OBJECTIVE: To compare the effectiveness of different puncture methods of the flexible bone cement delivery device in unilateral percutaneous curved vertebroplasty for osteoporotic vertebral upper 1/3 compression fractures. METHODS: A retrospective analysis was conducted on the clinical data of 67 patients with osteoporotic vertebral upper 1/3 compression fractures who were admitted and met the selection criteria between January 2023 and April 2024. The patients were divided into two groups based on the puncture method of the flexible bone cement delivery device: the oblique puncture group ( n=37) and the parallel puncture group ( n=30). There was no significant difference ( P>0.05) between the two groups in terms of gender, age, bone mineral density (T value), distribution of fractured vertebrae, time from injury to operation, and preoperative visual analogue scale (VAS) score for pain, Oswestry disability index (ODI), anterior vertebral height of the fractured vertebra, and Cobb angle of the fractured vertebra. The following parameters were compared between the two groups: operation time, incidence of secondary puncture, incidence of bone cement leakage, volume of injected bone cement, bone cement distribution score, as well as VAS score, ODI, anterior vertebral height of the fractured vertebra, and Cobb angle of the fractured vertebra at 1 day after operation and at last follow-up. RESULTS: Two cases in the oblique puncture group and 7 cases in the parallel puncture group underwent secondary puncture during operation, and the difference in the incidence of secondary puncture was significant ( P<0.05). No complications such as bone cement hypersensitivity, bone cement embolism, nerve injury, or epidural hematoma occurred in both groups. There was no significant difference in operation time, volume of injected bone cement, incidence of bone cement leakage, distribution score and rating of bone cement between the two groups ( P>0.05). All patients were followed up 6-18 months (mean, 12.0 months), and there was no significant difference in the follow-up time between the two groups ( P>0.05). No further fracture collapse or compression occurred in the fractured vertebra during follow-up. Both groups exhibited significant improvements in VAS score, ODI, anterior vertebral height, and Cobb angle of the fractured vertebra after operation compared to baseline ( P<0.05). There were also significant differences between the two time points after operation ( P<0.05). However, there was no significant difference in the above indicators between the two groups ( P>0.05). CONCLUSION For osteoporotic vertebral upper 1/3 compression fractures treated with unilateral percutaneous curved vertebroplasty, both oblique and parallel puncture methods of the flexible bone cement delivery device can effectively relieve pain, but the former is more conducive to reducing the incidence of secondary puncture.
Humans ; Bone Cements/therapeutic use* ; Fractures, Compression/surgery* ; Retrospective Studies ; Vertebroplasty/instrumentation* ; Osteoporotic Fractures/surgery* ; Spinal Fractures/surgery* ; Female ; Male ; Aged ; Middle Aged ; Treatment Outcome ; Punctures/methods* ; Aged, 80 and over

The translocator protein (TSPO) positron emission tomography (PET) can noninvasively detect neuroinflammation associated with epileptogenesis and epilepsy. This study explored the role of the TSPO-targeting radioligand [¹⁸F]F-TFQC, an m-trifluoromethyl ER176 analog, in the PET neuroimaging of epileptic rats. Initially, [¹⁸F]F-TFQC was synthesized with a radiochemical yield of 8%-10% (EOS), a radiochemical purity of over 99%, and a specific activity of 38.21 ± 1.73 MBq/nmol (EOS). After determining that [¹⁸F]F-TFQC exhibited good biochemical properties, [¹⁸F]F-TFQC PET neuroimaging was performed in epileptic rats at multiple time points in various stages of disease progression. PET imaging showed specific [¹⁸F]F-TFQC uptake in the right hippocampus (KA-injected site, i.e., epileptogenic zone), which was most pronounced at 1 week (T/NT 1.63 ± 0.21) and 1 month (T/NT 1.66 ± 0.20). The PET results were further validated using autoradiography and pathological analysis. Thus, [¹⁸F]F-TFQC can reflect the TSPO levels and localize the epileptogenic zone, thereby offering the potential for monitoring neuroinflammation and guiding anti-inflammatory treatment in patients with epilepsy.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Objective:To design a visual allocation system of emergency medical equipment based on the Internet of Things technology,and to realize the coordinated allocation of emergency medical equipment in hospitals.Methods:The client and server(C/S)architecture was adopted,and the design of emergency medical equipment visual allocation system was mainly based on Bluetooth 5.1 technology,with automatic acquisition and automatic analysis of Bluetooth positioning tag,low power consumption sensor and signal communication of Bluetooth Internet of Things base station.The sample data of 150 pieces of equipment managed by the traditional allocation center mode of The 900th Hospital of People's Liberation Army Joint Logistics Support Force from January to December 2021 were selected,and the sample data of 150 pieces of equipment allocation during the application of the visual allocation system from June 2022 to June 2023 were randomly selected,and the allocation response time and the allocation warehousing in and out time were compared.A total of 40 ventilator devices were randomly selected during the traditional allocation center mode and the visual allocation period,with 20 ventilators in each mode,the start-up rate,utilization rate and profitability of medical equipment during the service period were compared.Results:The visual allocation system can realize the functions of automatic equipment positioning,emergency deployment,ledger management,remote repair report and benefit analysis.The allocation response time,allocation outbound time and allocation inbound time of the visual allocation system were(19.61±3.119)min,(11.73±2.104)min,(10.21±2.165)min,respectively,which were shorter than(54.98±3.999)min,(21.54±2.811)min,(16.80±2.000)min of the traditional allocation center mode,the difference was statistically significant(t=85.407,34.229,27.395,P<0.05).The start-up rate,utilization rate and profitability of ventilator equipment using visual allocation mode were 78.24%,51.23%and 82.76%,respectively,which were higher than 43.52%,36.26%and 47.83%of the traditional allocation center mode,the difference was statistically significant(x2=8.792,7.813,12.216,P<0.05).Conclusion:The visual allocation system of emergency medical equipment based on the Internet of Things technology can realize the functions of emergency medical equipment allocation and storage,equipment positioning and use status analysis,provide a theoretical basis for the allocation of hospital emergency medical equipment,and maximize the role of emergency medical equipment.

Objective:To compare the efficacy and safety of gemcitabine and epirubicin curing for patients with non-muscle invasive bladder cancer (NMIBC).Methods:From October 2014 to October 2017, 86 patients with NMIBC diagnosed by transurethral resection of bladder tumor (TURBT) in Wenling Hospital Affiliated to Wenzhou Medical University were analyzed retrospectively. Among them, 42 were treated with gemcitabine (gemcitabine group) and the other 44 with epirubicin (epirubicin group). In gemcitabine group, there were 37 males and 5 females. The average age was 63.9 (48-81) years old. 30 cases were single tumor while 12 cases were multiple. 35 cases with tumor diameter less than 3cm and 7 cases with tumor diameter greater than 3cm. There were 28 cases in T a stage and 14 cases in T 1 stage. 13 patients’ tumor were high grade and 29 patients’ tumor were low grade. In the epirubicin group, there were 36 males and 8 females. The average age was 65.4 (48-88) years. 31 cases were single tumor while 13 cases were multiple. 36 cases with tumor diameter less than 3cm and 8 cases with tumor diameter greater than 3cm. There were 30 cases in T a stage and 14 cases in T 1 stage. 15 patients’ tumor were high grade and 29 patients’ tumor were low grade. There was no significant difference in the above general information between the two groups ( P > 0.05). The two groups were treated with epirubicin or gemcitabine within 24 hours after operation, and bladder perfusion once a week was performed continuously after the first week of operation, a total of 8 times, and after that once a month till one year after operation. The clinical efficacy and adverse reactions were compared between the two groups. Kaplan-Meier was used to compare the recurrence free survival time of tumor after operation. The prognostic factors were analyzed by Cox proportional hazards model. Results:The adverse reactions of the two groups were mainly bladder irritation, gross hematuria, fever, nausea and vomiting. The incidence of bladder irritation and gross hematuria in epirubicin group was 25.0% (11 / 44) and 18.2% (8 / 44), which were significantly higher than those in gemcitabine group [7.1% (3/42) and 2.4% (1/42)], and the difference was statistically significant ( P<0.05). There was no significant difference in other adverse reactions between the two groups ( P> 0.05). Kaplan-Meier survival analysis showed that the median tumor recurrence free survival time of gemcitabine group was 29.7 (6.3-58.8) months, and the 1-year and 2-year tumor recurrence free survival rates were 71.4% (30/42) and 45.2% (19/42), respectively; the median tumor recurrence free survival time of epirubicin group was 28.8 (4.5-57.8) months, and the 1-year and 2-year tumor recurrence free survival rates were 70.5% (31/44) and 47.7% (21/44), respectively. There was no difference in the tumor recurrence free survival rates between the two groups( P>0.05). Cox analysis showed that age ( HR=1.1, 95% CI 1.034-1.113) and tumor grade ( HR=12.2, 95% CI 5.776-25.680) were independent risk factors for prognosis. Conclusions:The efficacy of bladder perfusion chemotherapy with gemcitabine and epirubicin in patients with NMIBC was not significantly different, but the incidence of adverse reactions with gemcitabine was lower, which was safe and reliable. The risk factors affecting postoperative survival rates of NMIBC were patient's age and tumor grade.

Objective:To explore the feasibility and safety of long-term home mechanical ventilation(HMV) in children with chronic respiratory failure.Methods:Clinical data of 11 children with chronic respiratory failure, who underwent HMV with the care of the First Affiliated Hospital of Xiamen University from January 2013 to December 2019, were retrospectively reviewed. The clinical manifestation, growth and development, quality of life, adverse events and prognosis of HMV children were analyzed.Results:There were 8 boys and 3 girls with the onset age of 26 days to 13 years old; and the age at starting HMV was 3 months to 13 years old. Eight children were diagnosed as neuromuscular diseases, and 3 children were diagnosed as respiratory diseases. The duration of institutional mechanical ventilation was 2 weeks to 8 months. Six patients underwent invasive HMV via a tracheostomy, and 5 received non-invasive ventilation via nasal and face masks. Bi-level positive airway pressure ventilation mode was applied in all the patients. The duration of HMV was 3 months to 27 months. During follow-up, no HMV related adverse events were observed. Both the quality of life and nutritional status were improved in all cases. One patient lost follow-up 9 months later and 1 patient died of severe adenovirus pneumonia during hospitalization for examination, the remaining 9 cases survived. Liberation from HMV was obtained in 4 patients. The frequency of readmission was 1 to 2 times.Conclusion:It is suggested that long-term HMV is safe and feasible for children with chronic respiratory failure.

Objective:To prevent the occurrence of children′s unintentional injuries, clinical characteristics were analyzed for 1 379 children hospitalized for unintentional injuries over a 5-year period at the First Affiliated Hospital of Xiamen University.Methods:We searched the First Affiliated Hospital of Xiamen University Pediatric Refined Management Database for all cases of children aged 0-14 years who were hospitalized for unintentional injuries from January 1, 2015 to December 31, 2019.Descriptive statistics were calculated for age, gender, season of injury, location of residence, education level of the child′s parents/guardians, injury etiology and outcome, and cost of treatment.Results:Of 1 379 cases, 894 children(64.8%) were boys and 485(35.2%) were girls.The majority of cases were 1-5 years old(61.6%, n=849). The top three causes of unintentional injuries were foreign bodies(38.1%, n=526), falls(27.0%, n=372), and burns(17.1%, n=236). Children′s unintentional injuries occurred most frequently during the summer(29.0%). More children came from rural locations(56.3%, n=777). Approximately half of the parents/guardians had attained an education level of junior high school or below(50.5%, n=696). There were 47 cases(3.4%) resulting in death or permanent injury and 292 cases(21.2%) resulting in disability.Children injured in traffic accidents had the longest average length of hospital stay [11(7, 18)d] and incurred the highest healthcare costs per case[11 130.32(5 389.69, 24 216.90)RMB]. Conclusion:Children′s unintentional injuries are concentrated among rural boys aged 1-5 years, foreign bodies are the most common cause of unintentional injuries.Children from families with low parental/guardian education levels may be at heightened risk of unintentional injuries.

Objective To establish a HPLC method for simultaneous determination of oleanolic acid and ursolic acid and provide the basis for quality control of Hawthorn extract .Methods Chromatographic separation was performed on Agilent Zorbax SB C18 column(250 mm × 4 .6 mm ,5 μm) with mobile phase of methanol (A)-0 .06 mol/L ammonium acetate solution (B) (85∶15 ,V/V ) under isocratic elution for 30 min .The flow rate was set at 0 .8 ml/min and the detection was set at the wavelength of 210 nm .Results Oleanolic acid and ursolic acid showed good linearity (r> 0 .999 5) in the ranges of 0 .496-2.480 g and 0 .498-9 .960 g ,respectively .Repeatability ,precision ,recovery and stability were conform to the method valida-tion requirements of China Pharmacopoeia .Conclusion The method could provide the basis for the quality control of Hawthorn extract and its preparation .

Objective To explore the impact of ketogenic diet (KD) on follicular helper T cells(TFH) in children with intractable epilepsy.Methods Thirty-three cases with intractable epilepsy were selected between Jul.2013 and Jan.2014 in Shenzhen Children's Hospital,19 boys and 14 girls; average age was 39.6 months,and seventeen age-matched healthy children who took a physical examination in the same hospital were assigned as the healthy control group.Blood samples were collected from the children with refractory epilepsy before and after 1 week of KD treatment.The proportions of the various stages of B cells and TFH cells were detected by flow cytometry.The plasma concentration of interleukin-21 (IL-21) was determined by enzyme-linked immunosorbent assay(ELISA),and realtime quantitative PCR(RT-PCR) was performed to detect the levels of peroxisome proliferator-activated receptor gamma (PPAR-γ),B-lymphocyte-induced maturation protein-1 (Blimp-1),B-cell lymphoma 6 (Bcl6) and IL-21 mRNA expression in CD4 + T cells.Results (1) The number of TFH cells in children with intractable epilepsy [(3.57 ± 0.58) ％] was remarkably decreased after KD treatment(P ＜ 0.01),while there were no difference between after KD treatment and healthy control group[(4.93 ±0.70)％ vs (5.03 ±0.63)％,P ＞0.05].(2) The levels of transcription factor Bcl6 expression after treatment were significantly decreased,while inhibitory factor Blimp-1 expression increased (P ＜ 0.05).(3)The plasma concentration of IL-21 had a trend to decrease (P ＞ 0.05),while there were no difference before and after KD treatment,and levels of IL-21 mRNA expressions in CD4 +T cells were significantly decreased after the treatment (8.28 × 10-3 ± 1.19 × 10-3 vs 1.72 × 10-2 ± 0.81 × 10-2,t =3.08,P ＜ 0.05).(4) There was no significant difference in CD27-IgD + B cells before and after KD treatment (P ＞ 0.05),CD27 + IgD + B cell and CD27-IgD-B cells had a trend to decrease after KD treatment(P ＞0.05),and CD27 + IgD-B cells and CD27 + IgD-CD38 high plasma cells were significantly decreased after KD treatment (P ＜ 0.05).(5) The number of TFH cells were correlated positively with the number of CD27 + IgD-B cells and CD27 + IgD-CD3g high plasma cells (r =0.785,0.745,P ＜ 0.05).(6) The levels of PPAR-γmRNA in CD4 + T cells expression were significantly up-regulated after KD treatment (3.49 × 10-3 ± 1.10 × 10-3 vs 2.28 ± 10-3 ± 1.30 × 10-3,t =3.41,P ＜0.05),and the number of TFH cells and PPAR-γgene expression was correlated negatively (r =-0.619,P ＜ 0.05).Conclusions KD might down regulate TFH cell number and function through inducing PPAR-γexpression and could inhibit B cell differentiation,which might be one of the factors for hypogammaglobuinemia by KD treatment.

Objective To investigate the effects of ketogenic diet ( KD) treatment on helper T cell subsets in children with intractable epilepsy( IP) . Methods Thirty-five children with IP and eighteen age-matched healthy subjects were enrolled in this study.The percentages of CD3+CD8-IFN-γ+( Th1 ) cells, CD3+CD8-IL-17A+(Th17) cells and CD4+CD25+Foxp3+(Treg) cells were analyzed by flow cytometry.Re-al-time PCR assay was performed to evaluate the expression of T-bet, ROR-γ, IFN-γ, IL-17A and peroxi-some proliferator activated receptorγ( PPAR-γ) at mRNA level in CD4+CD25-T cells and the transcription-al levels of Foxp3, GITR, CTLA-4 and PPAR-γin CD4+CD25+T cells.The concentrations of cyclooxygen-ases-2 (COX-2) and prostaglandin F2a (PGF2α) in plasma samples were measured by enzyme-linked im-munosorbent assay.The expression of IL-17A and IFN-γin plasma samples were detected by using cytomet-ricbeadarray(CBA).Results (1)ThepercentagesofTregcellsinperipheralbloodsamplesfrompa-tients with IP were lower than those in healthy subjects (P<0.05), which were significantly increased with the treatment of KD (P<0.05).The percentages of Th17 and Th1 cells in patients with IP were significantly higher than those in healthy children (P<0.05), but were remarkably decreased with the treatment of KD (P<0.05).Patients with IP showed decreased transcriptional levels of Foxp3, GITR and CTLA-4 in CD4+CD25+T cells as compared with healthy controls, but were up-regulated with the treatment of KD.The ex-pression of transcription factors including T-bet, ROR-γ, IFN-γand IL-17A in CD4+CD25-T cells in pa-tients with IP were higher than those in healthy subjects and were down-regulated after the treatment of KD (P<0.05).(2) The expression of PPAR-γat mRNA level in CD4+CD25-T and CD4+CD25+T cells were decreased in patients with IP as compared with those in heathy controls, but were increased after the treat-ment of KD (P<0.05).Correlation analysis showed that Treg cells had a positive correlation with PPAR-γ(r=0.61, P<0.05).However, the Th1 and Th17 cells were negatively correlated with PPAR-γ[Th1 (r=-0.54, P<0.05), Th17 (r=-0.64, P<0.05) ].(3) The levels of IL-17A and IFN-γin patients with IP were higher than those in healthy controls, but were decreased with KD treatment (P<0.05).The levels of COX-2 and PGF2αin plasma samples from patients with IP were higher than those in healthy controls ( P<0.05).A negative correlation was observed between COX-2 and PPAR-γ(r=-0.571, P<0.05). Moreover, PGF2αand PPAR-γhad a negative correlation as well (r=-0.586, P<0.05).Conclusion The treatment of KD might enhance the expression of PPAR-γthrough inhibiting the products of oxidative stress such as COX-2 and PGF2α, resulting in the rebalance of Th cell subsets and reduced expression of in-flammatory cytokines.