Objective To investigate incision pathogenic bacteria after spinal surgery, and observe clinical effects of therapeutic methods. Methods A total of 30 cases of early surgical incision infection (7 cases of superficial infection and 23 cases of deep infection) after spinal surgery were retrospectively analyzed. The basic data including clinical manifes-tations, diagnosis, treatment, etiology and follow-up results were analyzed. Results It was found that the mean infection time after operation was 2-15 days in 30 patients. Thirty-three strains were isolated including 18 gram-positive cocci (54.5%, and Staphylococcus aureus account for 13, 39.4%), 15 gram-negative bacteria (45.5%, and Coli communior account for 6, 18.2%). The drug susceptibility test showed that gram-positive cocci were highly sensitive to vancomycin, rifampin, tei-coplanin and cotrimoxazole. No vancomycin-resistant Staphylococcus aureus were found. Gram negative bacteria were high-ly sensitive to imipenem (100%). Seven cases of superficial infection were cured after dressing. Twenty-three cases of deep incision wound infection were no recurrence of infection after treatment by deep wound debridement, and postoperative cathe-terization. Conclusion The early wound infection after spinal surgery is usually due to Staphylococcus aureus. It is good to perform wound debridement, continuous perfusion drainage, and treatment with vancomycin for deep wound infection.

Objective:To evaluate the clinical efficacy of percutaneous channel screwing assisted by the robot navigation positioning system combined with pelvic unlocking reduction frame for pelvic fractures.Methods:A retrospective analysis was conducted of the 12 patients with pelvic fracture who had been admitted to Department of Orthopaedics, The First Affiliated Hospital to Anhui Medical University from January to October 2018. They were 7 men and 5 women with an average age of 42.3 years (from 25 to 62 years). The time from injury to operation averaged 5.1 days (from 2 to 10 days). There were 2 cases of type B1, 5 ones of type B2 and 5 ones of type C1 according to the Tile classification. After closed reduction using the pelvic unlocking reduction frame, the orthopedics robot navigation positioning system was used to guide the placement of percutaneous screws. The posterior rings were fixated with sacroiliac screws, and the anterior rings with pubis screws, pubic symphysis screws or external fixation. The placement time for each screw, fluoroscopy frequency, reduction quality, fracture union time, function of the affected hip and complications at the final follow-up were recorded.Results:A total of 25 percutaneous screws were inserted in the 12 patients with a mean fluoroscopic frequency of 4.7 times (from 3 to 8 times) and a mean placement time of 14.9 min (from 12 to 20 min). According to the Matta rating system, the fracture reduction was rated as excellent in 7 cases, as good in 4 and as fair in one. The average follow-up time was 11.3 months (from 6 to 16 months). All fractures healed after an average period of 11.8 weeks (from 10 to 14 weeks). By the Majeed scoring, the pelvic function at the final follow-up was excellent in 8 cases and good in 4. The follow-ups observed no infection, nerve injury, deep vein thrombosis, heterotopic ossification, implant looseningor traumatic arthritis in these patients.Conclusion:Percutaneous channel screwing assisted by the robot navigation positioning system combined with pelvic unlocking reduction frame can reduce operative time and risks and lead to minimal invasion for pelvic fractures.

Facet joint is the important part of spinal biomechanical structures. The damage of facet joint will destroy the stability of spinal motion segments and accelerate the adjacent segments degeneration (ASD). The violation of cranial facet joint based on various screw insertion techniques is a common but easily overlooked factor in clinical application. The reduction of intra-operative cranial facet joint violation is essential for reduction of postoperative ASD. The rates of facet violation are related to screw insertion techniques. The insertion techniques, including robot-assisted guidance, computer-assistant navigation, and cortical bone trajectory, are used successfully well in protecting cranial facet joints, compared with the freehand pedicle screw placement technique, which has been widely utilized in clinical practice. However, the conventional X-ray guided screw insertion technique is associated with a higher rate of facet violation. The main reasons why different techniques lead to various rates of facet violation include various anatomical referenced landmarks during screw insertion, selection of assisted equipment for instruments, and resistance of soft tissues of the spine. In addition, the related risk factors, such as facet angle, screw insertion segments, lumbar degeneration, and learning curve effect, can also affect the rates of facet violation. In the present study, we compared the differences of facet joint violation when using various screw techniques, and summarized the causes of violations and related risk factor. The present review might provide references for surgeons regarding the decrease of cranial facet joint violation, optimization of insertion techniques and reduction of ASD.

Objective To investigate the role of B cell lymphoma/leukemia-2 and adenovirus E1B 19 000 interacting protein 3 (BNIP3) in oligodendrocyte cell apoptosis induced by carbon monoxide poisoning (CO poisoning) and the potential signal pathways.Methods Twenty-five male C57BL/6 mice were randomly divided into control group and CO poisoning group.Mice were left to breathe room air (control group) or subjected to 40-minute exposure to 2 500-3 000 ppm CO (CO poisoning group).The mice were sacrificed at 1,3,7 d and 14 d following CO poisoning.We examined the damage of myelin sheath and oligodendrocytes by observing the expression of myelin basic protein (MBP) and oligodendrocyte transcription factor 2 (Olig2) in corpus callosum.Furthermore,we explored the role of BNIP3 and potential signal pathways in the oligodendrocyte cell death following CO poisoning by observing the expression of BNIP3,Bcl-2 associated X protein (Bax) and cysteinyl aspartate specific proteinase 9 (caspase 9).Results Immunohistochemistry showed that the expression of MBP decreased significantly in the corpus callosum from 1 d (0.12±0.02,t=3.357,P＜0.05) to7 d (0.05±0.02,t=9.730,P＜0.01) and increased from 7 d to 14 d (0.13 ± 0.02,t =2.897,P ＜ 0.05) to some degree after CO poisoning compared with the control group (0.16 ± 0.02) and that Olig2 expression increased markedly in 3 d CO poisoning group (72.2 ± 5.45,t =12.211,P ＜ 0.01) compared with the control group (36.6 ± 3.58).The results of MBP and Olig2 in Western blotting revealed that MBP began to decrease from 1 d (0.39 ± 0.02,t =10.391,P＜0.01)to 7 d(0.09 ±0.01,t =34.767,P＜0.01)and increased in 14 d (0.45 ±0.03,t =6.146,P ＜ 0.01) compared with the control group (0.55 ± 0.03),and that O1ig2 increased obviously in 3 d (0.52 ± 0.02,t =16.651,P ＜ 0.01) compared with the control group (0.31 ± 0.02).Western blotting analysis showed that the levels of BNIP3 were increased in 1 d (2.49 ±0.40,t =15.342,P ＜0.01),started to decrease in 3 d (1.90 ± 0.24,t =12.417,P ＜ 0.01) and finally recovered in 14 d (0.24 ± 0.02,t =0.798,P ＞0.05),as compared with the control group(0.25 ±0.03).Moreover,compared with the control group(0.44 ±0.03),Bax was also upregulated in the corpus callosum from 1 d (1.09 ± 0.15,t =9.427,P ＜ 0.01) to 7 d (0.64 ± 0.09,t =4.540,P ＜ 0.05) after CO poisoning.The expression of caspase 9 showed the similar tendency that increased in 1 d (1.10 ± 0.17,t =7.137,P ＜ 0.01),decreased in 3 d (0.79 ± 0.10,t =5.051,P ＜ 0.01)and recovered in 7 d (0.55 ± 0.05,t =0.910,P ＞ 0.05) compared with the control group (0.51 ± 0.08).BNIP3 expression was positively correlated with Bax (r =0.995,P ＜0.01) and caspase 9 (r =0.950,P ＜ 0.01).Conclusion BNIP3 may play an important role in the apoptosis of oligodendrocytes induced by CO poisoning via the pathway of caspase dependent mitochondrial apoptosis.

Objective: Physical literacy is the breakthrough point and fundamental goal to achieve the integration of sports and education, sports and public health and expand the function of physical education. Studying the children and adolescents physical literacy is a common responsibility for children and adolescents health, sports and health education workers. This article was based on the latest research evidence and expert opinions in China, aiming to develop the core items of physical literacy guidelines for Chinese children and adolescents. Methods: This article systematically combed the dimensions and index system of children and adolescents physical literacy through systematic literature review. After five rounds of Delphi methods, the core items were extracted. Results: The core items included four interrelated dimensions of body, emotion, behavior, and cognition, which were specifically composed of four components: physical ability, emotional experience, physical activity related behaviors, and knowledge understanding and application ability. Conclusion Children and adolescents are the key periods, sensitive periods, and window periods to cultivate physical literacy. The core items can provide framework recommendations for further refining guidelines. More empirical studies should be carried out in the future, in order to accumulate enough evidences and further to improve Physical Literacy guidelines, better to guide physical literacy promotion.

Objective:To summarize the perioperative nursing points of percutaneous kyphoplasty (PKP) in elderly patients with osteoporotic vertebral compression fractures assisted by robots, so as to provide reference for orthopedic nursing.Methods:From July 2019 to February 2021, the data of 72 patients undergoing robot-assisted PKP in the spinal surgery of the First Affiliated Hospital of Anhui Medical University were retrospectively analyzed. The perioperative nursing points were summarized, and the nursing experience was summarized. The nursing under the new measures of precise minimally invasive treatment was analyzed and discussed. The length of hospital stay, postoperative ambulation time, complications and satisfaction survey results of patients were collected and recorded. The Numerical Rating Scale(NRS) score, Self-rating Anxiety Scale(SAS) score and Oswestry Disability Index (ODI) score before and after surgery were compared. The correlation analysis of the scores of various factors was combined to comprehensively evaluate the surgical and nursing effects.Results:All patients had no complications related to machine use during and after operation, and their symptoms were improved to varying degrees. Fifty-seven cases of indwelling catheter, catheter time (19.00±14.24) h. The preoperative hospitalization time was (6.16±2.22) d, and the postoperative hospitalization time was (1.94±0.99) d. Postoperative bed time was (16.34±6.81) h. Postoperative nursing satisfaction was (98.55±2.44)%.The postoperative NRS and SAS scores were (1.00±0.55) and (32.06±5.33) points, respectively, which were lower than those before operation (3.51 ± 0.71) and (39.08±8.86) points, and the differences were statistically significant ( t values were 33.976, 8.184, P<0.01). There were statistically significant differences in six indicators of ODI scores before and after surgery, including low back pain, walking, standing, sitting, sleep and self-care ( P<0.01). Correlation analysis showed that there was a strong correlation between the six ODI score factors and the NRS score. The four factors of sitting, walking, low back pain and standing were highly correlated with SAS. Conclusions:The implementation of good perioperative nursing management for patients with PKP assisted by robot can effectively promote the rehabilitation of patients, reduce the incidence of complications and improve patient satisfaction.

OBJECTIVETo study the relation between blood pressure level in prehypertensives and multiple metabolic disorders.

METHODSBased on the populations in Jiangsu province from the project of Multiple Metabolic Disorders and Metabolic Syndrome, a case-control study was conducted including 585 cases of isolated systolic prehypertensive,746 cases of diastolic-systolic prehypertensive, 340 cases of isolated diastolic prehypertensive and 1755 individuals with normal blood pressure.

RESULTSThe occurrence of triglyceride(TG), body mass index(BMI) and waist circumference(WC) disorders were significantly higher in the three case groups than in the normal blood pressare group. Among case groups, 50% of them had at least one more metabolic abnormalities as compared to 35% in the controls.

CONCLUSIONAmong patients in prehypertensive stage, TG disorder was most popular in multiple metabolic disorders. Prehypertensive was associated with WC, BMI and age, indicating that there had already been collections of cardiovascular risk factors in the prehypertensive stage.

Adult ; Aged ; Blood Pressure ; Body Mass Index ; Case-Control Studies ; Female ; Humans ; Hypertension ; Lipid Metabolism ; Male ; Metabolic Syndrome ; epidemiology ; metabolism ; physiopathology ; Middle Aged ; Waist Circumference

Objective:To investigate the effects of combined exposure of fluorine, arsenic, and fluorine-arsenic on the signaling pathway related protein expression of tumor necrosis factor receptor-related factor 6 (TRAF-6)/nuclear factor κB1(NF-κB1) in a co-culture system of mouse osteoblasts MC3T3-E1 and mouse monocyte macrophage RAW264.7.Methods:MC3T3-E1 cells were co-cultured with RAW264.7 cells after induction with osteogenic inducers. The cells were cultured for 7 days in vitro, and different doses of sodium fluoride (0.0, 0.1, 0.4, 1.6 mmol/L NaF, F), sodium arsenite (0.0, 0.5, 2.5, 12.5 μmol/L NaAsO 2, As) and different doses of fluorine and arsenic were added to the culture medium and cultured for 24 h using factorial design. The expression levels of nuclear factor κB receptor activating factor (RANK), TRAF-6, NF-κB1, T cell activating factor (NFATc1), and tartrate-resistant acid phosphatase (TRAP) protein were detected by Western blotting. Results:When fluorine was used alone, compared with the control group (F 0.0As 0.0, 1.00 ± 0.00), the expressions of RANK, NF-κB1 and TRAP proteins (1.11 ± 0.04, 1.29 ± 0.05, 1.38 ± 0.04, 1.24 ± 0.04, 1.13 ± 0.03, 1.34 ± 0.05, 1.12 ± 0.03, 1.24 ± 0.04, 1.61 ± 0.06) were increased ( P < 0.05); TRAF-6 protein expressions in F 0.1 and F 1.6 groups (1.23 ± 0.04, 1.35 ± 0.03) were increased ( P < 0.05). When arsenic was used alone, compared with the control group (F 0.0As 0.0), the expressions of RANK, TRAF-6, NF-κB1 proteins were increased in As 0.5 group ( P < 0.05), the expressions of RANK and NFATc1 proteins were reduced in As 12.5 group ( P < 0.05). When fluorine was combined with arsenic, at the same dose of fluorine, RANK protein expression in F 0.1As 0.5 group and TRAF-6 protein expression in F 0.1As 12.5, F 0.4As 0.5, F 0.4As 2.5 groups, NF-κB1 protein expression in F 0.1As 0.5 F 0.4As 2.5, F 0.4As 12.5 groups, NFATc1 protein expression in F 0.1As 0.5 and F 0.4As 0.5 groups, TRAP protein expression in F 0.1As 12.5 group were higher than the corresponding fluorine groups alone (F 0.1, F 0.4, P < 0.05), but lower than the sum of fluorine and arsenic alone. At the same dose of arsenic, RANK protein expression in F 0.1As 12.5 group, TRAF-6 protein expression in F 0.1As 12.5 and F 0.4As 2.5 groups, and NF-κB1 protein expression in F 0.1As 12.5, F 0.4As 2.5, F 0.4As 12.5, and F 1.6As 2.5 groups, TRAP protein expression in F 1.6As 2.5 and F 1.6As 12.5 groups were higher than the corresponding arsenic groups alone (As 2.5, As 12.5, P < 0.05), but lower than the sum of fluorine and arsenic alone. Fluorine had a major effect on the expressions of RANK, TRAF-6, NF-κB1, NFATc1, and TRAP proteins ( F=3.41, 341.73, 66.01, 56.49, 147.40, P < 0.05); arsenic also had a main effect on all protein indicators ( F=686.71, 174.96, 107.32, 235.80, 331.37, P < 0.05); the combined effect of fluorine and arsenic had an interaction effect on each protein indicator ( F=50.39, 234.94, 116.72, 67.77, 36.56, P < 0.05). Conclusions:In the co-culture system of MC3T3-E1 and RAW264.7 cells, fluorine can activate TRAF-6-mediated expression of NF-κB1 signaling pathway-related proteins, thereby promoting osteoclast differentiation; the effects of arsenic on the expression of related proteins are not completely consistent. The interaction of fluorine and arsenic exposure on TRAF-6-mediated expression of NF-κB1 signaling pathway-related proteins is mainly antagonistic.

Adult ; Humans ; Cardiovascular Diseases ; East Asian People ; Hypertension ; Prevalence ; Risk Factors ; Ethnicity