigate drug resistance gene in Mycoplasma pneumoniae(MP) and the distribution of 13 respiratory pathogens in bronchoalveolar lavage fluid(BALF) of children with Mycoplasma pneumoniae pneumonia(MPP).Methods:A total of 100 BALF of children with MPP in Peking University Third Hospital and Peking University First Hospital from January 2018 to January 2019 were collected.Fluorogenic quantitative PCR was used to detect nucleic acid and it′s drug resistance gene of MP and multiple PCR method was adopted to detect influenza A virus, influenza A virus-H 1N 1, influenza A virus-H 3N 2, influenza B, human parainfluenza virus, adenovirus, human bocavirus, human rhinovirus, Chlamydia pneumoniae, human metapneumovirus, MP, human coronavirus, and respi-ratory syncytial virus gene, and the results were compared by using Chi square test. Results:In 100 BALF samples, MP and drug resistance gene were detected by fluorogenic quantitative PCR.Totally, 83 cases (83.00%) were MP positive and 78 cases (93.98%) were drug resistant.All of them had the point mutations A2063G in V region of 23S rRNA domain.A total of 13 kinds of respiratory pathogens were detected by multiplex PCR method, and 89 cases (89.00%) were positive.Totally, 79 cases (79.00%) were MP positive, of which 74 cases (74.00%) detected only MP, and 5 cases (5.00%) detected MP combined with other pathogens.Other pathogens were detected in 10 cases (10.00%). The virus detection rate of 0-4 years old group was higher than that of >4-6 years old group ( P=0.042) and >6 years old group ( P=0.002), and the differences were statistically significant. Conclusions:MP can be detected in most BALF samples of MPP children, the drug resistance phenomenon is serious, and the main point mutation is A2063G.There were other respiratory pathogens and 2 or 3 pathogens were detected in a small number of BALF samples.

Application of short-term training path for prenatal ultrasound diagnostician in primary hospitals / 中华医学教育探索杂志

Objective:To explore the establishment and effect of short-term training path for prenatal ultrasound diagnosticians in primary hospitals.Methods:A total of 105 trainees from in total 5 batches of the "prenatal ultrasound screening training base" in Chongqing were selected as the research objects, and a combination of multiple teaching methods was used to carry out specialized training for primary prenatal ultrasound screening doctors before and after training. Theoretical examinations and practical operation assessments were performed, and after training, remote image quality control and continuous improvement methods were established for trainees to assess training effectiveness. SPSS 21.0 was used for t test, Wilcoxon test and chi-square test. Results:After training, the results of the theoretical examinations and practical operation examinations of the trainees were higher than those before the training ( P<0.05), and after the completion of the training, the number of trainees who returned to their original units to carry out prenatal ultrasound examination, the average number of prenatal ultrasound examinations per month and the number of referrals to higher prenatal diagnosis centers of each trainee increased significantly ( P<0.05). Conclusion:The establishment of short-term training path for prenatal ultrasound diagnosis can effectively improve the professional theoretical knowledge and practical operation level of prenatal ultrasound doctors in primary hospitals, and greatly solve the problem of technical promotion under the shortage of grassroots hospitals.

Three-dimensional printing combined with open reduction and internal fixation versus open reduction and internal fixation in the treatment of acetabular fractures: A systematic review and meta-analysis / 中华创伤杂志(英文版)

PURPOSE@#This meta-analysis compared the clinical outcome of three-dimensional (3D) printing combined with open reduction and internal fixation (ORIF) to traditional ORIF in the treatment of acetabular fractures.@*METHODS@#We searched the Cochrane Library, PubMed, Embase, VIP database, CNKI, and Wanfang database with keywords "acetabular fracture", "3D printing", "three-dimensional printing", "open reduction and internal fixation", "Acetabulum", "Acetabula" from January 2000 to March 2020. Two reviewers independently selected articles, extracted data, assessed the quality evidence and risk bias of included trials using the Cochrane Collaboration' s tools and/or Newcastle-Ottawa scale. When the two analysts had different opinions, they would ask the third analyst for opinion. Randomized controlled trials or retrospective comparative studies of 3D printing combined with ORIF (3D printing group) versus traditional ORIF (conventional group) in the treatment of acetabular fractures were selected. The data of operation time, intraoperative blood loss, intraoperative fluoroscopy times, incidence of complications, excellent and good rate of Matta score for reduction, and excellent and good rate of hip function score were extracted. Stata14.0 statistical software was used for data analysis.@*RESULTS@#Altogether 9 articles were selected, including 5 randomized controlled trials and 4 retrospective studies. A total of 467 patients were analyzed, 250 in the conventional group, and 217 in the 3D printing group. The operation time in the 3D printing group was less than that in the conventional group and the difference was statistically significant (standardized mean difference (SMD) = -1.19, 95% CI: -1.55 to -0.82, p  0.05). There was no significant difference in the excellent and good rate of hip function score at the end of postoperative follow-up between the two groups (OR = 0.84, 95% CI: 0.46-1.56, p > 0.05), but the follow-up time varies from 6 months to 40 months.@*CONCLUSION@#Compared with traditional ORIF, 3D printing combined with ORIF has certain advantages in terms that 3D printing not only helps surgeons to understand acetabular fractures more intuitively, but also effectively reduces operation time, intraoperative blood loss, intraoperative fluoroscopy times, and postoperative complications. However, there were no significant differences in the excellent and good rate of Matta score for reduction and the excellent and good rate of hip function score at the end of follow-up.

The Prediction of Hepatitis E through Ensemble Learning.

According to the World Health Organization, about 20 million people are infected with Hepatitis E every year. In 2015, there were 44,000 deaths due to HEV infection worldwide. Food, water and climate are key factors that affect the outbreak of Hepatitis E. This paper presents an ensemble learning model for Hepatitis E prediction by studying the correlation between historical epidemic cases of hepatitis E and environmental factors (water quality and meteorological data). Environmental factors include many features, and ones that are most relevant to HEV are selected and input into the ensemble learning model composed by Gradient Boosting Decision Tree (GBDT) and Random Forest for training and prediction. Three indicators, root mean square error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE), are used to evaluate the effectiveness of the ensemble learning model against the classical time series prediction model. It is concluded that the ensemble learning model has a better prediction effect than the classical model, and the prediction effectiveness can be improved by exploiting water quality and meteorological factors (radiation, air pressure, precipitation).

Implementation of High-Performance Blockchain Network Based on Cross-Chain Technology for IoT Applications.

With the development of technology, the network structure has changed a lot. Many people regard the Internet of Things as the next-generation network structure, which means all the embedded devices can communicate with each other directly. However, some problems remain in IoT before it can be applied in a large scale. Blockchain, which has become a hot research topic in recent years, may be one of the solutions. However, currently, the transaction speed of blockchain is still a disadvantage compared to traditional transaction methods. This paper focuses on to implement a high-performance blockchain platform. After investigation of the current blockchain consensus algorithm and blockchain architecture, we propose: (1) an improved blockchain consensus algorithm, which is implemented based on the mortgage model instead of probability model; (2) a cross-chain protocol with transverse expansion capacity, which would support the message transmission among chains; (3) a high-performance cross-chain blockchain network structure, which could handle more than 1000 transactions per second per chain by verification. Experiments have been carried out, and shown that the cross-chain blockchain network structure we provided is feasible to meet the requirement of large-scale distributed IoT applications.

Enlightenment from pathogen analysis and comparison of detection methods in 580 cases of influenza-like cases / 中华实用儿科临床杂志

Objective:To understand the pathogen distribution of children with influenza in North China in the past 2018-2019 years, and compare the accuracy of influenza virus antigen test results with that of influenza virus nucleic acid test results, provide reference data for clinical use good influenza virus pathogen detection methods.Methods:Five hundred and eighty throat swab samples of influenza-like children in 10 hospitals, northern China, were collected from December 2018 to January 2019.Each sample was tested by rapid influenza diagnostic test and reverse-transcription polymerase chain reaction(RT-PCR).Results:Of all 580 clinical samples, 256 positive samples (256/580 cases, 44.14%)were detected by the influenza rapid influenza diagnostic test, of which 235 were pure influenza A(235/256 cases, 91.8%), 21 cases were pave influenza B(21/256 cases, 8.2%), and 324 case were negative samples(324/580 cases, 55.86%). No cases were detected positive A and B at the same time.Of all 580 samples were detected using the A /B influenza virus RT-PCR, and a total of 353 cases(353/580 cases, 60.9%) were positive (of which 242 cases were influenza virus antigen-positive), of which 311 were pure A influenza(311/353 cases, 88.1%) and 41 were pure B influenza(41/353 cases, 11.6%), 1 case of mixed infection of A and B(1/353 cases, 0.3%), and 227 cases were negative(227/580 cases, 39.1%). In 324 cases of influenza virus antigen negative samples, 111 cases(111/324 cases, 34.3%) were positive for influenza virus nucleic acid.The detection rate of influenza A in Taiyuan was 23.2% (22/95 cases), and the detection rate of influenza B was 43.2% (41/95 cases), which was significantly different from other regions.With reverse-transcription polymerase chain reaction detection as the standard, the diagnostic value of influenza pathogen detection reagents was evaluated.The sensitivity, specificity, missed diagnosis rate, misdiagnosis rate, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, Youden index and area under the receiver operating characteristic curve were 68.56%, 93.83%, 31.44%, 6.17%, 94.53%, 65.74%, 11.12, 0.335, 0.624 and 0.812.Conclusions:From December 2018 to January 2019, the majority of children′s influenza in northern China is influenza A virus.Except Taiyuan which is dominated by influenza B. Influenza virus nucleic acid detection has high sensitivity and specificity for diagnosing influenza, and also has the ability to distinguish virus subtypes.Influenza virus antigen detection has a certain diagnostic value, a good specificity (93.83%), sensitivity (68.56%) which needs to be further improved, and a certain rate of missed diagnosis (31.44%) needs to be paid attention to possible missed diagnosis.Detecting positive cases of influenza virus antigens should be given a fast and effective anti-viral treatment, while the negative cases, especially those at high risk for influenza complications, should be confirmed influenza virus RT-PCR as soon as practical.

Feasibility of quantitative measurement of fetal trachea and bilateral bronchial angles by ultrasound to diagnose heterotaxy syndrome in middle and late pregnancy / 中华围产医学杂志

Objective@#To analyze the feasibility of prenatal ultrasound quantitative measurement of the angles between trachea and bilateral bronchi as a new diagnostic tool for fetuses with heterotaxy syndrome.@*Methods@#The angles between trachea and bilateral bronchi were measured at 18-34+6 gestational weeks for 200 fetuses with normal ultrasound findings (normal group) and 41 fetuses with heterotaxy syndrome [35 right atrial isomerisms (right group) and six left atrial isomerisms (left group)] diagnosed by ultrasound and confirmed after abortion or induction (case group) in Chongqing Health Center for Women and Children from October 2015 to December 2018. Scatter plots of left/right bronchus angle (α/β) ratios were drawn. Differences in bilateral bronchus angles between the three groups were statistically analyzed using one-way analysis of variance and paired t-test.@*Results@#In the normal group, scatter plots showed the α/β ratios were relatively constant at 0.8-1.0 with larger β than α (t=-33.14, P<0.05), indicating that the right bronchus always went more steeply than the left one. In the case group, the α/β ratios were around 1.0. In the right group, the α value increased and was close to the β value [(153.90±5.43)° vs (156.02±5.59)°, t=-2.56, P>0.05] and presented as bilateral right bronchial angle; in the left group, the β value decreased and was close to the α value [(147.38±3.16)° vs (148.82±5.56)°, t=-1.18, P>0.05] and presented as bilateral left bronchial angle. There were significant differences in the α and β values among the normal group, the right and left groups (all P<0.05), and the bronchial angles of the right group were both greater than those of the left group (all P<0.05).@*Conclusions@#Prenatal ultrasound measurement of the angles between trachea and bilateral bronchi can be used as an indirect indicator for the diagnosis of heterotaxy syndrome.

Feasibility of quantitative measurement of fetal trachea and bilateral bronchial angles by ultrasound to diagnose heterotaxy syndrome in middle and late pregnancy / 中华围产医学杂志

Objective To analyze the feasibility of prenatal ultrasound quantitative measurement of the angles between trachea and bilateral bronchi as a new diagnostic tool for fetuses with heterotaxy syndrome.Methods The angles between trachea and bilateral bronchi were measured at 18-34+6 gestational weeks for 200 fetuses with normal ultrasound findings (normal group) and 41 fetuses with heterotaxy syndrome [35 right atrial isomerisms (right group) and six left atrial isomerisms (left group)] diagnosed by ultrasound and confirmed after abortion or induction (case group) in Chongqing Health Center for Women and Children from October 2015 to December 2018.Scatter plots of left/right bronchus angle (α / β) ratios were drawn.Differences in bilateral bronchus angles between the three groups were statistically analyzed using one-way analysis of variance and paired t-test.Results In the normal group,scatter plots showed the α/β ratios were relatively constant at 0.8-1.0 with larger β than α (t=-33.14,P＜0.05),indicating that the right bronchus always went more steeply than the left one.In the case group,the α/β ratios were around 1.0.In the right group,the α value increased and was close to the β value [(153.90±5.43) ° vs (156.02±5.59) °,t=-2.56,P＞0.05] and presented as bilateral right bronchial angle;in the left group,the β value decreased and was close to the α value [(147.38±3.16)° vs (148.82±5.56) °,t=-1.18,P＞0.05] and presented as bilateral left bronchial angle.There were significant differences in the α and β values among the normal group,the right and left groups (all P＜0.05),and the bronchial angles of the right group were both greater than those of the left group (all P＜0.05).Conclusions Prenatal ultrasound measurement of the angles between trachea and bilateral bronchi can be used as an indirect indicator for the diagnosis of heterotaxy syndrome.

[Distribution Characteristics and Health Risk Assessment of Metals in Drinking Water Sources from the Luhun Reservoir].

In order to investigate the distribution characteristics and the human health risks of 12 metals in drinking water sources from the Luhun Reservoir, Al, As, Cd, Cr, Cu, Fe, Hg, Mn, Mo, Ni, Pb, and Zn concentrations in 46 water samples collected from the reservoir in 2016 were measured and analyzed. The health risks caused by metals were assessed by using a human health risk assessment model. The results showed that the maximum concentration of Al (200.27 µg·L-1) and all concentrations of Mo (151.42-170.69 µg·L-1) in drinking water from the Luhun Reservoir exceeded the Environmental Quality Standards for Surface Water (GB 3838-2002) and Standards for Drinking Water Quality (GB 5749-2006) by 4.35% and 100%, respectively. A distinct spatial heterogeneity was found in the metal distribution, and the region with the highest metals concentrations was located southwest (upstream) and northeast (downstream) of the reservoir. The results of a health risk assessment indicated that children had greater health risks than adults. The health risks for metals through drinking were all higher than the values caused by dermal contact. Carcinogenic risks caused by Cr and As exceeded the maximum allowance levels (5×10-5 a-1) by 100% and 3.80%, respectively, and Cr accounted for 85% of the total carcinogenic risks. The non-carcinogenic risks of the metals (10-12-10-7 a-1) decreased in the order of Al > Mo > Cu > Pb > Ni > Hg > Fe > Zn > Mn, which had levels two to seven orders of magnitude lower than the maximum allowance levels.

A Lightweight Anonymous Authentication Protocol with Perfect Forward Secrecy for Wireless Sensor Networks.

Due to their frequent use in unattended and hostile deployment environments, the security in wireless sensor networks (WSNs) has attracted much interest in the past two decades. However, it remains a challenge to design a lightweight authentication protocol for WSNs because the designers are confronted with a series of desirable security requirements, e.g., user anonymity, perfect forward secrecy, resistance to de-synchronization attack. Recently, the authors presented two authentication schemes that attempt to provide user anonymity and to resist various known attacks. Unfortunately, in this work we shall show that user anonymity of the two schemes is achieved at the price of an impractical search operation-the gateway node may search for every possible value. Besides this defect, they are also prone to smart card loss attacks and have no provision for perfect forward secrecy. As our main contribution, a lightweight anonymous authentication scheme with perfect forward secrecy is designed, and what we believe the most interesting feature is that user anonymity, perfect forward secrecy, and resistance to de-synchronization attack can be achieved at the same time. As far as we know, it is extremely difficult to meet these security features simultaneously only using the lightweight operations, such as symmetric encryption/decryption and hash functions.

Quantitative ultrasound analysis in evaluation of fetal lung maturity / 中国介入影像与治疗学

Objective To investigate the application value of DFY-Ⅱ ultrasound imaging analysis software in evaluation of fetal lung maturity in different pregnancy.Methods Totally 315 cases of healthy single pregnancies (24-41 weeks) were collected.The sonographic views of fetal right side sagittal plane were obtained.The echo intensity of fetal lung and liver were analyzed and the ratio was canculated with DFY-Ⅱ ultrasound imaging analysis software.Results The ratio of echo intensity from fetal lung and liver had positive correlation with gestational weeks (r=0.94,P＜0.05),the linear regression equation was Y=0.60+0.07X (r2 =0.883).Conclusion The ratio of echo intensity by fetal lung and liver analyzed with DFY-Ⅱ ultrasound imaging analysis software can be an effective method to evaluate fetal lung maturity.

Simultaneous pancreas-kidney transplantation in a single center: 10-year retrospective analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Simultaneous pancreas-kidney transplantation (SPKT) is the best treatment option for diabetic patients with advanced chronic renal failure. The current study aimed to analyze the surgical indications, treatments and prognosis of SPKT.</p><p><b>METHODS</b>We retrospectively analyzed 40 cases of SPKT performed between December 1999 and January 2010 in our center, including the survival rate, complications and the reasons of reoperation.</p><p><b>RESULTS</b>Of all the 40 SPKT cases, the one-year survival rates of the recipients, kidney and pancreas transplant graft were 97.6%, 97.6% and 92.7%, while 97.6%, 91.1%, 92.7% at 3 years and 83.6%, 78.0%, 79.4% at 5 years, respectively. After SPKT, 10 patients need reoperation because of surgical complications (14 operations). The reoperation rate was 25%, including 2 patients (4 operations) with hematuria, 4 patients with abdominal hemorrhage, 2 patients (3 operations) with abdominal infection, 1 patient with pancreatic venous thrombosis, 1 patient with anastomotic leakage, and 1 patient with fistula.</p><p><b>CONCLUSION</b>Although SPKT provides a successful and effective treatment for diabetics with end-stage renal disease, how to reduce the complications of this treatment still need further effort.</p>

Charge-selective recognition at fibroin-modified electrodes for analytical application.

A novel fibroin-modified electrode with charge recognition is reported. The characteristics of silk fibroin membranes have been exploited for analytical applications. The membrane, with an isoelectric point of pH 4.5, was applied to graphite and carbon-fiber electrodes. The modified electrode was negatively charged in solutions of pH > 4.5, and so rejected anions and attracted cations. In solutions of pH < 4.5 the electrode was positively charged, and so rejected cations and attracted anions. The pH-responsive charge recognition of the modified electrode was investigated for some neurocompounds. A fibroin carbon-fiber electrode was used for in-vivo determination of the concentration of the cationic neurotransmitter dopamine (DA).

[Dexamethasone enhances the effect of tropisetron and ondansetron against nausea and vomiting against nausea and vomiting after patient-controlled analgesia].

OBJECTIVE: To study the enhancement by dexamethasone of the effect of ondansetron and tropiesetron against postoperative nausea and vomiting (PONV) in patients receiving patient-controlled analgesia (PCA) and observe the effect of dexamethasone on wound healing. METHODS: One hundred and twenty elective surgical patients receiving PCA were divided into 4 groups, including 2 control groups with the prescription of ondansetron (8 mg) and tropiesetron (3 mg) respectively (control A and B) and 2 observation groups in which the patients were given ondansetron (8 mg) plus dexamethasone (10 mg) and tropiesetron (3 mg) plus dexamethasone (10 mg) respectively (observation groups C and D). The incidence and severity of PONV was observed at 4, 8, 2, 24 h and 2, 3 d postoperatively, and the time and grade of healing of the wound evaluated. RESULTS: Significant difference in PONV between group A and group B was observed (P<0.01), and in the observation groups, PONV was markedly reduced compared with the control groups (C vs A, P<0.01; D vs B, P<0.05). In light of the time and grade of wound healing, the observation groups differed little from the control groups. CONCLUSION: Dexamethasone (10 mg) can greatly enhance the effect of ondansetron and tropiesetron against PONV in patients receiving PCA without interfering the healing of the wound.