Study on frailty status quo and influencing factors of elderly stroke patients in community / 重庆医学

Objective To investigate the frailty status and influencing factors of the elderly stroke pa-tients in community to provide a basis for its prevention and treatment.Methods The convenience sampling was used to select 200 elderly stroke patients as the study subjects in a community hospital in Guangzhou City from October 2020 to January 2022.The general information questionnaire,Chinese version of Tilburg frailty indicator scale,Modified Rankin Index Scale,Barthel index scale,short version of Geriatric Depression Scale and Social Support Rating Scale were used to collect the data.Results The incidence rate of frailty in 200 ca-ses of community elderly stroke was 86.0％.The results of multiple linear regression analysis showed that the degree of disability,ability of daily living,depression and social support were the influencing factors of frailty of the elderly stroke patients in community(F=71.813,P＜0.001).Conclusion The incidence rate of frailty is higher in community elderly stroke patients,the higher the degree of disability,the lower the ability of daily living,the higher the level of depression and the lower the level of social support,the higher the frailty level of community elderly stroke patients.

A case of recurrent renal pelvic sarcomatoid carcinoma treated with PD-1 inhibitor achieved complete remission / 中华泌尿外科杂志

Sarcomatoid carcinoma of the renal pelvis accounts for a very low percentage of malignant tumors in the renal pelvis and has a poor prognosis. This article reported a patient with sarcomatoid carcinoma of the renal pelvis. The patient presented with macroscopic hematuria as the first symptom, and CT suggested left renal occupancy, unilateral nephrectomy was performed, and pathology suggested sarcomatoid carcinoma of the renal pelvis. Three weeks after surgery, a follow-up CT showed tumor recurrence. Programmed death 1(PD-1)inhibitor was given once every 3 weeks. Repeated CT examination after 24 weeks of continuous treatment suggested that the recurrent tumor disappeared. The patients was followed-up for 42 months without tumor recurrence or metastasis.

Current status and association analysis of sexual attitudes， sexual safety awareness and refusal skills among junior high school students in the suburbs of Shanghai / 上海预防医学

ObjectiveTo understand the acceptance of sex-related behaviors， sexual safety awareness， and refusal skills among junior high school students and conduct association analysis， and to provide a reference for the implementation of sex and reproductive health education for adolescents. MethodsA questionnaire survey related to knowledge of sexual and reproductive health was conducted among 478 students from two junior high schools in Jiading District， Shanghai. ResultsThe pass rate for sex and reproductive health knowledge among junior high school students was only 36.6%， with acceptance rates for dating， watching pornography， engaging in sexual behavior， pregnancy， and artificial abortion at 24.5%， 11.1%， 5.6%， 4.8%， and 5.9%， respectively. Binary logistic regression analysis showed that students who passed the sexual and reproductive health assessment had a significantly lower acceptance rate of sex-related behaviors than those who did not （aOR=1.666， 95%CI： 1.124‒2.470， P=0.011）. Adolescents with a passing knowledge of sexual and reproductive health （aOR=1.607， 95%CI： 1.060‒2.438， P=0.026） or a lower acceptance of sex-related behaviors （aOR=4.199， 95%CI： 2.804‒6.289， P<0.001） had higher awareness of sexual safety. Adolescents with a passing knowledge of sexual and reproductive health （aOR=1.691， 95%CI： 1.066‒2.684， P=0.026）， a lower acceptance of sex-related behaviors （aOR=1.756， 95%CI： 1.130‒2.729， P=0.012）， or higher awareness of sexual safety （aOR=2.872， 95%CI： 1.826‒4.516， P<0.001） had stronger skills to refuse sex-related behaviors. ConclusionSexual and reproductive attitudes， sexual safety awareness， and refusal skills for sex-related behaviors among junior high school students in Jiading District need to be improved. Schools should focus on cultivating adolescents’ sexual and reproductive knowledge and related skills， and advocate for relevant institutions to provide appropriate sexual healthcare services to meet their needs for reproductive healthcare.

Influence of Helicobacter pylori infection on anxiety and depression in patients with chronic gastritis / 中华消化杂志

Objective:To evaluate the influence of Helicobacter pylori ( H. pylori) infection on anxiety and depression in patients with chronic gastritis. Methods:From December 1 2020 to June 30 2021, 387 patients with chronic gastritis who visited the outpatient Department of Gastroenterology, the First Hospital Affiliated to Air Force Medical University were continuously recruited. According to the status of current H. pylori infection, the patients were divided into H. pylori uninfected group and H. pylori infected group. The general demographic information of patients was collected. Hamilton anxiety scale, Hamilton depression rating scale-24, Pittsburgh sleep quality index (PSQI) and gastrointestinal symptom rating scale (GSRS) were filled in. The detection rates of anxiety and depression were compared between the H. pylori uninfected group and the H. pylori infected group according to demographic characteristics. Chi-square test and multiple logistic regression analysis were used for statistical analysis. Results:Finally, 360 patients with chronic gastritis were enrolled, including 200 patients in H. pylori uninfected group and 160 patients in H. pylori infected group. The detection rates of anxiety and depression of the H. pylori infected group were both higher than those of the H. pylori uninfected group (48.1%, 77/160 vs. 30.0%, 60/200; 25.0%, 40/160 vs. 12.5%, 25/200), and the differences were statistically significant ( χ2=12.39 and 9.39, P<0.001 and=0.002). The detection rate of anxiety of male patients in the H. pylori infected group was higher than that in the H. pylori uninfected group (45.1%, 32/71 vs. 24.5%, 27/110); the detection rate of depression of female patients in the H. pylori infected group was higher than that in the H. pylori uninfected group (30.3%, 27/89 vs. 11.1%, 10/90), and the differences were statistically significant ( χ2=8.27 and 10.09, P=0.004 and 0.001). The detection rates of anxiety and depression of patients less than 48 years old in the H. pylori infected group were both higher than those in the H. pylori uninfected group (46.2%, 37/80 vs. 21.9%, 21/96; 20.0%, 16/80 vs. 7.3%, 7/96), and the differences were statistically significant ( χ2=11.73 and 6.20, P=0.001 and 0.013). The detection rates of anxiety and depression of the patients with high school education and below in the H. pylori infected group were higher than those in the H. pylori uninfected group (56.5%, 48/85 vs. 31.7%, 38/120; 32.9%, 28/85 vs. 14.2%, 17/120), and the differences were statistically significant ( χ2=12.57 and 10.24, P<0.001 and =0.001). The results of multivariate analysis showed that H. pylori infection, history of hypertension, PSQI score ≥8, GSRS score ≥7, chronic superficial gastritis and chronic atrophic gastritis were independent risk factors of anxiety in patients with chronic gastritis( P<0.001, =0.013, =0.001, <0.001, =0.036, =0.021), and the risk of anxiety of patients with H. pylori infection was 2.509 times as much as that in uninfected patients (95% confidence interval 1.512 to 4.163). H. pylori infection, PSQI score ≥8, GSRS score≥7, and having overnight dish ≥3 times per week all were independent risk factors of depression in patients with chronic gastritis( P=0.004, =0.002, <0.001, =0.001). The risk of depression in patients with H. pylori infection was 2.563 times as much as that in uninfected patients (95% confidence interval 1.356 to 4.846). Conclusion:H. pylori infection is correlated to anxiety and depression in patients with chronic gastritis, and it is an independent risk factor of anxiety and depression in patients with chronic gastritis.

Epidemiological analysis of inpatients with malignant tumor at the Affiliated Tumor Hospital of Xinjiang Medical University from 2010 to 2020 / 实用肿瘤学杂志

Objective The aim of this study was to collect diagnosis,treatment,and follow-up information of inpatients with malignant tumors at the Affiliated Tumor Hospital of Xinjiang Medical University,analyze the distribution and composition of malignant tumor types,mortality,and survival status,and provide reference for the prevention and treatment of malignant tumors in the local area.Methods The case and mortality data of inpatients with malignant tumor from 2010 to 2020 were calculated,and the survival status was collected by follow-up.The composition,different pathological stage,composition and sequential changes of malignant tumors,as well as survival rates of the 1-year,3-year and 5-year were analyzed.Results A total of 111,418 patients with malig-nant tumor were admitted to the hospital from 2010 to 2020.Breast cancer accounted for 20.67％of inpatients,followed by lung canc-er,thyroid cancer,cervical cancer and gastric cancer;The leading cause of malignant tumor death was lung cancer(accounting for 26.70％),followed by gastric cancer,esophageal cancer,liver cancer and colorectal cancer.The 1-year,3-year,and 5-year sur-vival rates were 87.20％,65.80％and 57.20％,respectively.The overall survival rates of patients with stages Ⅰ and Ⅱ malignant tumors were significantly higher than those of patients with stages Ⅲ and Ⅳ(P=0.003).Conclusion Breast cancer,lung cancer,thyroid cancer,cervical cancer and gastric cancer are the high incidence of malignant tumors in Xinjiang,among which thyroid cancer,breast cancer,and cervical cancer have a higher 5-year survival rate.Early screening,diagnosis and treatment of malignant tumors should be strengthened,and prevention strategies and resource allocation should be adjusted in time according to the distribution of malignant tumors to reduce the incidence and mortality of malignant tumor and improve the health level of people in Xinjiang.

Family cumulative risk and depression in junior high school students: the mediating role of non-adaptive cognitive emotion regulation and the moderating role of school climate / 中华行为医学与脑科学杂志

Objective:To explore the relationship between family cumulative risk, non-adaptive cognitive emotion regulation, school climate and depression of junior high school students.Methods:From June to September 2022, a total of 1 136 junior high school students were surveyed by the family cumulative risk questionnaire, the cognitive emotion regulation strategy questionnaire, the self-rating depression scale for children and school climate scale.The mediating effect of non-adaptive cognitive emotion regulation and the moderating effect of school climate were tested by the Macro program PROCESS of SPSS 25.0 software.Results:Family cumulative risk score was 1.00(2.00), non-adaptive cognitive emotion regulation score was 21.00(8.00) and depression score was 7.00(9.00). (2) Family cumulative risk was significantly positively correlated with non-adaptive cognitive emotion regulation( r=0.28, P<0.01) and depression( r=0.43, P<0.01). There was a significantly positive correlation between non-adaptive cognitive emotion regulation and depression( r=0.41, P<0.01), and a significantly negative correlation between school climate and depression( r=-0.56, P<0.01). (3) Non-adaptive cognitive emotion regulation played a partial mediating role between family cumulative risk and depression, and the direct effect and mediating effect accounted for 80.49%(0.33/0.41) and 19.51%(0.08/0.41)of the total effect respectively.(4) School climate played a moderating role in the influence of family cumulative risk on non-adaptive cognitive emotion regulation. Under the condition of the level of school climate was high, the positive predicting effect of family cumulative risk on non-adaptive cognitive emotion regulation was significantly enhanced( Bsimple=0.34, P<0.001). Conclusion:Family cumulative risk plays a certain role in depression through the mediation of non-adaptive cognitive emotion regulation strategies and the regulation of school climate in junior high school students.

Research progress on the application of infra-acetabular channel screws in acetabular fractures / 中华骨科杂志

The infra-acetabular channel is a channel parallel to the quadrilateral body of the pelvis that passes through the anterior and posterior columns at the medial side of the hip joint. With the widespread use of infra-acetabular channel screws, the acetabular frame screw fixation technique has been proposed to provide stronger fixation for acetabular fractures. There are gender differences in the anatomical parameters of the infra-acetabular channel screws (the length and diameter of the infra-acetabular channel in males are larger than those in females, and the angle between the long axis of the channel and the sagittal plane is smaller). Due to the narrow infra-acetabular channel, it may increase the risks of screw insertion into the hip joint and iatrogenic injury. 3D navigation system-guided placement of infra-acetabular channel screws improves the precision of nail placement. The application of infra-acetabular screws in the fixation of anterior and posterior column fractures has been proved by biomechanical experiments, however, in bicolumnar fractures and T-shaped fractures is still controversial. In order to standardize the placement of infra-acetabular channel screws and to clarify their indications, many studies have been conducted to observe the anatomical parameters of the infra-acetabular channel screws, the surgical technique of placement, biomechanics, and clinical efficacy. This article reviews these studies in order to provide theoretical basis and guidance for the application of infra-acetabular channel screws in acetabular fractures.

Influencing factors of intention to utilize preconception health care services among women with future pregnancy plan / 上海预防医学

ObjectiveTo understand the influencing factors of women’s intention to utilize preconception health care services， so as to promote the utilization of preconception care among women with future pregnancy plan. MethodsThe study was conducted at 8 outpatient health clinics of medical institutions providing perinatal health care in Jiading District of Shanghai. Women who had fertility intention for another child were invited to complete an electronic questionnaire from November 2020 to February 2021. ResultsWomen with better pregnancy and birth care behaviors during the last periconception were more likely to utilize preconception care service before the next conception than those with previous poorer behaviors （OR=1.980， 95%CI= 1.061‒3.694， P=0.032）. Women with higher preconception care knowledge scores had better pregnancy and birth care behaviors during the last periconception than those with lower knowledge scores （OR=1.362， 95%C1= 1.004‒1.846， P=0.047）. ConclusionsIn order to improve the utilization of preconception care among the population with future pregnancy plan， it is necessary to further strengthen health education and social mobilization to promote the preconception eugenic knowledge， planned pregnancy and pregnancy and birth care behaviors.

Emerging SARS-CoV-2 mutation hotspots associated with clinical outcomes

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the ongoing coronavirus disease 2019 (COVID-19) pandemic. Understanding the influence of mutations in the SARS-CoV-2 gene on clinical outcomes and related factors is critical for treatment and prevention. Here, we analyzed 209,551 high-coverage complete virus sequences and 321 RNA-seq samples to mine the mutations associated with clinical outcome in the SARS-CoV-2 genome. Several important hotspot variants were found to be associated with severe clinical outcomes. Q57H variant in ORF3a protein were found to be associated with higher mortality rate, and was high proportion in severe cases (39.36%) and 501Y.V2 strains (100%) but poorly proportional to asymptomatic cases (10.04%). T265I could change nsp2 structure and mitochondrial permeability, and evidently higher in severe cases (20.12%) and 501Y.V2 strains (100%) but lower in asymptomatic cases (1.43%). Additionally, R203K and G204R could decrease the flexibility and immunogenic property of N protein with high frequency among severe cases, VUI 202012/01 and 484K.V2 strains. Interestingly, the SARS-CoV-2 genome was more susceptible to mutation because of the high frequency of nt14408 mutation (which located in RNA polymerase) and the high expression levels of ADAR and APOBEC in severe clinical outcomes. In conclusion, several important mutation hotspots in the SARS-CoV-2 genome associated with clinical outcomes was found in our study, and that might correlate with different SARS-CoV-2 mortality rates.

Effect of mechano-growth factor on osteoclast activity and its mechanism / 中华创伤杂志

Objective:To investigate the effect of mechano-growth factor（MGF）on osteoclast activity and its mechanism.Methods:The RAW264.7 precursor osteoclast cell line was cultured with 25 ng/ml macrophage-colony stimulating factor（M-CSF）and 30 ng/ml receptor activator of NF-κB ligand（RANKL），and identified by tartrate resistant acid phosphatase（TRAP）staining after 7 days of culture. Western blot anslysis was used to determine the effect of 45 ng/ml MGF on the phosphoinositide-3-kinase/protein kinase B（PI3K/AKT）signaling pathway in separated osteoclasts，including levels of AKT，phosphorylation（p）-AKT，lactation mammalian target of rapamycin（mTOR），p-mTOR and TRAP at 0，4，8 and 12 hours. Real-time fluorescence quantitative PCR was used to expressions of TRAP in osteoclasts at 0，4，8 and 12 hours. The PI3K/Akt phosphorylation inhibitor LY294002（20 μmol/L）combined with MGF（45 ng/ml）was used to act on osteoclasts，and expression levels of Akt，p-Akt，mTOR，p-mTOR and TRAP were detected by Western blot at 0，4，8 and 12 hours.Results:After culturing RAW264.7 cells with M-CSF and RANKL for 7 days，a large number of osteoclasts with positive TRAP staining can be obtained. Western blot analysis showed expression levels of Akt and mTOR did not change significantly over time（ P>0.05），expression levels of p-Akt and p-mTOR increased continuously from（2.18±0.34）pg/ml and（0.83±0.10）pg/ml at 0 hour to（3.86±0.36）pg/ml and（1.56±0.19）pg/ml at 12 hours（ P<0.05），and expression level of TRAP decreased significantly over time，from（5.66±0.47）pg/ml at 0 hour to（3.76±0.38）pg/ml at 12 hours（ P<0.05）. Real-time fluorescence quantitative PCR analysis of expression of TRAP in osteoclasts showed that MGF inhibited the expression of TRAP in osteoclasts，which decreased from 1.02±0.06 at 0 hour to 0.53±0.11 at 12 hours（ P<0.05）. After acting LY294002 combined with MGF on osteoclasts，Western blot analysis showed expression levels of Akt and mTOR did not change significantly over time（ P>0.05），expression levels of p-AKT and p-mTOR decreased significantly from（3.28±0.18）pg/ml and（3.29±0.22）pg/ml at 0 hour to（2.06±0.34）pg/ml and（2.04±0.20）pg/ml at 12 hours（ P<0.05），and expression level of TRAP had no significant difference over time（ P>0.05）. Conclusions:MGF inhibits osteoclast activity by inhibiting the expression of TRAP in osteoclasts through PI3K/Akt signaling pathway. LY294002 inhibits the expression of PI3K/Akt signaling pathway in osteoclasts，further verifying the mechanism of MGF inhibiting osteoclast activity，and this finding puts forward new ideas for clinical prevention and treatment of osteoporosis.

The effect of life events during pregnancy on depression: the mediating role of cognitive emotional regulation strategies and the moderating role of neuroticism / 中华行为医学与脑科学杂志

Objective:To investigate the relationship between life events, cognitive emotional regulation strategies, neuroticism and depression in pregnant women and the internal mechanism of action.Methods:Short-term longitudinal follow-up design were used in this study.A total of 327 pregnant women in the third trimester of pregnancy were investigated with pregnant women's life events scale, cognitive emotion regulation strategy questionnaire, neuroticism subscale of Chinese big five personality questionaire-short form at T1 time point, and patient health questionnaire 9 were measured after 6 weeks(T2).SPSS 20.0 macro program PROCESS was used to examine the mediating effect of cognitive emotion and the moderating effect of neuroticism.Results:(1) The incidence of depression in the third trimester pregnant women was 12.23%.(2)There was significant positive correlation between the total score of life events in pregnant women(T1) and the total score of non-adaptive cognitive emotional regulation strategies(T1) ( r=0.25, P<0.01).Total neurotic personality(T1) and total depressive mood(T2) were significantly positively correlated ( r=0.46, P<0.01).The total scores of life events(T1) of pregnant women were significantly positively correlated with the total scores of depression(T2) ( r=0.36, P<0.01).(3) The non-adaptive cognitive emotion regulation strategy (T1) played a partial mediating role between life events (T1) and depression (T2).The direct effect (effect size=0.29) and the mediating effect (effect size=0.07) accounted for 80.55% and 19.44% of the total effect (effect size=0.36).(4) Neuroticism regulates the second part of the mediating effect of the mediating model.Specifically, the higher the level of individual neuroticism, the stronger the positive predictive effect of non-adaptive cognitive emotion regulation strategies on maternal depression. Conclusion:Pregnant life events play a role in maternal depression through the mediating role of non-adaptive cognitive emotional regulation strategies and the moderating role of neuroticism.

A systematic review of pseudoaneurysm after intertrochanteric fracture / 中华骨科杂志

Objective:To summarize the age, gender difference, cause, location, time, treatment and prognosis of femoral intertrochanteric fracture complicated with pseudoaneurysm, and analyze the influence of different treatment methods on the occurrence of femoral intertrochanteric fracture complicated with pseudoaneurysm.Methods:Using the method of systematic literature review, a total of 76 literatures were retrieved from multiple databases at home and abroad, and 45 literatures were screened out through the second screening of title, abstract and full text. The patients with intertrochanteric fracture complicated with pseudoaneurysm were selected as the research objects, and the duplicate cases were deleted; the age, gender, onset age, etiology, location, treatment and prognosis of the disease were retrospectively analyzed.Results:A total of 54 cases of femoral intertrochanteric fracture related pseudoaneurysms were selected from 45 literatures, including 25 males and 27 females, and 2 cases had no gender; aged from 43 to 94 years old, and 4 cases were younger than 60 years old, 6 between 61 and 70, 17 between 71 and 80, and 25 between 81 and 90. Forty-five cases occurred in deep femoral artery, 3 cases in superficial femoral artery, 1 case in superior gluteal artery, 1 case of medial circumflex artery, 1 case of lateral circumflex femoral artery, 1 case of femoral artery, and 2 cases of unknown location. The occurrence time of pseudoaneurysm: 17 cases within 1 week after fracture, 8 cases from 1 week to 3 weeks, 19 cases from 3 weeks to 3 months, 2 cases more than 3 months, and 8 cases unknown. The causes of pseudoaneurysm: among the 54 patients, 41 cases had definite causes, including 21 cases of vascular injury caused by fracture block; 20 cases of iatrogenic injury, of which the incidence of direct injury of blood vessels by screw or drill was the highest, accounting for 55% (11/20). Twenty-two cases were treated with vascular embolization, 10 cases with surgical sutures, 8 cases with surgical ligation, 4 cases with resection of pseudoaneurysm, 5 cases with covered stent, and 4 cases with thrombin injection. There were 42 cases who had follow-up data, and no recurrence and other complications were found during the follow-up period.Conclusion:The peak age of femoral intertrochanteric fracture complicated with pseudoaneurysm was 71-90 years old. The incidence of femoral intertrochanteric fracture complicated with pseudoaneurysm was more often within 1 week after fracture and 3 weeks to 3 months after fracture, due to fracture fragments and iatrogenic vascular injury caused by the location of the profundus femoris artery. Treatment options include vascular embolization, surgical ligation, suture or resection of pseudoaneurysm, covered stent and thrombin injection, and the prognosis is generally good.

Optimization and finite element analysis of a safe screw pathway in bilateral lumbo-iliac fixation / 中华创伤骨科杂志

Objective:To analyze the biomechanical characteristics of bilateral lumbo-iliac fixation by finite element analysis after digital optimization of a safe screw pathway.Methods:Firstly, a healthy adult male volunteer was recruited for this study who underwent CT scanning of the lumbus and pelvis, with a slice thickness of 0.625 mm.The original data were imported into Mimics 16.0 software for 3D lumbar and pelvic reconstruction.At the same time, a geometric screw pathway and a free screw pathway were generated in the pedicles of L4 and L5 and ilium.Secondly, all 3D models were imported into Ansys 12 software to assemble a finite element model.The displacements and von Misses stress distribution were measured in the conditions of forward bending, backward extending, lateral bending to the left and right, and left and right rotations in the models of 2 kinds of pathway after gravity axial load of 500 N was applied.Results:The models of 2 different pathways were similar in comprehensive displacement and stress in the conditions of forward bending, lateral bending and backward extending, and in the maximum stress of the screw in the conditions of forward bending and lateral bending.However, the comprehensive displacement and stress in the condition of rotation and the stress of the screw in the conditions of backward extending and rotating in the model of geometric screw pathway were obviously smaller than those in the model of free screw pathway.The maximum pelvic stress was on the screw surface between 190 and 260 MPa, concentrated on the bending area of the 2 screws connecting the sacrum and vertebral body.The lumbar-iliac fixation model showed high com-pressive stiffness.The maximum von Misses stress appeared in the L4-L5 pedicle screw on the longitudinal rod.Under rotational loading, the upper longitudinal rod connecting the L4-L5 pedicle screw and the iliac bone screw bore the maximum stress.Conclusions:Our finite element analysis shows that double verte-bral bodies and long screw fixation are effective ways of iliolumbar fixation.The geometric screw path optimized by digital analysis exhibits better fatigue resistance, rotation resistance and overall stability.Internal lum-bo-iliac fixation can effectively share the stress of vertebral bodies.

Research on novel auxiliary placement techniques for sacroiliac screws / 中华创伤骨科杂志

Pelvic fracture is a common serious injury in traumatic orthopedics. Internal fixation with percutaneous sacroiliac screws is an effective minimally invasive method widely applied in clinic which enables the patients to carry out early weight-bearing and functional exercise. Novel auxiliary placement techniques for sacroiliac screws have been introduced into the field of orthopaedics to improve placement accuracy and reduce operative risk, such as 3D navigation, 3D printing and orthopedic robots. These new techniques have advantages of precision and convenience, but their disadvantages and limitations cannot be ignored. This article reviews the research progress in the above 3 auxiliary techniques for placement of sacroiliac screws, and discuss their advantages, disadvantages and safety, hoping to provide a reference for clinicians who want to choose a new auxiliary placement technique in the treatment of pelvic fractures with sacroiliac screws.

Research on the correlation between parents' posttraumatic growth, mental resilience and family function in children with autism spectrum disorder / 中国实用护理杂志

Objective:To explore the correlation between parents′ posttraumatic growth, mental resilience and family functioning in children with autism spectrum disorder.Methods:Using the convenience sampling method, 169 parents of children with autism spectrum disorders were selected. General data questionnaire, Posttraumatic Growth Inventory (PTGI), Conner-Davidson Resilience Scale (CD - RISC) and Family Assessment Device (FAD) were investigated.Results:The total PTGI score of parents of children with autism spectrum disorder was 58.79±18.92. The scores of appreciation of life, new possibilities, personal strength, relating to others and spiritual change were 19.49±6.15, 10.46±4.59, 9.05±3.32, 7.79±3.65, 12.01±3.83. The PTGI score of 37.3% parents was lower than 52, which was at a low level. Parents in the high score (> 74) group and the low score (< 52) group had statistically significant differences ( P<0.05) in the total score of CD - RISC and scores in all dimensions, as well as the differences in the scores of the four dimensions of FAD, namely problem solving, communication, role and behavior control. The total score of PTGI of parents was positively correlated with the total score of CD - RISC and the scores of its all dimensions ( r values were 0.201-0.317, P<0.05), and negatively correlated with the scores of Problem Solving, Communication and Behavioral Control of FAD ( r values were -0.233 - -0.196, P<0.05). Conclusions:The parents of children with autism spectrum disorder have an average level of posttraumatic growth. People with better mental resilience and healthier family functions have higher post-traumatic growth level.

Recent advance in aluminum induced programmed death of neural cells / 中华神经医学杂志

Aluminium causes nerve cell death, neurotoxicity and eventually learning and cognitive impairment. In multicellular organisms, programmed cell death (PCD), as a basic biological phenomenon of cells, plays an important role in removing unnecessary or abnormal cells. Abnormal regulation of this process is closely related to neurodegenerative diseases. In this paper, the effects of aluminum on PCD, especially neuronal apoptosis, autophagy and programmed necrosis, are summarized to provide some clues for the pathogenesis of neurodegenerative diseases.

Treatment of complex acetabular fractures involving the posterior column by anterograde lag screws via the ilioinguinal approach / 中华创伤骨科杂志

Objective@#To evaluate the treatment of complex acetabular fractures involving the posterior column by anterograde lag screws via the ilioinguinal approach.@*Methods@#A retrospective study was conducted of the 8 patients with complex acetabular fracture involving the posterior column who had been treated at Department of Orthopaedics, The Second Affiliated Hospital to Inner Mongolia Medical University from January 2017 to June 2018. They were 5 males and 3 females, aged from 35 to 62 years (average, 43.5 years). According to the Letournel-Judet classification, 3 cases were T-shaped fractures, 4 anterior column plus posterior hemitransverse fractures and one both column fracture. The interval from injury to operation averaged 8 days (from 7 to 17 days). The anterior acetabulum was fixated by a reconstruction plate and the posterior column by antegrade lag screws, all through the ilioinguinal approach. The quality of fracture reduction, fracture union time, function of the affected hip and complications were recorded.@*Results@#By the Matta imaging criteria, the quality of fracture reduction was rated as excellent in 7 cases and as fine in one. Intraoperative major hemorrhage or injury to sciatic nerve occurred in none of the patients. This cohort obtained an average follow-up of 8 months (from 6 to 18 months). All fractures united well after an average of 10 weeks (from 8 to 12 weeks). The function of affected hip evaluated by the improved Merle d’Aubigne & Postel criteria at the last follow-up was excellent in 7 cases and fine in one. Follow-ups revealed no incidence of deep vein thrombosis or heterotopic ossification.@*Conclusions@#For patients with complex acetabular fracture involving the posterior column, internal fixation of the anterior acetabulum with a reconstruction plate through the ilioinguinal approach and fixation of the posterior column with antegrade lag screws also through the ilioinguinal approach can result in fine therapeutic effects, because complications like ectopic ossification and sciatic nerve injury related to the Kocher-Langenbeck approach can be prevented. This treatment is particularly suitable for the patients whose condition of the soft tissues at the posterior pelvis is poor.

The second generation endometrial ablation (NovaSure) improves efficacy of levonorgestrel-releasing intrauterine system in management of adenomyosis / 浙江大学学报·医学版

OBJECTIVE@#To determine the efficacy of second generation endometrial ablation (NovaSure) combined with levonorgestrel-releasing intrauterine system (Mirena) in the treatment of adenomyosis.@*METHODS@#Clinical data of patients with adenomyosis admitted in Women's Hospital, Zhejiang University School of Medicine from January 2015 to December 2018 were retrospectively analyzed. Among 66 patients, 44 received Mirena placement only (control group) and 22 received Mirena placement and NovaSure treatment (study group). The menstruation blood loss, dysmenorrhea score, uterine size, expulsion rate of Mirena and the patients' satisfaction rate were assessed in two groups.@*RESULTS@#There was a significant reduction in menstruation blood loss (0.05).@*CONCLUSIONS@#NovaSure can improve the efficacy of Mirena in treatment of adenomyosis.

Efficacy and adverse effects of levonorgestrel-releasing intrauterine system in treatment of adenomyosis / 浙江大学学报·医学版

OBJECTIVE@#To evaluate the efficacy and adverse effects of levonorgestrel-releasing intrauterine system (Mirena) in the treatment of adenomyosis.@*METHODS@#The clinical data of 75 patients with adenomyosis who had Mirena insertion in Women's Hospital,Zhejiang University School of Medicine from September 2013 to December 2013 were retrospectively analyzed. The patients were followed up to 39 months. The efficacy and adverse effects were assessed.@*RESULTS@#Pictorial Blood Loss Assessment Chart (PBAC) scores were decreased significantly after Mirena insertion both in patients with menorrhea (118±13 vs. 29±33, 0.05).@*CONCLUSIONS@#Mirena is effective and safe in the long term management of adenomyosis, but about one third patients may require further treatment because of the expulsion or ineffectiveness of Mirena.

Study on the preparation and physicochemical properties of fish swim bladder membrane / 中国修复重建外科杂志

Objective : To manufacture fish swim bladder membrane material by crosslinking techniques, and to explore its physical and chemical properties and cytotoxicity. Methods: After decellularization, the swim bladders were randomly divided into two groups. The swim bladders were treated with 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC)/N-hydroxysuccinimide (NHS) crosslinking method, surface hole making, and freeze-drying in crosslinking group, and only surface hole making and freeze-drying in non-crosslinking group. The physical and chemical properties of the materials were observed, including microstructure by scanning electron microscopy (SEM), mechanical properties (tensile strength and breaking elongation) by universal tensile machine, hydrophilicity by contact angle measuring instrument, porosity by ethanol infiltration method, degradation performance in vitro and thermal stability test, and the components of materials by infrared spectrum analysis. Mouse fibroblasts (L929) were cultured with the extracts of two groups of materials in order to determine the cytotoxicity of materials by using cell counting kit 8 (CCK-8) method. Results: The porous structure and rough surface of materials were observed by SEM. Compared with the non-crosslinking group, the tensile stress of the crosslinking group was higher, the breaking elongation was lower, and the porosity increased, showing significant differences ( P0.05). The degradation was faster within the first 7 days and then tended to be smooth in the two groups. But the degradation rates of crosslinking group were significantly lower than those of non-crosslinking group ( P0.05). Conclusion: The fish swim bladder membrane obtained by crosslinking treatment with EDC/NHS method has good physical and chemical properties, no cytotoxicity, and is expected to be used as a dura mater repair material.