Objective To analyze the influence factors of long-term efficacy of different fusion combined with pedicle fixation for lumbar spondylolysis.Methods The surgical and postoperative follow-up data of 196 cases with lumbar spondylolysis were analyzed retrospectively.Age,gender,body mass index ( BMI ),disease course,preoperative Japanese orthopaedic association (JOA) score,fusion segments,fusion method,immediate postoperative recovery rate and postoperative functional exercise,which might affectlong-term operation efficacy,were selected to undergo single-factor analysis and multivariate regression analysis.Results All the patients were followed up for 5-9 years and 5.4 years for average,163 cases got excellent or good curative effect,the rate of excellent and good effect was 83.2％( 163/196);33 cases got poor efficacy.There was no cerebrospinal membrane tear,cerebrospinal fluid leakage,infection,fracture fixation and other complications happened after operation.Single-factor analysis showed that disease course,BMI,preoperative JOA score and postoperative functional exercise had obvious relation with long-term efficacy (P ＜ 0.05 ) ;while age,fusion method,fusion segments,immediate postoperative recovery rate and gender had no significant relation with long-term efficacy (P ＞ 0.05).Multivariate regression analysis showed that disease course,preoperative JOA score,postoperative functional exercise were important factors influencing long-term efficacy (OR =1.423,2.089,1.320,P=0.023,0.012,0.034).Conclusions Disease course,preoperative JOA score,postoperative functional exercise are important factors influencing long-term efficacy of surgery for patients with lumbar spondylolysis.

Objective To explore the correlation of the operation effects of the miorovascular decompression(MVD) and the findings on magnetic resonance tomographic angiography(MRTA) in patients of neurovascular compression of the cranial nerves.Methods Two hundred and twenty three patients treated with the microvascular decompression were analyzed retrospectively.They were grouped and graded according to the vessel compression on the cranial nerves.The compression were grouped as none, moderate and severe, and the operation effects were graded as Ⅰ ( complete relief), Ⅱ ( partial relief) and Ⅲ ( no relief).The operation effects grades were correlated according to the compression groups by Kruskal-Wallis test and the operation effects between each two of the groups were compared using Nemenyi test.P < 0.05 was defined as statistic significant.Results Of the 53 cases of non-compression group, 31 cases were graded as Ⅰ , 13 cases were graded as Ⅱ and 9 cases were graded as Ⅲ, according to the operation-effects of the decompression.Of the 110 cases of moderate group,95 cases were grade as Ⅰ , 11 cases were graded as Ⅱ and 4 cases were graded as Ⅲ.Of the 60 cases of severe group, 48 cases were graded as Ⅰ, 7 cases were graded as Ⅱ and 5 cases were graded as Ⅲ.There were statistic significance among the three groups,where χ2= 16.84 and P <0.05.The mean rank of the non-compression, the moderate and the severe group was 134.21,102.37 and 110.4 ,respectively.The difference of the mean ranks between the non-compression group and the moderate group was 31.84, and between the non-compression and the severe group was 24.17, respectively, where P < 0.05 both.Conclusions There was close relationship between the findings on magnetic resonance tomographic angiography and the operation effects of the MVD.The operation effects of patients with moderate and severe vessel compression were much better than the non-compression group.MRTA is helpful for MVD surgical indication and its prognosis.

OBJECTIVETo explore the clinical significance of eukaryotic initiation factor 4 E (eIF4E) and mammalian target of rapamycin (mTOR) expressions in esophageal squamous carcinoma tissues.

METHODSClinicopathological data and paraffin samples of resected tumor tissue from 148 patients with esophageal squamous carcinoma undergoing resection in our department between January 2010 and December 2012 were collected retrospectively. Expressions of eIF4E and mTOR were detected in above carcinoma tissues, counterpart para-carcinoma tissues (1 cm distance to carcinoma) and normal tissues (5 cm distance to carcinoma) with Western blot and immunohistochemistry. Their relevance with clinicopathological features was analyzed.

RESULTSExpression of mTOR located mainly in cytoplasm and elF4E mainly in cellular membrane, presenting as yellow grains. These two markers showed strong expression in carcinoma tissues and weak or none in para-carcinoma tissues. In esophageal squamous carcinoma tissues, counterpart para-carcinoma tissues and normal tissues, mTOR protein expression was 85.8% (127/148), 35.1% (52/148) and 3.4% (5/148), eIF4E protein expression was 93.9% (139/148), 35.1% (52/148) and 12.8% (19/148), with a downtrend respectively (all P<0.05). Expressions of mTOR and eIF4E were associated with tumor invasion depth and lymphatic metastasis (all P<0.05), while mTOR expression was associated with differentiation degree (P=0.003), but eIF4E expression was not. Both expressions were not associated with gender, age, and tumor size (all P>0.05).

CONCLUSIONSExpressions of eIF4E and mTOR are up-regulated in esophageal squamous carcinoma tissues, which may be associated with tumor malignance and lymphatic metastasis of esophageal squamous carcinoma. Combined detection of two markers may be helpful to predict the tumor malignance and the prognosis of patients.

Carcinoma, Squamous Cell ; diagnosis ; metabolism ; Esophageal Neoplasms ; diagnosis ; metabolism ; Eukaryotic Initiation Factor-4E ; metabolism ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Prognosis ; Retrospective Studies ; TOR Serine-Threonine Kinases ; metabolism

The academic ethics education is an important part of students' ideological and political education, which not only affects the students' personality character and personal growth, but also is about the healthy development of colleague academic and the formation of moral system of the whole society. In this study, through the relay inheritance of three generations of the old, middle and young doctors, and the development of Chinese medicine hospital culture, the embryonic form of academic and moral mutual cul-tivation model is described. Through the diverse and distinct second classroom education, the connotation of "art education" and "moral education" is deepened. Through effective supervision and management and system restriction, the moral education of quality and morality education can be effectively carried out. Probing from the system construction,connotation construction and institutional construction, Longhua Hos-pital has established academic and moral mutual cultivation model and provided those interns a new model of academic ethics cultivation.

Objective To study the effect of autophagy regulation on hypoxia/reoxygenation injury(H/RI)in mouse spermatogonia,and to explore the effect of autophagy on ischemia-reperfusion injury(IRI)in mouse testicular tissue.Methods The mouse spermatogonial cell line GC1 spg was used as the research object to construct the H/RI model.Rapamycin(RAPA)and 3-methyladenine(3-MA)were used as autophagy ago-nists and inhibitors.The control group,the model group,the autophagy agonist intervention group(H/RI+autophagy agonist intervention),and the autophagy inhibitor intervention group(H/RI+autophagy inhibitor intervention)were set up.The cells proliferation ability of each group was detected by methyl thiazol tetrazoli-um(MTT)method.The release level of reactive oxygen species(ROS)and apoptosis level of each group were detected by flow cytometry.The expression levels of autophagy-related gene Beclin1 and apoptosis-relat-ed genes Bcl-2 and Bax mRNA in each group were detected by real-time fluorescence quantitative PCR(qPCR).The expression levels of autophagy-related proteins LC3-Ⅰ,LC3-Ⅱ,Beclin1,p62 and apoptosis-relat-ed proteins Bcl-2,Bax,caspase-3 in each group were detected by Western blot.Results Compared with the control group,the proliferation abiliy,the expression levels of Beclin1 and Bcl-2 mRNA in the model group were significantly decreased(P＜0.01),the relative expression levels of p62 and Bcl-2 proteins were significantly decreased(P＜0.01).The ROS level,apoptosis rate and the mRNA expression level of Bax were significantly increased(P＜0.01),and the protein expresion levels of Beclin1,Bax,caspase-3 and the protein ratio of LC3-Ⅱ/LC3-Ⅰ were significantly increased(P＜0.01).Compared with the model group,the cell proliferation a-bility,the expression levels of Beclin1 and Bcl-2 mRNA in the autophagy agonist intervention group were the protein ratio of significantly increased(P＜0.01),the protein expression levels of Beclin1 and Bcl-2 and the protein ration of LC3-Ⅱ/LC3-Ⅰ were significantly increased(P＜0.01).The ROS level,apoptosis rate and the expression level of Bax mRNA were significantly decreased(P＜0.01),and the protein expression levels of p62,Bax,caspase-3 and the protein ratio of LC3-Ⅱ/LC3-Ⅰ were significantly decreased(P＜0.01).Com-pared with the model group,the cell proliferation ability,the mRNA expression levels of Beclin1 and Bcl-2 in the autophagy inhibitor intervention group were significantly decreased(P＜0.01),the protein expression lev-els of Beclin1 and Bcl-2 protein were significantly decreased(P＜0.01).The ROS level,apoptosis rate and the mRNA expression level of Bax were significantly increased(P＜0.01),and the protein expression levels of p62,Bax,caspase-3 and the protein ratio of LC3-Ⅱ/LC3-Ⅰwere significantly iecreased(P＜0.01).Conclusion Enhanced au-tophagy can inhibit apoptosis of spermatogonia and repair H/RI in mice,which provides a theoretical basis for the treatment of testicular tissue IRI.

Objective To explore the physical development and immune function of infants without human immunodeficiency virus(HIV)infection who were delivered by HIV_infected mothers. Methods Two hundred and ninety_seven infants delivered HIV_infected mothers in Guangxi province from January 2008 to November 2011 were selected as observation group. According to whether infants had HIV infection or not,the children were further divided into the HIV_infection group and the infants in the non_HIV infection group according to the presence or absence of HIV infection,and the infants in the non_HIV infection group were divided into the antiretroviral drug(ART)treatment group and the non_ART treatment group according to whether the mother had used ART during pregnancy. Ninety_one healthy children born at the same time were selected as the healthy control group. The physical examination,T lympho_cyte subgroup analysis and humoral immunity test were performed on all infants. Results The weight and body length at birth of infants born from HIV_infected mothers were all significantly lower than those in the healthy control group [(2. 86 ± 0. 49)kg vs.(3. 15 ± 0. 52)kg;(47. 05 ± 2. 20)cm vs.(50. 01 ± 2. 58)cm],and the differences were sta_tistically significant(t﹦2. 652,2. 247,all P〈0. 05). The CD8 level and CD4∕CD8 ratio of infants delivered by HIV_infected mothers had no significant differences statistically compared with those in the healthy control group[(21. 31 ± 6. 49)% vs.(22. 01 ± 5. 43)%;1. 82 ± 0. 79 vs. 1. 82 ± 0. 67,t﹦0. 933,0. 033,all P〉0. 05];the CD3 and CD4 levels were lower than those in the healthy control group[(62. 36 ± 7. 94)% vs.(65. 70 ± 6. 32)%;(4. 83 ± 7. 62)% vs.(37. 02 ± 5. 69)%],and the differences were statistically significant(t﹦3. 66,2. 946,all P〈0. 01). The immunoglobulin(Ig)M,IgG and IgA levels of children born to HIV_infected mothers had no statistically significant differences compared with those in the healthy control group[(1. 79 ± 0. 66)g∕L vs.(1. 76 ± 0. 66)g∕L;(8. 96 ± 2. 74)g∕L vs.(8. 80 ± 1. 97)g∕L;(0. 85 ± 0. 57)g∕L vs.(0. 86 ± 0. 41)g∕L,t﹦0. 341,0. 619,0. 173,all P〉0. 05). The weight and body length at birth of non_HIV infected children born from HIV_infected mothers were all significantly lower than those in healthy control group[(2. 92 ± 0. 43)kg vs.(3. 15 ± 0. 52)kg;(49. 03 ± 2. 22)cm vs.(50. 01 ± 2. 58)cm],and the differences were statistically significant( F﹦4. 163,2. 87,all P〈0. 05). The birth weight,birth length and head circumference of the ART group were all significant lower than those in the healthy control group[(2. 90 ± 0. 43)kg vs.(3. 15 ± 0. 52)kg;(48. 27 ± 1. 89)cm vs.(50. 01 ± 2. 58)cm;(31. 80 ± 1. 47)cm vs. (34. 88 ± 3. 21)cm],and the differences were statistically significant( F﹦3. 711,2. 970,3. 689,all P〈0. 05). The CD8 level and CD4∕CD8 ratio of non _ HIV infected children born to HIV _ infected mothers had no significant differences statistically compared with those in the healthy control group[(20. 77 ± 5. 60)% vs.(22. 01 ± 5. 43)%, 1. 85 ± 0. 76 vs. 1. 82 ± 0. 67,F﹦43. 568,11. 705,all P〉0. 05];the CD3 and CD4 levels were lower than those in the healthy control group[(62. 27 ± 7. 94)% vs.(65. 70 ± 6. 32)%;(35. 30 ± 6. 86)% vs.(37. 02 ± 5. 69)%],and the differences were statistically significant(F﹦7. 083,28. 06,all P〈0. 05). Conclusions The humoral immune func_tion of the non_HIV infected infants delivered by HIV_infected mothers is not significantly affected,but the physical development at birth and cellular immune function are significantly affected. ART during pregnancy is not a major factor in the limitation of physical development at birth. Therefore,the nutrition support for the infants delivered by HIV_in_fected mothers and prevention of infection are especially necessary clinically.

BACKGROUND:The risk factors for patellofemoral pain syndrome are still unclear and research on risk factors is gradually becoming a hot topic in order to improve the therapeutic outcome of this disease. OBJECTIVE:To investigate the relationship between lower limb alignment and patellofemoral pain syndrome in young male runners. METHODS:In the same running population,21 patients with bilateral knee pain,29 patients with single knee pain and 20 normal runners were collected from January 2021 to July 2022.Full-length X-ray examination of both lower limbs in standing position was performed in all subjects.The lateral distal femoral angle,medial tibial proximal angle,joint line congruence angle,hip-knee-ankle angle,and knee physical valgus angle were measured and statistically analyzed. RESULTS AND CONCLUSION:There was no significant difference in the parameters between the left and right knees in each group(P>0.05).Compared with the normal group,no significant changes in lateral distal femoral angle,medial tibial proximal angle,joint line congruence angle,and hip-knee-ankle angle were observed in the single knee pain group and double knee pain group,while the knee physical valgus angle was significantly increased in these two groups(P<0.05).To conclude,increased knee physical valgus angle may be a risk factor for patellofemoral pain syndrome.

OBJECTIVEThe aim of this study was to assess the secular changes of BMI, prevalence rates of overweight and obesity as well as related factors in an elderly population of Beijing, during 2001 and 2010.

METHODSA two-round population-based cross-sectional study was conducted in an elderly population, selected from a representative urban area in Beijing in 2001 (n = 2 277) and 2010 (n = 2 102) respectively.

RESULTSIn this population, the age-adjusted means on BMI were 25.3 (95%CI, 25.1-25.5) for men and 25.8 (95%CI, 25.5-25.9) for women in 2001, and 25.0 (95%CI, 24.8-25.1) and 25.0 (95%CI, 24.7-25.1) in 2010, respectively, which all significantly declined. According to the WHO criteria, related data were shown as follows:the age standardized prevalence rates of overweight (BMI ≥ 25 kg/m²) were 48.3% among men and 46.3% among women in 2001, 44.5% and 39.9% for men and women in 2010 respectively; the age-standardized prevalence rates of obesity (BMI ≥ 30 kg/m²)were 5.4% on men and 11.6% on women in 2001, but declined to 4.9% and 7.3% in 2010 respectively; the prevalence rates of overweight and obesity were both significantly declined in women, but not in men. However, according to WGOC criteria, the age standardized prevalence rates on overweight (BMI ≥ 24 kg/m²) were 47.9% in men and 44.9% in women in 2001, and were 47.2% and 41.0% respectively for men and women in 2010; the age-standardized prevalence rates of obesity (BMI ≥ 28 kg/m²) were 19.2% in men and 24.2% in women in 2001, both significantly declined to 15.5% and 18.0% in 2010, respectively. Positive correlations were found between the levels of blood pressure, glucose and lipids and BMI. Results from multiple factors logistic regression analysis also indicated that healthy lifestyle including reducing cigarette smoking, alcohol drinking and increasing daily exercises in the last 10 years, also played roles in the decrease of prevalence rates on both overweight and obesity.

CONCLUSIONThe mean BMI and prevalence rates of overweight and obesity decreased in the last 10-year period, 2001-2010. Hypertension, hyperglycemia and hyperlipidemia remained as risk factors of overweight and obesity. Healthy lifestyle in elderly seemed partially account for the declined BMI.

Aged ; Aged, 80 and over ; Body Mass Index ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Obesity ; epidemiology ; Overweight ; epidemiology ; Prevalence ; Risk Factors ; Urban Population