To explore the application value of a wearable precise rehabilitation system in treatment of elderly patients after total knee arthroplasty.

A clinical prospective case-control study was adopted, and a total of 86 elderly patients with unilateral total knee arthroplasty from March 2019 to March 2021 were selected as research objects. Finally, 81 patients carried out the follow up, and they were randomly divided into control group with 40 cases and observation group with 41 cases. The control group carried out rehabilitation training according to the doctor′s instructions after discharge, while the observation group adopted the wearable precision rehabilitation system (independently developed by the research team of Southeast University, patent No.: 202120211016.2), and both groups were followed up for 6 months. The active range of motion (AROM) of affected side, knee joint function score of American Hospital for Special Surgery (HSS), average daily rehabilitation time, rehabilitation compliance rate, satisfaction degree and score of Short-form Health Survey (SF-36) were compared between the two groups at 1 month, 3 and 6 months of follow-up.

At the 1 month, 3 and 6 months of follow-up, the AROM and HSS scores of knee joints of the affected side in both groups were gradually increased, and the AROM and HSS scores of the observation group at of 1 month, 3 and 6 months of follow-up were significantly higher than those of the control group (P < 0.05). The daily recovery time of the observation group was (4.6±0.7) h, which was significantly longer than (2.3±0.3) h of the control group (P < 0.05); the total compliance rate and total satisfaction rate of the observation group were 90.2% and 82.9%, respectively, which were significantly higher than 72.5% and 62.5% of the control group (P < 0.05). At 6 months of follow-up, the scores of physical health, mental health and social relations as well as the total score in the observation group were significantly higher than those in the control group (P < 0.05).

The wearable precision rehabilitation system can significantly improve the rehabilitation quality of elderly patients after knee arthroplasty, and improve the rehabilitation compliance rate and satisfaction degree.

To observe the effect of high-energy laser combined with stepped intervention strategy in patients with meniscus injury.

A total of 87 patients with meniscus injury were selected as research subjects. According to the random number table method, they were divided into control group (n=44) and observation group (n=43). After admission, patients in both groups were electively treated with arthroscopic surgery. The control group received step-by-step nursing intervention, and the observation group received high-energy laser intervention on the basis of the control group. All patients were intervened continuously for 8 weeks. The limb pain [assessed by Visual Analogue Scale (VAS)] 1 day and 3 days after operation, the first time out of bed after operation, the hospitalization time and hospitalization expenses were observed, and knee function (Lysholm knee score) 1 day before operation and 8 weeks after operation and the occurrence of postoperative complications were compared between the two groups.

The VAS scores of both groups at 3 days after operation were lower than those at 1 day after operation, and were lower in the observation group when compared with the control group (P < 0.05); the first time out of bed, hospitalization time and hospitalization expenses in the observation group were 5.00 (5.00, 6.00) d, 6.00(5.00, 7.00) d and (12.20±1.20) thousand CNY, respectively, which were shorter than 6.00 (5.00, 8.00) d, 7.00 (6.25, 8.00) d and (12.80±1.40) thousand CNY. At 8 weeks after operation, the Lysholm knee of the control group and the observation group scored (74.87±4.12) and (82.25±4.54), respectively, which were higher than those of the first preoperative day, and the Lysholm knee score in the observation group was higher than that of the control group (P < 0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups (P>0.05).

High energy laser combined with stepped intervention strategy for rehabilitation of patients with meniscus injury can reduce the degree of postoperative limb pain, shorten the early time out of bed and hospitalization time, reduce hospitalization expenses and promote the recovery of knee function of patients.

To observe the clinical effect of 3D printing adjuvant therapy in treatment of patients with posterior Pilon fracture after treatment.

The clinical materials of 92 patients with posterior Pilon fracture from January 2012 to December 2020 in the Department of Orthopedics of Liyang People′s Hospital were retrospectively analyzed. Among them, 47 patients with preoperative 3D printing for simulating operation were selected as 3D printing group, and 45 patients without 3D printing for simulating operation were selected as control group. The operation related complications were recorded in both groups, and the operation time, intraoperative X-ray fluoroscopy times, condition of surgical reduction, clinical healing time of fractures, the score of ankle scoring system of the American College of Foot and Ankle Surgeons (AOFAS) and the score of Visual Analogue Scale (VAS) of ankle pain at the last follow-up were compared between the two groups.

All the patients were followed up for 12 to 20 months. All the patients achieved primary healing after operation, and no patient had complications such as incision infection, skin necrosis, deep venous thrombosis of lower limbs, and checkrein deformity of toes. The operation time and intraoperative fluoroscopy times in the 3D printing group were (81.4±9.4) min and (13.0±2.3) times respectively, which were significantly shorter and less than (94.9±11.6) min and (18.4±3.2) times in the control group (P < 0.05). In the control group, there were 3 cases with poor reduction of posterior malleolus fracture, but there were no patients with poor reduction of posterior malleolus fracture in the 3D printing group, and there was no significant difference between two groups (P>0.05). The fracture healing time, postoperative AOFAS score and VAS score in the 3D printing group were (12.9±1.0) weeks, (92.8±4.2) points and (1.1±0.8) points respectively, while were (13.2±1.3) weeks, (90.8±4.5) points and (1.3±0.8) points respectively in the control group, and there were no significant differences between two groups (P>0.05).

Application of 3D printing adjuvant therapy can optimize the operation plan of posterior Pilon fracture, shorten the operation time, reduce the number of intraoperative fluoroscopy, and achieve individualized precision treatment.

To observe the effect of modified anchor technique in the repair of avulsion injury of lateral collateral ligament of elbow joint.

From January 2016 to September 2021, the clinical materials of 20 patients with modified anchor technique for repair of avulsion injury of lateral collateral ligament of elbow joint were analyzed retrospectively. The injury type of 20 patients was closed injury, including 8 cases of radius fractures, 1 case of ulna fractures, 5 cases of ulna and radius fractures, 3 cases of humerus fractures, 2 cases of humerus and ulna and radius fractures, and 1 case of simple ligament injury. The repair effect of the modified anchor technique was evaluated.

All the patients achieved primary wound healing after operation, and they were followed up for 6 to 26 months, with an averageof 11.9 months. CT result showed that the anchors were all in place and there was no nail detachment. At the last follow-up, the range of joint pronation was 58° to 90°, the range of joint supination was 40° to 65°, and with an average rotation range of 123.2°; the range of flexion was 90° to 130°, the range of extension was 0 to 13°, and with an average motion range of 115.6°. The lateral stress test was negative, the fracture was not displaced, no looseness or fracture of internal fixation were observed, and there were no complications such as ectopic ossification. Mayo elbow function score was excellent in 16 cases and good in 4 cases.

Modified anchor technique is reliable in the repair of avulsion injury of lateral collateral ligament of elbow joint, which ensures the strong stability of the elbow joint through double compression fixation, and at the same time, the occurrence of nail detachment is also avoided.

To explore the effect and mechanism of compound chamomile and lidocaine hydrochloride gel on skin wound healing in rats.

The model rats with skin wound was established by surgical resection, and the rats were randomly divided into experimental group (treated with compound chamomile and lidocaine hydrochloride gel), positive drug group (treated with compound polymyxin B ointment) and model group (treated with normal saline). At 7 and 14 days of treatment, the wound size of rats in each group was measured. Tumor necrosis factor-α (TNF- α), interleukin-6 (IL-6) and interleukin-1β (IL-1β) levels in wound tissues were detected by enzyme-linked immunosorbent assay (ELISA). The expression levels of CD68, CD163 and CC chemokine receptor 7 (CCR7) in the wound tissues were detected by immunohistochemistry, and the change of macrophage phenotype was observed. The distribution of collagen in wound tissues was observed by Picric acid Sirius red staining.

After 7 days of treatment, the inflammatory cells and blood vessels decreased while the fibroblasts increased in the experimental group, which was more advantageous than the positive drug group. At the 14th day of treatment, the wound healing of the experimental group was mainly composed of fibroblasts and collagen, and there was no significant difference between the experimental group and the positive drug group (P>0.05). At 7 days of treatment, the expression levels of TNF-α, IL-6 and IL-1β in the experimental group were significantly lower than those of model group and positive drug group (P < 0.05 or P < 0.01). After 14 days of treatment, there were no significant differences in the expression levels of TNF-α, IL-6 and IL-1β in the wound tissues of rats between groups (P>0.05). At 7 and 14 days of treatment, the collagen content in the experimental group increased significantly, but the phenotype of macrophages did not change obviously.

Compound chamomile and lidocaine hydrochloride gel has good anti-inflammatory and healing effects on skin wounds, and inhibiting the release of inflammatory factors may be one of its main mechanisms.

To explore the relationship between single nucleotide polymorphism(SNP) rs1333049 and susceptibility to coronary heart disease of permanently inhabited Yi ethnic people in frontier plateau area.

Using the random number table method, 120 cases of permanently inhabited Yi ethnic patients of frontier plateau area in Diannan Central Hospital of Honghe Prefecture were selected as study objects, and were divided into coronary artery disease group and control group according to clinical diagnosis results, with 60 cases in each group. Peripheral venous blood was collected and rs1333049 genotype in 9p21.3 region of chromosomewas detected by TaqMan real-time fluorescence quantitative polymerase chain reaction (PCR). The frequency of genotypes (CC, CG, GG), frequency of allele (C, G) and gene amount were compared between the coronary artery disease group and the control group. The genotype frequency, allele frequency and gene amount of rs1333049 in coronary artery disease patients with different disease stages were analyzed. MultivariateLogistic regression analysis was used to explore the influencing factors of rs1333049 CG gene expression in patients with coronary heart disease.

The CG genotype frequency and CG gene amount of rs1333049 SNP locus in the coronary artery disease group were higher than those in the control group (P < 0.05). The CG genotype frequency and CG gene amount of rs1333049 SNP locus in patients with acute myocardial infarction in the coronary heart disease group were higher than those in the control group (P < 0.05). There were no significant differences in genotype frequency, allele frequency and gene amount of rs1333049 SNP locus in patients with unstable angina pectoris and stable angina pectoris in the coronary heart disease group when compared with those of the control group (P>0.05). CG gene amount expression of rs1333049 was associated with left main branch (LM)/left anterior descending branch (LAD) lesions in permanently inhabited Yi ethnic patients with coronary artery disease in the border plateau area (P < 0.05), but had no correlations with blood lipid indexes, fasting blood glucose (FBG), different disease stages of coronary heart disease, right coronary artery disease, lesion of left circumflex branch and the stenosis degree of each coronary artery (Gensini score) (P>0.05). Multivariate Logistic regression analysis showed that FBG (OR=1.55; 95%CI, 1.01 to 2.36), LM/LAD lesions (OR=1.87; 95%CI, 1.10 to 3.16) were independent influencing factors of rs1333049 CG gene expression in Yi ethnic patients with coronary heart disease in border and plateau areas (P < 0.05).

The rs1333049 CG gene is a susceptibility gene for coronary heart disease in permanently inhabited Yi ethnic people in frontier plateau, while FBG and LM/LAD lesion are influencing factors for expression of rs1333049 CG gene.

To analyze risk factors of impairment of carotid vascular elastic function [pulse wave conduction velocity at onset of systole (PWV-BS) and pulse wave conduction velocity at end of systole (PWV-ES)] based on ultrafast pulse wave velocity (ufPWV) quantitative evaluation technique, providing objective evidence for prevention and treatment of vascular elasticity function injury of hypertension.

The desensitization physical examination data of 189 hypertensive patients were retrospectively collected. According to whether the arterial vascular elastic function was damaged, the patients were divided into vascular elastic function injury group (125 cases) and vascular elastic function normal group (64 cases). The clinical indicators of the two groups were compared. The relations of left common carotid artery (LCCA) PWV-BS (LCCA-BS), right common carotid artery (RCCA) PWV-BS (RCCA-BS), LCCA PWV-ES (LCCA-ES) and RCCA PWV-ES(RCCA-ES) in hypertensive patients with age, gender, history of smoking/drinking, systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure difference (PP), heart rate (HR), history of diabetes, history of hyperlipidemia, use of antiplatelet drugs/antilipidemia drugs, blood routine indexes, blood biochemical indexes, electrocardiogram (ECG) were analyzed, and binary Logistic regression analysis and multiple linear stepwise regression analysis were performed to analyze the factors with differences in univariate analysis of vascular elastic function injury, PWV-BS (average value of LCCA-BS and RCCA-BS) and PWV-ES (average value of LCCA-ES and RCCA-ES).

There were statistically significant differences in age, platelet (PLT), total bilirubin (TBIL), alkaline phosphatase (ALP) and fasting blood glucose (FBG) between the vascular elasticity function injury group and the normal vascular elasticity function group (P < 0.05). Stratified comparison results showed that there were statistically significant differences in LCCA-ES and RCCA-ES among the four age subgroups (F=6.721, P < 0.001; F=8.251, P < 0.001); there was significant difference in LCCA-ES among the four subgroups (F=4.493, P=0.005). The RCCA-ES of PP≥60 mmHg group showed a significant difference compared with that of PP < 60 mmHg group (P < 0.05). Compared with males of the non-smoking and drinking history group, RCCA-ES in males of the smoking/drinking history group showed a significant difference (P < 0.05). Compared with normal ECG group, RCCA-ES in abnormal ECG group showed a significant difference (P < 0.05). Binary Logistic regression analysis showed that age (OR=1.134, 95%CI, 1.069 to 1.202, P < 0.001), DBP (OR=1.101, 95%CI, 1.034 to 1.174, P=0.003), TBIL (OR=0.879, 95%CI, 0.805 to 0.959, P < 0.001), TBIL(OR=0.879, 95%CI, 0.805 to 0.959, P=0.004) were the influencing factors of vascular elastic function injury. Multiple linear stepwise regression analysis results showed that age (β=0.045, 95%CI, 0.013 to 0.058, P < 0.001), TBIL (β=-0.063, 95%CI, -0.099 to -0.016, P=0.003), red blood cells (β=0.622, 95%CI, 0.110 to 1.043, P=0.008) were the influencing factors of PWV-BS. Age (β=0.071, 95%CI, 0.042 to 0.100, P < 0.001), ECG (β=0.709, 95%CI, 0.160 to 1.259, P=0.012), DBP (β=0.043, 95%CI, 0.008 to 0.078, P < 0.001) were the influencing factor of PWV-ES.

Injury of carotid vascular elastic function in hypertensive patients may be correlated with age, course of disease, DBP, PP, HR, ECG, PLT, TBIL and FBG. Anti-plate and lipid-lowering therapy can improve arterial function to a certain extent, while alcohol consumption may have a bidirectional regulatory effect on vascular elasticity function. Clinical diagnosis and treatment of hypertension should not only actively reduce blood pressure, but also perform early assessment and intervention of arterial vascular elastic function, fully identify and pay attention to the risk factors related to arterial vascular elastic function injury, so as to prevent and delay the injury of arterial vascular elastic function in hypertension.

To investigate the effects of Yiqi Huoxue Lishui Recipe on calcium transport, endoplasmic reticulum stress apoptosis and the expressions of angiotensin Ⅱ (Ang Ⅱ) and transforming growth factor-β₁ (TGF-β₁) in cardiomyocytes of heart failure (HF) rats.

Ten healthy rats were set as Sham group, and another 45 successfully modeled rats were divided into HF group, low intervention group, medium intervention group, high intervention group and western medicine group, with 9 rats in each group. The low intervention group, middle intervention group and high intervention group were gavaged with 2.6, 5.2 and 10.4 g/(kg·d) of Yiqi Huoxue Lishui Recipe, the western medicine group was gavaged with 10 mg/(kg·d) trimetazidine, and the Sham and HF groups were gavaged with the same volume of 0.9% NaCl solution, respectively. HE staining and electron microscopy were used to observe the pathological morphology of myocardial tissue. Bradford dye binding method was used to analyze the calcium intake in the myocardial sarcoplasmic reticulum. The apoptosis of cardiomyocytes in each group was detected by Terminal deoxynucleotidyl transferase dUTP Nick-End Labeling (TUNEL). Western blotting was used to detect the expressions of endoplasmic reticulum stress-related proteins[B cell lymphoma/leukemia-2 (Bcl-2), Bcl-2 associated X protein (Bax), caspase-3 protein (Caspase3)]and calcium transport-related proteins[calcium/calmodulin-dependent protein kinase Ⅱ (CAMK Ⅱ), ryanodine receptor (RyR2) and sarcoplasmic reticulum Ca²⁺ ATPase (SERCA2a); the positive expression rates of TGF-β₁ and Ang Ⅱ in myocardial tissue were detected by immunohistochemistry.

The calcium uptake rates of rats in the Sham group, HF group, low intervention group, middle intervention group, high intervention group and western medicine group were (19.63±5.63) μmol/(min·mg), (10.25±4.11) μmol/(min·mg), (13.70±5.12) μmol/(min·mg), (14.08±4.80) μmol/(min·mg), (16.91±5.03) μmol/(min·mg), (16.65±5.10) μmol/(min·mg), respectively, there were differences among different groups (F=3.946, P=0.004). The apoptosis rates of cardiomyocytes in the Sham group, HF group, low intervention group, medium intervention group, high intervention group and western medicine group were (7.52±2.01)%, (30.63±6.58)%, (19.14±5.03)%, (18.41±5.21)%, (13.61±3.65)% and (13.17±4.11)%, respectively, there were differences among different groups (F=28.900, P < 0.001); compared with the Sham group, Bcl-2 and SERCA2a levels in the HF group in myocardial tissue of rats were decreased, and Bax, Caspase3, CaMK Ⅱ, RyR2, TGF-β₁ and Ang Ⅱ expression were increased (P < 0.05). Compared with the HF group, expressions of Bcl-2 and SERCA2a were increased in the low, medium and high intervention groups and western medicine group, Bax, Caspase3, CaMK Ⅱ, RyR2, TGF-β₁ and Ang Ⅱ were all decreased (P < 0.05). There were no significant differences in the low intervention group in above eight indicators compared with the medium intervention group (P>0.05). Compared with the medium intervention group, the high intervention group showed significant differences in above indexes (P < 0.05), but there was no significant differences compared with the western medicine group in above indexes (P>0.05).

Yiqi Huoxue Lishui Formula can improve calcium transport in heart failure rats, and reduce myocardial apoptosis by inhibiting endoplasmic reticulum stress in a concentration-dependent manner. The mechanism may be related to the inhibition of TGF-β₁ and Ang Ⅱ expression.

To investigate the role and mechanism of developmental endothelial locus-1 (Del-1) in collagen-induced arthritis (CIA).

CIA mouse model was constructed, and the mice were divided into control group, CIA group, and Del-1 group (Del-1 for intervention of CIA). In the Del-1 group, each mouse was injected with Del-1 for 2 μg each time through caudal vein for 2 times in total. Arthritis index (AI) was used to assess the progression of arthritis; hematoxylin-eosin (HE) staining was used to observe the arthritic lesions in mice; enzyme-linked immunosorbent assay (ELISA) was used to detect the expression of serum interleukin-6 (IL-6) and matrix metalloproteinases-9 (MMP-9) in mice.

On the 34th, 36th, 38th and 40th days after the primary immunization, the AI scores in the Del-1 group were (3.80±1.17), (3.80±1.17), (4.20±1.17) and (4.20±1.17) respectively, which were significantly lower than (6.80±1.94), (8.80±3.19), (9.60±3.61) and (9.40±3.61) in the CIA group (P < 0.05). On the 42nd day after the primary immunization, when compared to the CIA group, the HE staining showed that the local inflammatory infiltration and synovial hyperplasia of the joints in the Del-1 group were obviously alleviated, and the cartilage destruction was obviously reduced. On the 42nd day after the initial immunization, ELISA result showed that the expression levels of serum IL-6 and MMP-9 in the CIA group were significantly higher than that in the normal control group (P < 0.05), while those in the Del-1 group were significantly lower than the CIA group (P < 0.05).

Del-1 can improve the joint symptoms of CIA mouse model, reduce inflammation and bone destruction, inhibit the expression of key cytokines such as IL-6 and MMP-9, and these actions may play certain roles in the treatment of RA.

To explore the clinical significance and expression levels of angiogenin protein 4(ANGPTL4), interleukin-17(IL-17) and receptor activator of nuclear factor-kappa B ligand (RANKL) in serum and joint fluid of patients with rheumatoid arthritis.

A total of 165 patients with rheumatoid arthritis were selected as observation group, 165 patients with osteoarthritis during the same period were selected as disease control group, and another 165 healthy physical examination subjects as normal control group. The expressions of ANGPTL4, IL-17 and RANKL in serum and(or) joint fluid of the observation group, normal control group and disease control group were detected by enzyme linked immunosorbent assay. The correlations of the levels of ANGPTL4, IL-17 and RANKL in serum of the observation group with disease activity were analyzed.

The serum levels of ANGPTL4, IL-17 and RANKL in the observation group were higher than those of the disease control group and the normal control group, while the ANGPTL4, IL-17 and RANKL in the disease control group were higher than the normal control group (P < 0.05). There was no significant difference in the expression levels of ANGPTL4, IL-17 and RANKL in the joint fluid between the observation group and the disease control group (P > 0.05). The expression levels of ANGPTL4, IL-17 and RANKL in the joint fluid of the observation group and the disease control group were lower than those in the serum, and the differences were statistically significant (P < 0.05). In patients with different disease activity degree in the observation group, the serum levels of ANGPTL4, IL-17 and RANKL in the highly active patients were higher than those in the low and moderate activity degree patients, and were higher in the moderate activity degree patients than those in the low activity degree patients, and the differences were statistically significant (P < 0.05). Pearson correlation analysis showed that serum ANGPTL4, IL-17 and RANKL levels were positively correlated with Disease Activity Score in 28 joints (DAS28) score, erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) levels(P < 0.001). Receiver operating characteristic curve showed that the area under the curve of ANGPTL4, IL-17 and RANKL in combination in predicting the 1-year joint imaging progression in patients with rheumatoid arthritis was 0.910.

Serum levels of ANGPTL4, IL-17 and RANKL are significantly positively correlated with disease activity degree in patients with rheumatoid arthritis, their combined prediction of 1-year joint imaging progression has better efficacy, providing a new way to monitor the changes of rheumatoid arthritis.

To investigate the effects of serum epidermal growth factor (EGF) and vascular cellular adhesion molecule-1 (VCAM-1) levels on fracture healing and bone metabolism in patients with traumatic fracture after surgery.

A total of 158 patients with traumatic fracture were selected and divided into normal healing group (117 cases) and delayed healing group (41 cases) according to the healing of fracture end at 4 months after operation. The levels of serum EGF and VCAM-1 at 24 h after operation as well as bone mineral density and serum bone metabolic indexes [bone gla protein (BGP), bone alkaline phosphatase (BALP), N-terminal procollagen type Ⅰ propeptide (PⅠNP), tartrate-resistant acid phosphatase isoform 5b (TRACP-5B), type Ⅰ collage cross-linked-telopeptide (CTX)] at 4 months after operation in two groups were compared. Pearson test was used to analyze the correlations of serum EGF and VCAM-1 levels with bone mineral density value and bone metabolism indexes levels in patients with traumatic fracture 24 h after operation.

At 24 h after operation, the serum EGF level of patients in the delayed healing group was significantly lower, and the serum VCAM-1 level was significantly higher than that in the normal healing group (P < 0.05). At 4 months after operation, the bone mineral density, BGP, BALP and PⅠNP levels in the delayed healing group were significantly lower, and TRACP-5B and CTX levels were significantly higher than those in the normal healing group (P < 0.05). The serum EGF level at 24 h after surgery was positively correlated with bone mineral density, serum BGP, BALP and PⅠNP levels at 4 months after surgery, and negatively correlated with TRACP-5B and CTX levels in patients with traumatic fracture (P < 0.05). The serum VCAM-1 level at 24 h after operation was negatively correlated with bone mineral density value, serum BGP, BALP and PⅠNP levels at 4 months after operation, and positively correlated with TRACP-5B and CTX levels (P < 0.05). Conclusion Abnormal high levels of serum EGF and VCAM-1 in the early postoperative period may indicate delayed bone healing and abnormal bone metabolism in patients with traumatic fracture.

To explore the risk factors of non-infectious fever (NIF) within 7 days after total knee arthroplasty (TKA), and to construct and verify the nomogram predictive model, so as to provide a concise and quantitative tool for clinical early diagnosis of NIF.

A total of 201 patients with knee osteoarthritis underwent unilateral TKA were enrolled as study objects by retrospective cohort study. According to whether NIF occurred within 7 days after operation, the patients were divided into NIF group (n=57) and non-NIF group (n=144). The clinical data between the two groups were compared, and the risk factors of NIF were screened by LASSO regression and multivariate Logistic regression. The nomogram model was established and verified internally.

Compared with the non-NIF group, the intraoperative blood loss, postoperative drainage volume, the number of patients with blood transfusion, operation time, antibiotic use time and hospital stay in the NIF group were significantly more or longer(P < 0.05). LASSO regression screened four variables with non-zero characteristics, namely intraoperative blood loss, postoperative drainage volume, blood transfusion and operation time. Multivariate Logistic regression analysis showed that intraoperative blood loss (OR=3.652, 95%CI, 2.856 to 3.958, P < 0.001), postoperative drainage volume(OR=2.857, 95%CI, 2.242 to 3.234, P < 0.001), blood transfusion (OR=4.001, 95%CI, 3.562 to 4.659, P < 0.001) and operation time (OR=1.859, 95%CI, 1.326 to 2.525, P < 0.001) were the independent risk factors to NIF within 7 days after TKA. R software was used to establish the nomogram model, total score was 120. The receiver operating curve (ROC) showed that the area under the curve (AUC) of nomogram for predicting NIF was 0.865(95%CI, 0.799 to 0.901), suggesting that the discrimination of the model was good. Calibration correction curve showed a good consistency of the model. Decision curve analysis (DCA) showed that the clinical value of the model was the greatest when the risk threshold of NIF exceeded 8%.

There is a high incidence of NIF within 7 days after TKA. Intraoperative blood loss, postoperative drainage volume, blood transfusion and operation time are the independent risk factors for the occurrence of NIF. The nomogram model constructed has good visualization effect, which has high efficiency in predicting the occurrence of NIF.

To investigate effect of thymus pentapeptide injection on immune function and postoperative infection in patients with open fractures of lower extremity.

The clinical data of 60 patients with Gustilo-Anderson type Ⅲ open fracture of lower extremity admitted to the emergency intensive care unit of Shanghai Jiao Tong University Affiliated to Sixth People′s Hospital were collected. The patients were divided into infected group (n=8) and non-infected group (n=52) according to whether postoperative infection occurred or not, and were divided into experimental group (n=42) and control group (n=18) according to whether they received treatment of injection of thymopentin or not. The control group received routine treatment, while the experimental group received intramuscular injection of thymopentin for 20 mg once a day for 7 days on the basis of routine treatment. The levels of lymphocytes and subsets were compared between the infected group and the non-infected group. The changes of immune function indexes and the occurrence of postoperative infection were observed between the experimental group and the control group.

Of 60 patients with lower extremity open fracture, 8 patients developed wound infection after operation. A total of 17 strains were isolated, including 5 strains of Klebsiella pneumoniae, 4 strains of Pseudomonas aeruginosa, 3 strains of Acinetobacter baumannii, 2 strains of Enterococcus faecium, 1 strain of Staphylococcus aureus, 1 strain of Escherichia coli and 1 strain of Enterobacter cloacae. On the 7th day after injury, the proportions of CD3 and CD4 cells in the infected group were lower than those in the non-infected group (P < 0.05). The infection rate of the experimental group was 9.52%, which was lower than 22.22% of the control group, but the difference was not statistically significant (P>0.05). On the 1st day after injury, the proportions of CD3 and CD4 cells in the experimental group were lower than those in the control group, while the proportion of CD19 cells was higher than that in the control group (P < 0.05). The proportions of CD3 cells, CD4 cells and ratio of CD4 to CD8 of the control group on the 7th day after injury were lower than those on the 1st day after injury (P < 0.05). In the experimental group, the proportions of CD3, CD4 and CD8 cells increased on the 7th day after injury, while the proportion of NK and CD19 cells decreased (P < 0.05).

Immunosuppression occurs after severe trauma. The proportions of CD3 and CD4 cells in infected patients decrease significantly. Although thymopentin injection can′t significantly reduce the postoperative infection rate of patients with open lower limb fractures, it can increase the proportions of CD3 and CD4 cells, and effectively improve the immune function of patients after injury.

To explore the effect of antagonistic exercise combined with extracorporeal shock wave therapy on elbow function and inflammatory factors in patients with tennis elbow.

A total of 86 patients with tennis elbow were randomly divided into observation group and control group, with 43 cases in each group. The control group was treated with antagonistic exercise, while the observation group was treated with antagonistic exercise combined with extracorporeal shock wave therapy. Both groups were treated for 8 weeks, and the therapeutic effect was compared between two groups.

At 8 weeks after treatment, the degrees of flexion activity, excess extension activity, internal rotation activity and external rotation activity in the observation group were (114.28±10.33), (8.68±2.22), (57.82±9.66) and (62.53±7.85) °, which were significantly higher than (85.44±9.65), (5.59±1.712), (46.65±6.83) and (51.47±5.67) °in the control group (P < 0.05). At 4 and 8 weeks after treatment, the Mayo elbow function (MEPS) scored (74.66±5.95) and (86.74±6.52) respectively in the observation group, which were significantly higher than (67.51±4.78) and (80.32±5.33) in the control group (P < 0.05); the grip strength of the observation group were (23.63±3.59) and (25.86±3.77) kg respectively, which were significantly higher than (19.18±2.74) and (23.42±2.22) kg of the control group (P < 0.05). At 8 weeks after treatment, serum tumor necrosis factor-α (TNF-α), nitric oxide (NO) and interleukin-1 (IL-1) decreased in both groups when compared to those before treatment, but there was no significant difference between the two groups (P > 0.05). At 8 weeks after treatment, the maximum thickness of the extensor tendon of the elbow joint in the observation group was (3.24±0.11) mm, which was significantly smaller than (4.62±0.42) mm in the control group (P < 0.05).

Antagonistic exercise combined with extracorporeal shock wave therapy can alleviate the local pain and discomfort of patients with tennis elbow, promote healing of soft tissues, and improve elbow mobility.

To investigate the clinical efficacy of modified minimally invasive surgery of integrated traditional Chinese and western medicine combined with Akin osteotomy in the treatment of patients with moderate to severe hallux valgus.

Sixty patients (114 feet) with moderate to severe hallux valgus were selected and divided into observation group and control group according to different surgical methods, with 30 cases in each group. The observation group was treated with modified minimally invasive surgery of integrated traditional Chinese and western medicine and Akin osteotomy, while the control group was treated with simple minimally invasive surgery of integrated traditional Chinese and western medicine. The hallux valgus angle (HVA), the intermetatarsal angle (IMA) between the first and second metatarsal bones, the distal articular set angle (DASA) and the score of the American Orthopedic Foot and Ankle Society (AOFAS) were compared between the two groups before operation, 6 weeks after operation and at the last follow-up.

The patients in both group finished operations successfully, the postoperative healing was good, and no complications such as nonunion or delayed union of fracture, permanent injury of medial cutaneous nerve and necrosis of metatarsal head were observed. The HVA in the control group and the observation group decreased from (39.14±6.62)°, (40.20±7.15)° before operation to (9.45±3.70)°, (5.89±1.70)° at 6 weeks after operation and (14.94±4.63)°, (8.54±2.14)° at the last follow-up, and there were significant differences between two groups (P < 0.01). The IMA of the control group and the observation group decreased from (13.74±2.83)°, (13.66±2.52) °before operation to (10.35± 3.08)°, (10.11±2.57)° at 6 weeks after operation and (8.11±2.71)°, (7.62±2.85)° at the last follow-up, but there were no significant differences between two groups (P > 0.05). The DASA of the control group and the observation group decreased from (11.75±4.73)°, (11.58±4.20)° before operation to (9.87±2.53)°, (7.19±1.25)°at 6 weeks after operation and (7.88±1.35)°, (5.74 ± 1.07)°at the last follow-up, and there were significant differences between two groups (P < 0.01). The AOFAS scores of the control group and the observation group increased from (48.45±7.88), (49.61±8.77) before operation to (83.29±3.91), (88.74±4.41) at 6 weeks after operation and (88.67±3.87), (95.53±2.60) at the last follow-up, and there were significant differences between two groups (P < 0.01).

Modified minimally invasive surgery of traditional Chinese and western medicine and Akin osteotomy is effective in the treatment of patients with moderate and severe hallux valgus, the obvious postoperative complications are few, and the probability of recurrence and postoperative metastatic metatarsal pain is low.

To observe the efficacy and complications of retrograde femoral intramedullary nailing and anterograde femoral intramedullary nailing in the treatment of midshaft fracture of femoral shaft.

A total of 76 patients with middle femoral shaft fracture were included in this study. According to the different placement methods of main screws, they were divided into retrograde group (36 cases) and anterograde group (40 cases). The conditions of perioperation, during follow-up and occurrence of complications of the two groups were compared.

There were no significant differences in diameter of intramedullary nail, the number of fluoroscopy, the number of screws at both ends of fracture between the two groups (P > 0.05). In the retrograde group, the operation time was shorter than that in the anterograde group, and amount of bleeding was more than that in the anterograde group (P < 0.05). At the last follow-up, there were no significant differences in fracture healing time, Harris score, Lysholm score and fracture healing rate between the two groups (P > 0.05). The knee flexion degree in the anterograde group was (130.22±4.31)°, which was better than (126.58±8.41)° in the retrograde group, and the incidence of knee pain in the retrograde group was 19.4%, which was significantly higher than 2.5% in the anterograde group (P < 0.05).

Both retrograde intramedullary nail and anterograde intramedullary nail can achieve satisfactory clinical effects in the treatment of middle femoral shaft fractures. Retrograde nail placement is relatively convenient without traction bed, but there are relatively more complications in knee joint after retrograde nail fixation.

To compare the anesthetic effect of lumbar plexus-sciatic nerve block anesthesia and combined spinal-epidural anesthesia respectively combined with dexmedetomidine for patients with femoral neck fracture.

A total of 80 elderly patients with femoral neck fracture were randomly divided into control group and study group, with 40 cases in each group. The control group was treated with lumbar plexus-sciatic nerve block anesthesia and dexmedetomidine, while the study group was treated with combined spinal-epidural anesthesia and dexmedetomidine. The anesthesia effect, anesthesia indexes, changes of vital signs before and after anesthesia, pain scores at different time points after operation, and adverse reactions were compared between the two groups.

The excellent and good rate of anesthesia in the study group was 95.00%, which was significantly higher than 72.50% in the control group (P < 0.05). The onset time of anesthesia, duration of motor nerve block and duration of sensory block in the study group were significantly shorter than those in the control group, while the duration of analgesia was significantly longer than that in the control group (P < 0.05). There were no significant differences in mean arterial pressure (MAP), heart rate (HR) and blood oxygen saturation (SpO₂) before anesthesia between the two groups (P > 0.05); the MAP and HR after operation in the control group were significantly lower than those before operation in the same group and in the same period in the study group (P < 0.05). The pain scores of the study group were significantly lower than those of the control group at 2, 12 and 24 hours after operation (P < 0.05). The incidence of adverse reactions in the study group was 7.50%, which was significantly lower than 25.00% in the control group (P < 0.05).

Combined spinal-epidural anesthesia and dexmedetomidine can better maintain the stability of physical function of elderly patients, which is more favorable for the prognosis of patients.

To evaluate the early clinical effect of a new type of titanium plate combined with titanium cable fixation in the treatment of acromioclavicular joint dislocation.

The clinical data were reviewed in 10 patients with acromioclavicular joint dislocation of Rockwood Type Ⅲ, and were treated by a new type of titanium plate combined with titanium cable fixation. Preoperative and postoperative coracoclavicular distance and acromioclavicular joint space were compared by imaging examination, and the loss of reduction was observed at 1 month, 3 and 6 months after operation were observed. Six months after the operation, the shoulder joint efficacy was evaluated according to the Karlsson evaluation standard of shoulder joint. The Visual Analogue Scale (VAS) and Constant-Murley shoulder joint function score were used to evaluate the shoulder joint function of the patients before operation, 3 and 6 months after operation.

All patients were followed up. Karlsson standard was used for evaluation at 6 months after surgery, the results showed that there were 8 excellent cases, 2 good cases. The preoperative coracoclavicular distance and acromioclavicular joint space significant difference compared with 1 month after operation (P < 0.05). There were no significant differences between the coracoclavicular distance and the acromioclavicular joint space at 1 month, 3 and 6 months after operation (P > 0.05). The VAS scores and Constant-Murley shoulder function scores before operation showed significant differences compared with those at 3 and 6 postoperative months (P < 0.05).

The new steel plate fixation combined with titanium cable fixation can effectively treat Rockwood Ⅲ type acromioclavicular joint dislocation, has less interference to the acromion and shoulder joint, and is simple in operation and firm in fixation, which guides a new direction for the treatment of acromioclavicular joint dislocation.

To observe the clinical effect of electromagnetic focused shock wave combined with coracohumeral ligament release in the treatment of patients with adhesive capsulitis of shoulder.

A total of 65 patients with adhesive capsulitis of shoulder were selected. A total of 33 patients in the control group were treated with coracohumeral ligament release, while 32 patients in the observation group were treated with electromagnetic focused shock wave and coracohumeral ligament release. Visual Analogue Scale (VAS) score, shoulder function (Constant scale) score, American Shoulder and Elbow Surgeons′ Form (ASES) and motion range of shoulder were compared between the two groups before and after treatment.

Before treatment, there were no significant differences in VAS score, Constant score, ASES score and score of motion range of shoulder between the two groups (P > 0.05); after treatment, the scores of patients in both groups improved significantly, and was significantly better in the observation group than that of the control group (P < 0.05).

In the rehabilitation of patients with adhesive capsulitis of shoulder, the clinical effect of coracohumeral ligament release combined with electromagnetic focused shock wave is more significant.

To investigate the characteristics of gut microbiota in pregnant women with gestational diabetes mellitus (GDM) and type 2 diabetes mellitus (T2DM) patients.

A total of 61 women were selected as research objects, including GDM pregnant women in group G (n=15), healthy pregnant women in group N (n=18), T2DM patients in group D (n=14), and healthy women in group A (n=14). Four groups of fecal samples were collected and sequenced by 16S rDNA high-throughput sequencing technology. The species diversity of samples and species differences between groups were analyzed.

Intestinal microbiota diversity analysis showed that there were statistically significant differences in Beta diversity between the GDM pregnant women and the healthy pregnant women as well as between the T2DM patients and the healthy women (P < 0.05). In terms of Alpha diversity, the microbiota richness of T2DM patients showed significant difference compared with that of the healthy women (P < 0.05). Compared with the healthy pregnant women, the abundance of Firmicutes in the gut microbiota of the GDM pregnant women was increased, while the abundance of Bacteroidetes and Lachnobacterium were decreased, and the differences were statistically significant (P < 0.05). Compared with the healthy women, the abundance of Phascolarctobacterium in the gut microbiota of T2DM patients was increased, while the abundance of human symbiotic bacteria such as Proteobacteria, Actinobacteria, Roseburia, Turicibacter, Streptococcus, Actinomyces, Coprococcus and Proteus were decreased, and the difference was statistically significant (P < 0.05).

Compared with the healthy women, the gut microbiota of pregnant women with GDM and T2DM patients are significantly different. The results of this study can provide a reference for the future clinical application of intestinal probiotics in the treatment of GDM and T2DM.

To construct and validate a predictive model for risk of hypoglycemia in neonates delivered by pregnant women with normal glucose tolerance.

The clinical materials of 1 865 pregnant women with normal glucose tolerance and their newborns were retrospectively analyzed, and they were divided into modeling population with 1 305 cases and validation population with 560 cases according to a ratio of 7 to 3 by random number method. In the modeling population, they were divided into hypoglycemia group 91 cases and normal group 1 214 cases according to occurrence of neonatal hypoglycemia, and the clinical indexes were compared between the two groups. The indicators with statistical significance were included in the multivariate Logistic regression analysis to screen the risk factors of neonatal hypoglycemia, and a prediction model was established based on the screening results. The performance of the model was evaluated by chi-square goodness-of-fit test and receiver operating characteristic (ROC) curve, and the validation population data was included in the predictionmodel to verify the prediction efficiency of the model.

There were no significant differences in the clinical materials between the modeling population and the validation population (P > 0.05). There were significant differences in the growth of body mass during pregnancy, estimated fetal body mass, gestational weeks of delivery, number of prenatal training, delivery mode and postpartum feeding between the hypoglycemic group and the normal group (P < 0.01). Multivariate Logistic regression analysis showed that increased growth of body mass during pregnancy (OR=2.939; 95%CI, 1.941 to 6.462), lighter estimated fetal body mass (OR=1.590; 95%CI, 1.158 to 2.906), earlier gestational week (OR=1.815; 95%CI, 1.397 to 3.872), less number of prenatal training (OR=1.828; 95%CI, 1.281 to 3.045), cesarean section (OR=3.411; 95%CI, 2.196 to 5.949) and improper postpartum feeding (OR=1.529; 95%CI, 1.182 to 2.748) were the risk factors of neonatal hypoglycemia in pregnant women with normal glucose tolerance (P < 0.05). The prediction model was established according to the risk factors, the chi-square goodness-of-fit test showed no significant difference (χ²=1.619, P=0.983), the area under the curve of ROC curve was 0.890 (95%CI, 0.842 to 0.937), which indicated that the model had no overfitting phenomenon and a strong discrimination ability. The materials of the validation population were included in the prediction model for validation, and it was found that the area under the curve of ROC curve was 0.864 (95%CI, 0.808 to 0.920), the sensitivity was 86.10%, and the specificity was 82.50%.

The prediction model for risk of hypoglycemia in neonates delivered by pregnant women with normal glucose tolerance based on the indexes such as growth of body mass during pregnancy, estimated fetal body mass, gestational weeks of delivery, number of prenatal training, delivery mode and postpartum feeding has a certain application value.

To observe the therapeutic effect of ultrasound debridement and traditional Chinese medicine foot bath in Wagner grade 2 or grade 3 ulcer of diabetic foot.

A total of 60 patients with Wagner grade 2 or grade 3 ulser in diabetic foot were selected and randomly divided into observation group (30 patients) and control group(30 patients). The observation group was treated with ultrasonic debridement combined with traditional Chinese medicine foot bath, and the control group was treated with mechanical surgical debridement. Four weeks later, the wound healing and the changes of hypersensitive C reactive protein and procalcitonin levels of the two groups were recorded, and the overall treatment effect was observed.

After 4 weeks of treatment, the wound area of the observation group was (1.86±0.61) cm², and the wound reduction rate was (86.13±12.36)%, while the wound area of the control group was (4.53±0.87) cm², and the wound reduction rate was (52.28±14.57)%. The wound area of the observation group was smaller than that of the control group, and the wound reduction rate was higher than that of the control group (P < 0.05). After treatment, high sensitivity C-reactive protein and procalcitonin in the observation group were (6.42±1.82) mg/L and (0.21±0.16) ng/L, respectively, which were lower than (12.38±2.46) mg/L and (0.35±0.32) ng/L in the control group (P < 0.05). The total effective rate of treatment in the observation group was 83.33%, which was higher than 56.67% of the control group, and the difference was statistically significant (P < 0.05).

Treatment of ultrasonic debridement and Chinese medicine foot bath can promote granulation tissue growth, wound healing and improve blood circulation of affected limb, which is worth of clinical promotion and application.

To analyze the correlations of serum parathyroid hormone (PTH) and 25 hydroxyvitamin D[25-(OH)-D]with glycolipid metabolism in patients with type 2 diabetes mellitus complicated with carotid atherosclerosis (CAS).

The clinical materials of 110 patients with type 2 diabetes mellitus from April 2019 to December 2021 were collected, and carotid ultrasound, glucose and lipid metabolism examination, and PTH and 25-(OH)-D detections were routinely performed after hospital admission. They were divided into simple type 2 diabetes group (n=51) and CAS group (n=59) according to the results of carotid artery intima-media thickness (CIMT) examination. The levels of PTH, 25-(OH)-D, blood glucose indexes [fasting blood glucose (FBG), glycated hemoglobin (HbA1c)]and blood lipids indexes [total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)]were compared between the two groups, and the relationships of serum PTH and 25-(OH)-D with blood glucose and lipid metabolism were analyzed.

There were no significant differences in gender, age, body mass index and course of disease between the two groups (P > 0.05); the level of serum PTH in the CAS group was significantly higher than that in the simple type 2 diabetes group, while the level of 25-(OH)-D was significantly lower than that in the simple type 2 diabetes group (P < 0.05); the levels of FBG and HbA1c in the CAS group were significantly higher than those in the simple type 2 diabetes group (P < 0.05); levels of TC, TG and LDL-C in the CAS group were significantly higher than those in the simple type 2 diabetes group, while the HDL-C was significantly lower than that in the simple type 2 diabetes group (P < 0.05). The results of bivariate Pearson linear correlation test showed that serum PTH was positively correlated with FBG, HbA1c, TC and TG (P < 0.05), and negatively correlated with HDL-C in patients with type 2 diabetes complicated with CAS (P < 0.05). 25-(OH)-D was negatively correlated with HbA1c, TC and TG (P < 0.01), and positively correlated with HDL-C (P < 0.05).

Serum PTH and 25-(OH)-D levels in type 2 diabetes mellitus patients with CAS are closely related to glucose and lipid metabolism.

To explore the correlation between atherogenic index of plasma(AIP) and diabetic retinopathy(DR).

A total of 445 patients with type 2 diabetes hospitalized in the Affiliated Hospital of Xuzhou Medical University were selected as study objects. According to DR diagnosis and staging criteria, the patients were divided into non-DR group (NDR group, n=188), nonproliferative group (NPDR group, n=134) and proliferative group (PDR group, n=123). The general information of patients and main biochemical indicators were collected. The general data and main biochemical indicators of patients in each group were compared, and AIP was calculated. The risk factors of DR were analyzed by Logistic regression, the correlations of AIP with risk factors were analyzed by Spearman correlation, and receiver operating characteristic (ROC) curve was used to analyze the value of AIP in screening DR.

Age in the PDR group was older, duration of diabetes in the PDR group was longer, the level of fasting blood glucose(FBG), glycosylated hemoglobin (HbA1c), low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and AIP in the PDR group were significantly higher, and the level of estimated glomerular filtration (eGFR) were lower than those in the NDR group and NPDR group(P < 0.05). Logistic regression analysis showed that age, duration of diabetes, HbA1c, LDL-C, eGFR and AIP were independent influencing factors for DR in T2DM patients. The area under the curve of AIP in predicting DR in T2DM patients was 0.745 (95%CI, 0.700 to 0.791). The threshold of AIP for DR screening was 0.186, the sensitivity was 74.3%, and the specificity was 64.4%.

AIP may be a reliable new indicator for DR screening in T2DM patients.

To explore the possible mechanism of vitamin C in alleviating macular degeneration in rats by regulating the function of macrophages.

SD rats were injected with sodium iodate into the tail vein to create a macular degeneration model, and vitamin C was given to the rats by gavage. Thirty SD rats were randomly divided into normal group, model group and treatment group after adaptive feeding for one week, with 10 rats in each group. The normal group was not given any treatment measures; in the treatment group, 40 mg/kg sodium iodate was injected into the tail vein to establish the model, and 100 mg/kg vitamin C was given by gavage once a day after the start of experiment; in the model group, 40 mg/kg sodium iodate was injected into the tail vein to establish the model, and the equal volume of normal saline was given by gavage every day after the start of experiment. After the treatment, the electroretinogram recording system was used to detect retinal potential of rats, the retinal structure, the number of retinal external nuclear cells and the epithelial layer of retinal pigment cells were detected by hematoxylin-eosin staining (HE staining), and flow cytometry was used to detect CD36 and CD206 in retinal macrophages.

Vitamin C was able to alleviate the retinal damage in rats. The number of retinal external nuclear cells in the model group was (72.90±15.60) cells per field of vision, which was lower than (126.40±13.60) cells per field of vision in the treatment group (P < 0.01). The epithelial layer of retinal pigment cells in the model group was (1.56±0.93) layers per field of vision, which was significantly lower than (3.49±0.88) layers per field of vision in the treatment group (P < 0.05). Vitamin C was able to increase the retinal potential of age-related macular degeneration (AMD) rats, protect the retinal function of rats, and alleviate the progression of AMD. Vitamin C was able to increase the ratio of CD36 positive cells and reduce the ratio of CD206 positive cells, which was reflected as follows: the ratio of CD36 positive cells of retinal macrophages in the model group was (33.98±6.86)%, which was significantly lower than (46.86±3.83)% in the treatment group (P < 0.01). The ratio of CD206 positive cells of retinal macrophages in the model group was (43.59±6.51)%, which was significantly higher than (31.52±4.08)% in the treatment group (P < 0.01).

Vitamin C can alleviate macular degeneration in rats by enhancing phagocytic capacity of retinal macrophages and inhibiting M2 polarization of macrophages.

To investigate the clinical value of pterygium excision combined with conjunctival flap transplantation in treatment of pterygium.

A total of 60 patients (72 eyes) with pterygium were selected as research objects, 30 patients (36 eyes) treated with pterygium excision combined with conjunctival flap transplantation were included in observation group, and 30 patients (36 eyes) treated with pterygium excision combined with amniotic membrane transplantation were included in control group. The tear film function parameters, including basal tear secretion length (5 min), tear film rupture time and fluorescein staining score were evaluated before operation and at 3 and 6 months after operation. On 1st, 3rd, 5th and 14th postoperative day, the ocular comfort of patients in the two groups were evaluated respectively. After 1 year of follow-up, the efficacy and recurrence of the two groups were compared.

There were no significant differences in the preoperative basal tear secretion length, tear film break-up time and fluorescein staining score between the two groups(P > 0.05). The tear film break-up time of the observation group was longer than that of the control group at 3 and 6 months after the operation, and the fluorescein staining score was lower than that in the control group (P < 0.05). The total scores of eye comfort on the 1st, 3rd, 5th, and 14th day after operation in the observation group were significantly lower than that in the control group (P < 0.05). There were no significant differences in curative effect and recurrence rate between the two groups at one year after operation (P < 0.05).

Pterygium excision combined with conjunctival flap transplantation is effective in treatment of pterygium, and no serious complications occur.

To observe the adverse reactions of 0.01% atropine eye drops in treatment of children with myopia.

The children in observation group wore full correction single focus frame glasses, and every night before going to bed, children had to put one drop of 0.01% atropine eye drops into the conjunctival sac; children in control group only wore full correction single focus frame glasses. Before administration and after 6 months of treatment, the best corrected near vision, diopter, intraocular pressure, ocular axis, pupil diameter, adjustment range, tear film rupture time and tear secretion test were examined in both groups.

There were no significant differences in refractive diopter and optic axis between two groups before treatment(P > 0.05). After 6 months of treatment, refractive diopter was -1.38 (-2.19, -0.50) D in the observation group and -2.25 (-2.94, -1.75) D in the control group (P < 0.05); after 6 months of treatment, the length of optic axis in the observation group was (24.17±0.72) mm, and (24.67±0.88) mm in the control group, and the difference was statistically significant (P < 0.05). After 6 months of treatment, the pupils of the observation group were slightly enlarged, the amplitude of adjustment was decreased, the tear film rupture time was shortened, and the tear secretion test value was decreased, and the differences were statistically significant (P < 0.05). No blurred vision for near objects, dry, red and itching eyes occurred in children of both groups.

0.01% atropine eye drops can effectively slow down the growth of the ocular axis and the progression of myopia degree in children with myopia, and the adverse reactions are relatively mild, which have no significant impacts on children′s daily life and learning.