Objective To provide an anatomic data of the lumbar isthmus, and to increase the fusion rate of the graft bone for spondylolisthesis treated with posterolateral spinal fusion and Steffee plate fixation. Methods The area and volume of the bone graft bed for posterolateral spinal fusion in the lumbar isthmus were studied on 30 dried specimens of adult lumbar spines from L 1 to L 5(a total of 150 lumbar vertebrae) with a vernier calipers, a goniometer and a graduate. Results The length of the superior edge of the isthmus gradually increased from L 1[(7.34? 1.15) mm] to L 5[(10.31? 1.89) mm], and that of its inferior edge progressively decreased from L 1[(6.63? 1.24) mm] to L 5 [( 4.73? 1.21) mm]. The superior edge of the isthmus was the thinnest at L 1[(1.85? 0.64)mm], and the thickness increased inferiorly from L 1[(6.57? 1.24) mm] to L 5[(7.57? 1.16) mm]. The medial and caudal inclination of the isthmus with respect to the pedicle gradually increased from L 1 (113.9?? 13.3? ) to L 5(119.1?? 13.5? ) medial inclination and from (101.2?? 9.5? ) at L 1 to (117.6?? 13.4? ) at L 5 caudal inclination, respectively. The length of the superior edge of the isthmus and the transverse diameter of the pedicle were positively correlated to the vertebral levels. The length of the inferior edge of the isthmus were negatively correlated to the vertebral levels. The dimensions of the graft bed area were postively correlated to dimensions of the graft bone volume. Conclusion The application of firm spinal internal fixation system with adequate graft bed area and adequate graft volume, the maintenance of close contact between the graft bed and the graft bone, and adequate period of postoperative stable contact of the graft in bed were the keys to enable reduction of the spondylolisthesis and to increase the fusion rate of posterolateral bone graft.

Objective To provide the anatomical basis for treatment of comminuted fractures of the radial head with bending steel miniplates by observations of the proximal end of the radius (PEOTR) in adults and to investigate the effect of its application. Methods The PEOTR and the dynamic relationship between the articular circumference of the radial head and the ulnar radial notch were studied with 32 pairs of specimen of the dried radii and ulnae in adults. From Jan 1988 to Mar 1998, eleven cases of comminuted fractures of the radial head were treated with bending steel miniplates procedure; there were seven males and four females, with an average age of 35 years. According to Mason's grading, 9 cases were classified as Type Ⅲ radial head fractures, 2 cases as Type Ⅳ radial head fractures. Results The average length of the PEOTR was 41.6 mm. The radial neck deviated from the radial shaft at an angle of 164?. Then at the neutral position, the greatest range of pronation and supination of the forearm, the range of contact of radians and the range of non contact radian between the articular circumference of the radial head and the ulnar radial notch were 69?,108?,45? and 138?, respectively. The period of follow up in all cases was 20-38 months. All had bony union, with an average healing time of 8.5 months. Evaluation was done according to the criterion made by Broberg and Morrey. The result was excellent in 6 cases, good in 4 cases, and fair in 1 case. Conclusion The treatment of comminuted fractures of the radial head with bending steel miniplates is a safe and effective method.

Tibia shaft fracture is the most common long bone fractures clinically and intramedullary nail fixation is the best choice due to superior biomechanical characteristics for unstable tibia shaft fractures.At present,the common approaches for intramedullary nail insertion are divided into supra-patellar approach and infra-patellar approach.The semi-extended position of supra-patellar approach contributes to better fracture reduction but lead to potential patella-femoral cartilage injury.In contrast,flexion or hyper-flexion position of infra-patellar approach might result in unsatisfactory fracture reduction,then have an impact on clinical outcome.Therefore,the clinical outcome might be different because of approach choice.However,there is no consensus about the optimal surgical approach for intramedullary nailing.Thus,we performed the review to discuss the approaches for tibia intramedullary nailing and compare their strengths and weaknesses.

Objective: To analyze the suicide attitude and influencing factors of college students with mental disorders in Shaoxing City, and to provide a basis for improving the attitude of college students with mentaldisorders towards suicide. Methods: From January 2018 to December 2021, 1 100 college students, among which 110 were previously confirmed by medical institutions to have mental disorders, were selected from two schools in Shaoxing, including Shaoxing University and Yuexiu Foreign Languages College, to participate in a questionnaire survey. Univariate and multivariate Logistic regression analysis were used to identify the main factors affecting the suicide attitude of college students with mental disorders. Results: Univariate analysis showed that the influence of different nature of college students with mental disorders on suicide attitude was related to age, gender, origin, suicide ideation, whether suicidal thoughts can be controlled, impulsive personality type, problem solving style, the differences were statistically significant ( χ 2/t=9.01, 15.05, 5.90, 5.86, 6.47, 4.92, 13.48, P <0.05). Multivariate Logistic regression analysis showed that age, gender, origin, suicidal ideation, uncontrolled suicidal thoughts, impulsive personality type, problem solving style were the main factors influencing the suicidal attitude of college students with mental disorders ( OR=3.13, 3.06, 2.89, 3.22, 3.25, 3.13 , 3.16, P <0.05). Conclusion problem solving and other factors. The selection of targeted treatment plan can improve the mental disorder condition of college students and promote the recovery of the disease.

Objective: To investigate the safety and efficacy of needle-tract assisted standard percutaneous nephrolithotomy (PCNL) for the treatment of complicated upper urinary tract calculi. Methods: The clinical data of 1 562 patients with complicated upper urinary calculi who received standard PCNL from December 2013 to December 2017 at Department of Urology, the First Affiliated Hospital of Xiamen University were retrospectively analyzed. There were large residual stones in 256 patients through B-ultrasound exploration after standard PCNL, could′t be detected with nephoscope in standard PCNL tracts. 16 F mini PCNL tract were established in 120 cases for treatment of residual stones, while needle-tract were established in order to guide nephroscope to find residual stones in 126 cases. Needle-tract were transferred to 16 F mini PCNL tract for treatment of residual stones in 10 patients if these residual stones could′t be detected through needle-tract. Operation time, change of hemoglobin level after operation, incidence of postoperative complications, time of hospitalization and rate of stone clearance were measured in two groups. The statistical methods used included t test, Wilcoxon rank sum test, and χ² test. Results: There were 1 to 3 mini tracts (M(Q_R): 1(1)) established in the mini tracts group and 1 to 7 needle-tracts (M(Q_R): 3(2)) established in the needle-tract group (Z=-10.57, P=0.000). Compared with mini tract group, the operation time ((62.0±18.0) minutes vs. (84.0±15.5) minutes, t=10.242, P=0.000), hospitalization time ((4.40±0.86) days vs. (5.20±0.81) days, t=7.570, P=0.049), hemoglobin dropped ((1.31±0.47) g/L vs. (2.74±0.63) g/L, t=20.12, P=0.000), and incidence of postoperative complications (7.9% (10/126) vs. 19.2% (23/120), χ²=6.674, P=0.01) of needle-tract group were lower, while postoperative stone clearance rate was higher (89.7% vs. 76.7%, χ²=7.497, P=0.006). No perioperative severe complications such as pleural injury, pneumatothorax, perforation of renal, trauma of abdominal organ occurred in two groups. Conclusion Needle-tract assisted standard PCNL for the treatment of complicated upper urinary calculi can significantly improve stone clearance rate, reduce operation time, decrease risk of kidney and surrounding organs damage.

Objective To investigate the changes in the percentages of CD4+T lymphocyte subsets and the homeostasis of T lymphocytes among MSM ( men who have sex with men) population with different stages of HIV-1 infection. Methods A total of 166 untreated MSM with HIV infection were enrolled and di-vided into three groups including early HIV infection (EHI, n=38) , HIV (n=94) and AIDS (n=34) groups. Sixty-two MSM negative for anti-HIV antibody were selected as healthy controls. Blood samples were collected into EDTA tubes and detected to analyze the changes in the distribution of CD4+ T cells and CD8+T lymphocyte subsets ( CD4+ CD45RA+, CD8+ CD28+, CD4+ CD25+ CD127-) and the percentages of activated (CD38, HLA-DR) and apoptotic cells (CD95) with disease progression by flow cytometry. Re-sults The expression of CD4+CD45RA+ T lymphocytes gradually decreased with the progression of AIDS. The percentage of CD4+CD45RA+ T lymphocytes in HIV group was lower than that of the control group, but higher than that of the AIDS group (P=0. 015, P=0. 000). No significant difference was found between the EHI and the control groups (P>0. 05). CD8+CD28+T cells were significantly reduced in the EHI group and remained at a low level with disease progression. No significant difference in the proportion of CD4+CD25+CD127- T cells was observed among all groups (P>0. 05). The percentage of CD4+CD38+HLA-DR+T cells increased gradually and the highest level was detected in the AIDS group, followed by those in the HIV, EHI and control groups (P<0. 01). The percentages of CD8+CD38+, CD8+HLA-DR+, CD8+ CD38+HLA-DR+and CD8+CD95+T cells in the EHI, HIV and AIDS groups were significantly higher than those in the control group (P<0. 01), but there was no significant difference among the former three groups (P>0. 05). Con-clusion HIV infection caused the changes in the numbers and functions of T lymphocyte subsets and accel-erated the activation and apoptosis of T lymphocytes, which aggravated the T lymphocyte immune dysfunction even further. A comprehensive analysis of the alterations in different T cell subsets would be conducive to re-flect the immune deficiency and the severity of disease. CD4+ and CD8+ T cells were activated in the early stage of HIV infection, which indicated that studying the immune response during that stage might help to understand their roles in disease progression.

Objective:To investigate the effects of highly active anti-retroviral therapy (HAART) on the activation of T lymphocytes and expression of CD4 + CD45RA + T cell subsets in HIV/AIDS patients. Methods:This study prospectively analyzed 105 HIV/AIDS patients undergoing HAART and 35 HIV-1-negative cases (healthy controls). Flow cytometry was used to detect the activation of T lymphocytes and the percentages of CD4 + CD45RA + T cell subsets in whole blood samples taken from healthy controls and HIV/AIDS patients before and after therapy. Results:The activation of T lymphocytes was significantly enhanced in the 105 HIV/AIDS patients than in the healthy controls before treatment ( P<0.01). The activated T lymphocytes gradually decreased after HAART. Firstly, CD4 + CD38 + HLA-DR + , CD8 + CD38 + and CD8 + HLA-DR + T lymphocytes decreased one month after therapy ( P<0.05). Then, four indicators of T lymphocyte activation including the expression of CD8 + CD38 + HLA-DR + T lymphocytes decreased significantly six months after therapy ( P<0.01). The percentage of CD8 + CD38 + HLA-DR + T lymphocytes detected 12 months after therapy was significantly lower than that analyzed six months after therapy ( P<0.01). No significant difference was found in the expression of the other three indicators for activation ( P>0.05). Twelve months after therapy, the four indicators for T lymphocyte activation in HIV/AIDS patients were still significantly higher than those of the control group ( P<0.01). The percentages of CD4 + CD45RA + T lymphocytes in HIV/AIDS patients were significantly lower than those in healthy controls before and 12 months after treatment ( P>0.05). Conclusions:HAART could reduce immune activation after six months of treatment, but could not reverse the activation nor restore the expression of CD4 + CD45RA + T lymphocytes in HIV/AIDS patients.

Objective To investigate the subtype distribution of HIV-1 infection among men having sex with men (MSM) in Xi' an city.Methods 5 ml anti-coagulating blood samples were collected from MSM who had been reported during 2010-2012 in Xi'an.Both gag and env genes were amplified by nested RT-PCR from the extracted RNA and then sequenced.The acquired sequences were compared with international subtype references,and then the genetic distances were calculated and phylogenetic trees were constructed by Mega 5.2.Epidemiological information including sexual behavior characteristics,history of drug use,blood donation,etc.were gathered.Results 168 samples were successfully amplified and sequenced.Results from Phylogenic analysis showed that the gag and env sequences of 165 samples shared the same subtypes,of which 79 (47.0％) were CRF01_AE,74 (44.0％) were CRF07_BC and 12 (7.1％) belonged to subtype B.There were 3 samples with gag and env sequences classified into different subtypes,of which 2 (1.2％) were CRF01_AE/A1,and the other 1 was CRF07_BC/CRF01_AE.Conclusion At least three HIV-1 subtypes including CRF01_AE,CRF07_BC were identified among MSM population in Xi'an city.

Human dental pulp stem cells (DPSCs) have emerged as an important source of stem cells in the tissue engineering, and hypoxia will change various innate characteristics of DPSCs and then affect dental tissue regeneration. Nevertheless, little is known about the complicated molecular mechanisms. In this study, we aimed to investigate the influence and mechanism of miR-140-3p on DPSCs under hypoxia condition. Hypoxia was induced in DPSCs by Cobalt chloride (CoCl
Cell Differentiation ; Histone-Lysine N-Methyltransferase ; Humans ; Hypoxia ; Methyltransferases ; MicroRNAs