BACKGROUND: Anterior cervical discectomy combined with cage and anterior locking titanium plate is widely used for the treatment of various kinds of cervical spondylosis. Microsurgical technique has increasingly become a standard technique.OBJECTIVE:To explore the clinical effects of anterior cervical microsurgical discectomy combined with cage and anterior locking titanium plate for cervical spondylosis. METHODS: Clinical data of 108 patients treated with anterior cervical microsurgical discectomy combined with cage and anterior locking titanium plate were retrospectively analyzed. According to the clinical outcome before and after surgery,including the scores of Japanese Orthopedic Association, visual analogue scale of neck and upper extremities, neck disability index, imaging manifestations (disc space height and Cobb angle) and other indexes, the surgical results were evaluated.RESULTS AND CONCLUSION: Compared with pre-operation, the postoperative Japanese Orthopedic Association score, visual analogue scale score of neck and upper extremities, neck disability index score, disc space height and Cobb angle were markedly improved, with a significant difference (P < 0.05). The improvement-rate of the spinal function included 102 excellent cases and 6 good cases. Complete fusion of bone graft observed in all cases. It suggested that anterior cervical microsurgical discectomy combined with cage and anterior locking titanium plate has significant effect on various types of cervical spondylosis.

Objective To investigate the risk factors for severe hypoglycemia in the treatment of type 2 diabetes mellitus (T2DM) and to provide scientific rationales for the prevention of hypoglycemia in treating diabetes.Methods Clinical data of 49 T2DM patients with severe hypoglycemia (hypoglycemic group) and 98 T2DM patients without hypoglycemia as control group were retrospectively analyzed.Severe hypoglycemia was defined as that patient requiring assistance for intaking carbohydrate to alleviate hypoglycemia and plasma glucose concentration was less than 3.9 mmol/L.Clinical and biochemical indexes were analyzed by the single-factor analysis.Logistic regression model was established by multi factors regression analysis,and the receiver operating characteristic (ROC) curve was used to assess the performance of the logistic regression model.Results The mean serum glucose level was (2.3±0.7) mmol/L during hypoglycemia in hypoglycemia group.The mean age was higher in hypoglycemia group than in control group [(76.2±6,5) years vs.(69.8±11.5) years,P=0.001].The mean glycosylated hemoglobin Alc (HbAlc) level was lower in hypoglycemia group than in control group [(6.4±0.8)％ vs.(9.1± 2.5)％,P＜0.001].Endogenous creatinine clearance rate (Ccr) was lower in hypoglycemia group than in control group [(46.8±21.0) ml/min vs.(74.2 ± 24.5) ml/min,P＜0.001].Logistic regression analysis indicated that female and HbA1c level were the independent risk factors for severe hypoglycemia (OR=11.83,0.91 and 0.18,95％CI:1.82 76.93,0.86-0.97 and 0.08-0.44,respectiely] ; T2DM therapies with insulin and insulin secretagogues increased the risk of hypoglycemia (OR＝12.31 and 5.36,95％CI:1.70-88.88 and 1.08-26.56); however,duration of diabetes,body mass index (BMI),and urinary microalbumin (UMA) had no correlation with severe hypoglycemia (all P＞0.05).The area under the ROC curve was 96.5％ by the logistic regression model.Conclusions Gender,Ccr,HbA1c,insulin and insulin secretagogues are the main risk factors for severe hypoglycemia in T2DM patients.Preventive interventions of hypoglycemia should be taken earlier for the patients with the high risk factors.

Objective To investigate the prevalence of the depression and the activities of daily living in the elderly population in Hebei province.Methods In this cross-sectional study,3 176 subjects aged over 60 were selected from 4 urban communities in Hebei Province.The demographic data was collected,and the Center for Epidemiological Survey,Depression Scale,(CES-D) and the activities of daily living Scale (ADL) were used to assess their depression status and activities of daily living.Results Among the 3 176 subjects,268 cases (8.4％) got the CES-D scores of over 15 and 232 cases (7.3％) got the ADL scores of over 26.14.2％ of depression group needed life care,27.9％ of depression group had absence of daily living activities.Multivariate logistic results showed that gender (OR=2.142),diseases situation (OR=2.214),marriage (OR=0.484),and life abilities like shower (OR =1.333),walk around home (OR=1.275),wear clothes(OR=2.129),moving on a wheelchair(OR=1.118) had significant effect on depression.Conclusion Elder people population who have characteristics like female,single,illness,can't take shower by themselves,life care depended,more likely get higher CES-D scores and depression.

of glucose and insulin are also marked after congee intake.

OBJECTIVE：To study the reversal effect of quercetin on human cervical squamous carcinoma cisplatin-resistant cell line SiHa/DDP. METHODS ：The drug resistance index of cisplatin to SiHa/DDP cells ，and the reversal resistance multiple of quercetin to SiHa/DDP cells were determined. The effects of quercetin （0.005 μg/mL），cisplatin（2.5 μg/mL），cisplatin combined with quercetin （2.5 μg/mL cisplatin+0.005 μg/mL quercetin），quercetin combined with pathway inhibitor（0.005 μg/mL quercetin+ 20 nmol/L rapamycin ）on the apoptotic rate of SiHa/DDP cells were investigated ，as well as its effects on the expression of phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）/mammalian rapamycin target protein （mTOR） signaling pathway related proteins （PI3K，Akt，mTOR，P-gp，p70S6K）. RESULTS ：The resistance index of cisplatin to SiHa/DDP cells was 5.19， and reversal resistance multiple of quercetin to SiHa/DDP cells was 4.00. Compared with cisplatin alone and quercetin alone ， cisplatin combined with quercetin ，quercetin combined with rapamycin could significantly increase the apoptotic rate of SiHa/DDP cells（P＜0.05），while decreased the phosphorylation of Akt ，mTOR and p 70S6K protein as well as the expression of P-gp protein （P＜0.05）. CONCLUSIONS ：Quercetin can effectively reverse drug resistance of SiHa/DDP cells to cisplatin ，which may be associated with inhibiting the expression of the protein related to PI 3K/Akt/mTOR signaling pathway.

OBJECTIVETo understand the distribution of diarrheagenic Escherichia (E.) coli in population in Shanghai and discuss the practice model of cooperation in enteric infectious disease prevention and control between public health institution and hospital.

METHODSSentinel hospitals were assigned, standard detection and identification of diarrheagenic E. coli were conducted, incidence curve of diarrheagenic E. coli infection was drawn and epidemiologic survey and laboratory detection were conducted for suspect diarrheagenic E. coli infection outbreaks.

RESULTSA total of 7 204 stool specimens were collected from diarrhea patients in 4 hospitals during 2012-2013, in which 712 (9.9% ) were diarrheagenic E. coli positive, including 351 enteropathogenic E. coli (EPEC) strains, 292 enterotoxigenic E. coli (ETEC) strains, 32 enteroinvasive E. coli(EIEC) strains and 6 Shiga toxin-producing E. coli (STEC/EHEC) strains, as well as 31 mixed strains. EPEC infection mainly occurred in children aged 1-5 years; and all of these infections were caused by aEPEC. The incidence peak of ETEC infection was during August, the positive rate was >20%. The ETEC infection mainly occurred in infants aged 1-28 days in 2012 and in people aged 20-60 years in 2013 (P<0.05). ST was the major type (59.6%), followed by LT (27.8%) and ST/LT (12.6%). EIEC infection increased in children obviously in 2013 (P<0.01). No EHEC O157:H7 case was detected, but two EHEC O26:H11 (eae-hlyA-stx1a) cases in children were reported for the first time in Shanghai. The survey result indicated that the multidrug-resistant ETEC (STh-CS21-CFA/I-ClyA-EatA-ST2332-SHNL0005) strain causing outbreak in 15 newborns in Shanghai in 2012 was in the same clone as the strain detected in Zigong in Sichuan province.

CONCLUSIONSignificant change has occurred in diarrheagenic E. coli distribution in Shanghai in recent years, ETEC has potential risk to cause outbreak of hospital acquired infection in neonates and food borne infection. The active surveillance on ETEC and other enteric pathogens by both public health institutions and hospitals need to be improved.

Adult ; Child, Preschool ; China ; epidemiology ; Diarrhea ; microbiology ; Disease Outbreaks ; Enteropathogenic Escherichia coli ; isolation & purification ; Enterotoxigenic Escherichia coli ; isolation & purification ; Escherichia coli Infections ; epidemiology ; Humans ; Incidence ; Infant ; Infant, Newborn ; Middle Aged ; Sentinel Surveillance ; Young Adult