Objective To observe the clinical effects and safety of vertebroplasty combined with zoledronic acid for osteoporotic thoracolumbar vertebral compression fractures .Methods 56 osteoporotic thoracolumbar vertebral compression fractures patients were radomly divided into the two groups ,each group had 28 cases.All patients had re-set treatment including lying on the hard bed and Padded waist .The treatment group had the surgery of vertebroplasty , 3 days after surgery these patients treated with 100mL Zoledronic acid by means of intravenous drip .The control group had the conservative treatment ,these patients received the closed reduction ,after operations the patients had the treat-ment of traction suspension ,lying on the hard bed ,padded the fractures .The two groups were compared at the time be-fore treatment,24h after treatment and 6 months after treatment .The anterior height of vertebral body ,kyphosis Cobb's
angle,low back pain visual analog scale ,Oswsetry dysfunction index score and complications were included into the study.Results (1) The anterior height of vertebral body: The difference of the anterior height of vertebral body at different time before or after the treatment was statistically significant , that showed the time effect [ the treatment group:(13.81 ±2.09)mm,(20.14 ±2.26)mm,(21.89 ±2.60mm;the control group:(15.24 ±2.21)mm,(17.39 ± 2.57)mm,(17.40 ±1.81) mm].The difference of the overall anterior height of vertebral body between the two groups was statistically significant ,which showed the grouping effect .(2) Kyphosis Cobb's angle: The difference of Kyphosis Cobb's angle at different time was statistically significant ,which showed the time effect [ the treatment group:(26.18 ±2.03)°,(9.56 ±1.11)°,(9.57 ±1.08)°;the control group:(27.36 ±2.71)°,(14.59 ±1.28)°, (14.52 ±1.48)°],the difference of the overall Kyphosis Cobb's angle between the two groups was statistically signifi-cant,which showed the grouping effect .(3) Low back pain visual analog scale:The difference of low back pain visual analog scale at different time was statistically significant ,which showed the time effect[the treatment group:(8.31 ± 0.94)points,(1.86 ±0.74) points,(1.87 ±0.77) points;the control group:(8.12 ±0.95) points,(3.85 ± 1.07)points,(3.82 ±1.08)points].The difference of the overall low back pain visual analog scale between the two groups was statistically significant , which showed the grouping effect .( 4 ) Oswsetry dysfunction index score: The difference of Oswsetry dysfunction index score at different time was statistically significant , which showed the time effect[the treatment group:(73.27 ±4.55)points,(32.11 ±2.57)points,(29.14 ±3.60)points;the control group:(75.49 ±4.20)points,(43.83 ±2.98)points,(38.67 ±5.28)points].The difference of the overall Oswsetry dys-function index score between the two groups was statistically significant ,which showed the grouping effect .Conclusion The treatment of vertebroplasty combined with zoledronic acid for osteoporotic thoracolumbar vertebral compression fractures was effective .It is able to relieve low back pain ,improve bone density and quality ,improve life quality ,and prevent Osteoporosis from further development .

Omega-3 polyunsaturated fatty acids are a kind of nutrients mainly derived from deep-sea fish, and their role in cardiocerebrovascular diseases has been extensively studied. This article reviews the correlation between omega-3 polyunsaturated fatty acids and the risk and outcome of ischemic stroke and its mechanism of action.

BACKGROUND:Reducing the rate of abnormal fertilization is an effective approach to improving the efficacy of in vitro fertilization and reducing patients'financial strain.However,the current research on abnormal fertilization has focused on exploring the types of prokaryotic nuclei and their generation mechanisms,as well as analyzing embryos formed by abnormal fertilization,chromosomal ploidy and utilization value.There is a lack of clinical prediction models for abnormal fertilization based on retrospective studies. OBJECTIVE:To construct a nomogram model to predict abnormal female factors in in vitro fertilization. METHODS:A total of 5 075 patients undergoing treatment for conventional in vitro fertilization at Nanxishan Hospital of Guangxi Zhuang Autonomous Region from March 2017 to March 2022 were retrospectively analyzed.The male confounders were calibrated on a 1:1 propensity score with a match tolerance of 0.02,and 1 672 cases were successfully matched.According to the Vienna Consensus,patients with≥60%normal fertilization capacity were included in the normal fertilization group(n=836)and those with<60%normal fertilization capacity were included in the abnormal fertilization group(n=836).The model and validation groups were obtained by random sampling at a ratio of 7:3.Factors related to the occurrence of abnormal fertilization following conventional in vitro fertilization in the model group were screened using univariate analysis and the best matching factors were selected using the Least Absolute Shrinkage and Selection Operator(LASSO)and included in a multifactorial forward stepwise Logistic regression to identify their independent influencing factors and plot a nomogram.Finally,the prediction model was validated for discrimination,accuracy and clinical application efficacy using receiver operating characteristic curves,calibration curves,clinical decision curves and clinical impact curves. RESULTS AND CONCLUSION:The univariate analysis indicated the factors influencing the occurrence of abnormal fertilization were age,controlled ovarian hyperstimulation protocol,number of assisted pregnancies,years of infertility,infertility factors,anti-mullerian hormone,sinus follicle count,basal luteinizing hormone,luteinizing hormone concentration on the human chorionic gonadotropin day,and estradiol level on human chorionic gonadotropin injection day(P<0.05).LASSO regression further identified the best matching factors,including age,microstimulation protocol,number of assisted pregnancies,years of infertility,anti-mullerian hormone,luteinizing hormone level on human chorionic gonadotropin injection day,and estradiol level on human chorionic gonadotropin injection day(P<0.05).Multifactorial forward stepwise Logistic regression results showed that age,microstimulation protocol,number of assisted conceptions,years of infertility,anti-mullerian hormone,and estradiol level on human chorionic gonadotropin injection day were independent influencing factors for the occurrence of abnormal fertilization following conventional in vitro fertilization.The receiver operating characteristic curves showed an area under the curve of 0.761(0.746,0.777)for the model group and 0.767(0.733,0.801)for the validation group,indicating that the model has good discrimination.The mean absolute error of the calibration curve was 0.044,and the Hosmer-Lemeshow test indicated that there was no significant difference between the predicted probability of abnormal fertilization and the actual probability of abnormal fertilization(P>0.05),indicating the prediction model has good consistency and accuracy.The clinical decision curves and clinical impact curves showed that the model and validation groups had the maximum net clinical benefit at valve probability values of 0.00-0.52 and 0.00-0.48,respectively,and there was a good clinical application efficacy in this valve probability range.To conclude,the nomogram model has good discrimination and accuracy as well as clinical application efficacy for predicting the occurrence of abnormal fertilization in women undergoing conventional in vitro fertilization based on age,microstimulation protocol,number of assisted conceptions,years of infertility,anti-mullerian hormone,and estradiol level on human chorionic gonadotropin injection day.

AIM:To investigate the impact of aquaporin 4(AQP4)expression inhibition on autophagy and apoptosis in a mouse model of cerebral ischemia-reperfusion(I/R)injury,and to elucidate its underlying mechanism.METHODS:Cerebral I/R injury was induced in mice via transient middle cerebral artery occlusion(tMCAO).Totally 60 mice were randomly divided into sham group,I/R group,AQP4 inhibition group,and 3-methyladenine(3-MA)group,with 15 mice in each group.Among them,the mice in sham and I/R groups received intraperitoneal injections of normal saline,while those in AQP4 inhibition group and 3-MA group received intraperitoneal injections of AER-271(2 mg·kg-1·d-1)and AER-271+3-MA(2 mg·kg-1·d-1)for 3 d,respectively,once per day.Longa score was adopted to assess the neu-rological function,and to record changes in body weight.Cerebral infarction volume and histopathological alterations were evaluated using hematoxylin-eosin staining.Western blot analysis was performed to determine the levels of AQP4,LC3-Ⅱ,P62 and cleaved caspase-3,while the LC3-Ⅱ,P62,cleaved caspase-3 and NeuN(neuronal marker)colocalization and expression assessment were conducted with immunofluorescence.RESULTS:The mice in I/R and AQP4 inhibition groups exhibited extensive cerebral infarction,cerebral edema,and elevated Longa scores.However,in comparision to I/R group,the mice in AQP4 inhibition group showed significantly reduced cerebral infarct volume,cerebral edema vol-ume,and Longa score(P<0.05).Additionally,in contrast to sham group,the mice in I/R group displayed increased ex-pression of AQP4,LC3-Ⅱ and cleaved caspase-3(P<0.01),accompanied by decreased body weight and P62 expression(P<0.05 or P<0.01).Furthermore,compared with I/R group,the mice in both AQP4 inhibition group and 3-MA group demonstrated a decrease in the expression levels of AQP4,LC3-Ⅱ and cleaved caspase-3(P<0.05 or P<0.01),along with increased body weight and P62 expression(P<0.05 or P<0.01).Nonetheless,no significant differences were ob-served between AQP4 inhibition group and 3-MA group regarding Longa score,cerebral infarct volume,body weight,and the expression of AQP4,LC3-Ⅱ,cleaved caspase-3 and P62.CONCLUSION:Inhibition of AQP4 expression signifi-cantly reduces cerebral infarction area and nerve injury severity in tMCAO mice.Moreover,AQP4 expression inhibition decelerates autophagy and apoptosis after cerebral infarction,with the additional autophagy inhibitor showing no notable impact on the protective effect of AQP4 inhibition.