BACKGROUND:The type of simply youth compressibility fracture of thoracic and lumbar spine with posterior vertebral injury nailing reset scheme can effectively reset with mechanics from the rear, but due to bone characteristics of the youth, the rear force cannot effectively open anterior and middle columns. To improve the effect of rear reset during the operation becomes the focus of clinical attentionand difficult issues.
OBJECTIVE:To retrospectively analyze reset reconstruction effects of posterior screw rod fixation for youth thoracolumbar simple flexion compression fracture.
METHODS:Patients with youth thoracolumbar simple flexion compression fracture were treated with posterior screw rod fixation from June 2014 to June 2015. Perioperative indicators (operation time, blood loss, average length of stay and complication rate) were recorded. Patients were folowed up. Imaging indexes (anterior height of vertebral compression, Cobb angle of the injured vertebra) and subjective effect index (low back pain visual analog scale and the Oswestry Disability Index) were observed.
RESULTS AND CONCLUSION:(1) Imaging index: Anterior height of vertebral compression and Cobb angle of the injured vertebra were significantly improved after treatment (P< 0.05). No significant difference was detected at different time points after treatment (P> 0.05). (2) Subjective effect index: low back pain visual analog scaleand the Oswestry Disability Index were significantly improved after treatment (P< 0.05). No significant difference was found at different time points after treatment (P> 0.05). (3) No nerve injury complications appeared in al patients, without leakageof cerebrospinal fluid. (4) Results indicated that extended posterior screw rod fixation for youth thoracolumbar simple flexion compression fracture can obtain effective reduction due to special bone characteristics of the youth, improve reduction efficiency, do not increase patient’s trauma and the effects are affirmative.

AIM: To investigate the relationship between human cholesteryl ester transfer protein CETP gene polymorphism and postoperative neurocognitive disorders (PND). METHODS: A total of 124 elderly patients over 65 years of age who underwent elective non-cardiac surgery were enrolled in the study while 25 healthy volunteers matching age and sex were recruited as the control group. Neuropsychological tests were performed 1 day before surgery, 7 days, and 3 months after surgery. PND was determined using the Z value method. The venous blood sample of the surgical patient was taken before the operation, followed by direct gene sequencing. Statistical methods were used to calculate the correlation between CETP gene polymorphism (rs5882) and PND. RESULTS: The incidence of PND was 29.3% and 18.2% at 7 days and 3 months after operation respectively. The A allele frequency of PND patients was significantly higher than that of non-PND patients 7 days and 3 months after surgery (65.52% vs. 41.43%, 34.48% vs. 58.57%, P=0.001), while the G allele frequency in PND group lower than that of non-PND (58.33% vs. 37.86%, 41.67% vs. 62.14%, P=0.004).AA genotype in PND patients was 34.48%, 38.89% at 7 days and 3 months after surgery respectively, significantly higher than 14.29%, 16.05% of non-PND (P=0.023, P=0.029). CONCLUSION: CETP rs5882 polymorphism is associated with PND and AA genotype may be a predisposing factor for postoperative PND in Chinese Han elderly patient.

Purpose: Loss-of-function mutations in the adenomatous polyposis coli (APC) gene are common in metastatic colorectal cancer (mCRC). However, the characteristic of APC specific mutations in mCRC is poorly understood. Here, we explored the clinical and molecular characteristics of N-terminal and C-terminal side APC mutations in Chinese patients with mCRC. Materials and Methods: Hybrid capture-based next-generation sequencing was performed on tumor tissues from 275 mCRC pati-ents to detect mutations in 639 tumor-associated genes. The prognostic value and gene-pathway difference between APC specific mutations in mCRC patients were analyzed. Results: APC mutations were highly clustered, accounting for 73% of all mCRC patients, and most of them were truncating mutations. The tumor mutation burden of the N-terminal side APC mutations group (n=76) was significantly lower than that of the C-terminal side group (n=123) (p < 0.001), further confirmed by the public database. Survival analysis showed that mCRC patients with N-terminus side APC mutations had longer overall survival than C-terminus side. Tumor gene pathway analysis showed that gene mutations in the RTK/RAS, Wnt and transforming growth factor β signaling pathways of the C-terminal group were significantly higher than those of the N-terminal group (p < 0.05). Additionally, KRAS, AMER1, TGFBR2, and ARID1A driver mutations were more common in patients with C-terminal side APC mutations. Conclusion APC specific mutations have potential function as mCRC prognostic biomarkers. There are obvious differences in the gene mutation patterns between the C-terminus and N-terminus APC mutations group, which may have certain guiding significance for the subsequent precise treatment of mCRC.