Objective:To measure the clivo-axial angle (CAA)and cervicomedullary angle (CMA)in upper cervical deformity patients who underwent computer-assisted posterior upper cervical reduction and fixation surgery,and analyze their correlation.Methods:In the study,25 patients with symptomatic upper cervical deformity were chosen for measurement of preoperative and postoperative CMA and CAA using magnetic resonance imaging (MRI)and intraoperative C-arm.The angle between the clivus plane and the straight line parallel to that of the posterior margin of the C2 vertebral body was defined as CAA;moreover,the angle between the straight line parallel to the ventral side of the cervical spinal cord and the straight line parallel to that of the ventral side of the medulla oblongata was defined as CMA.Two ex-perienced spinal surgeons performed the measurements.The CAA and CMA were measured three times, and the mean value was considered as the result.Results:Analyses of the CAA and CMA were per-formed with Wilcoxon rank test,which showed that there was consistency between the CAAs measured with MRI and intraoperative C-arm.The result showed that the postoperative CAA and CMA increased significantly compared with preoperation (P<0.001).Through Spearman rank correlation analysis,the preoperative CAA was positively correlative with the CMA (r=0.902,P<0.001),and so was the post-operative CAA (r=0.921,P<0.001).Conclusion:Preoperative and postoperative CAA in upper cer-vical deformity patients is significantly correlative with preoperative and postoperative CMA.CAA can be measured during surgery using intraoperative CT or C-arm based three-dimension navigation,and may predict the patient’s CMA,which cannot be measured during operation,but is essential for evaluating the decompression and reduction of the spinal cord.

Objective To measure the clivus-axial angle (CAA) of Chinese,provide a normal value,and explore the correlation between CAA with cervico-medullary angle (CMA).Methods The CAA was measured on the CT of cervical spine in 225 Chinese with normal cranio-vertebral junction (CVJ).Both the CAA and the CMA were measured on the MRI of cervical spine in 117 subjects.All measurements were performed under a bone window (window level,300 Hu; window width,1 000 Hu) with an accuracy of 0.01°.A regression analysis was used for analyzing the correlation between CAA and CMA.The angle between the clivus plane and the straight line parallel to that of the posterior margin of the C2 vertebral body was defined as CAA; moreover,the angle between the strajght line parallel to the ventral side of the cervical spinal cord and the straight line parallel to that of the ventral side of the medulla oblongata was defined as CMA.Two experienced spinal surgeons performed the measurements.The CAA and CMA were measured three times,and the mean value was considered as the result.Results The CAA of 225 subjects was 133.52°-172.16° (156.93°±6.53°).The 95％ confidence interval was 145.10°-170.19° in male and 142.67°-168.47° in female.If the patients were divided into five groups according to their age,a comparison of these groups showed that there were no significant differences among the groups with respect to CAA.It showed that there was consistency between the CAAs measured with MRI and CT.The CMA for 117 patients ranged from 130.38° to 168.75° with a mean value of 154.17°±6.54°,and its 95％ confidence interval ranged from 141.35° to 166.99°.If the patients were distributed according to their gender or to their age,there were no significant differences among the groups.The relationship between CAA and CMA was linearity,and the regression coefficient was as high as 0.95 (P=0.007).Conclusion The normal CAA of Chinese is from 133.52° to 172.16°.The 95％ confidence interval goes from 145.10° to 170.19° in male,and 142.67° to 168.47° in female,close to CMA.It is valuable for measuring the compression of spinal cord,which can be accessed easily during the procedure.

To examine the ability of intrastriatal gene transfer of vascular endothelial growth factor 165 mediated by adenoviral vector to rescue dopaminergic neurons in a rat model of Parkinson's disease (PD), we constructed recombinant replication-deficent adenoviral vectors carrying the gene of VEGF165 (Ad-VEGF), and injected Ad-VEGF (or Ad-LacZ and PBS as controls) into the striatum of rats 7 days after the lesion by 6-hydroxydopamine. The rat rotational behavior analysis and tyrosine hydroxylase (TH) immunohistochemistry were performed to assess the change of dopaminergic neurons. Our results showed that the rats receiving Ad-VEGF injection displayed a significant improvement in apomorphine-induced rotational behavior and a significant preservation of TH-positive neurons and fibers compared with control animals. It is concluded that intrastriatal gene transfer by Ad-VEGF may rescue the dopaminergic neurons from degeneration in a rat model of PD.

Objective: To provide the normal value of atlas (C₁) inner sagittal diameter in adults thus defining the diagnostic value of developmental canal stenosis at C₁ and to establish the Jishuitan (JST) morphological classification for C₁ developmental canal stenosis in craniovertebral junction (CVJ) anomalies. Methods: From December 2010 to November 2018, 101 patients with various CVJ anomalies (50 males, 51 females; mean age 48.8±12.9 years, range 15-78 years; the anomaly group) and 857 patients with normal CVJ (461 males, 396 females; mean age 50.2±8.3 years, range 21-79 years; the normal group) were enrolled in a retrospective study. In the anomaly group, 92 cases of atlantoaxial dislocation were furtherly divided into three subgroups according to Wadia classification: atlantoaxial dislocation with os odontoideum (OO subgroup, n=33), atlantoaxial dislocation with occipitalization of the atlas (OA subgroup, n=24), atlantoaxial dislocation without both OO and OA (AAD subgroup, n=35); the rest of the anomaly group was combined with Chiari malformation (CM subgroup, n=9). The range of C₁ inner sagittal diameter in each group was measured via CT scan images. The normality of C₁ inner sagittal diameter of each group was tested via Shapiro-Wilk method. T test was performed on C₁ inner sagittal diameter of each group. The diagnostic value of C₁ developmental canal stenosis was defined as the lower bound of 95% confidence interval (CI) for the mean of the normal group. The C₁ morphology of developmental canal stenosis cases in anomaly group were analyzed via CT scan images thus establishing the JST morphological classification for C₁ developmental canal stenosis in CVJ anomalies. Results: The mean C₁ inner sagittal diameter was 29.05±1.60 mm (range, 24.05-33.50, 95%CI: 25.91-32.19). C₁ developmental canal stenosis was defined as C₁ inner diameter ≤ 25.91 mm. The mean C₁ inner sagittal diameter of the whole anomaly group was 26.84±2.04 mm (95%CI: 22.84-30.84), which differed significantly from that in the the normal group (t=10.504, P< 0.01). A total of 33 cases meeting the criteria of C₁ inner diameter ≤ 25.91 mm were diagnosed as C₁ developmental canal stenosis, including 14 cases of the OO subgroup, 4 cases of the OA subgroup, 15 cases of the AAD subgroup and none of the CM subgroup. Based on the C₁ morphological characteristics of 33 cases, the JST classification of C₁ developmental canal stenosis in CVJ anomalies was established, which could be divided into type I-III. Type I: little atlas type, 84.9% (28/33), normal C₁ posterior arch morphology without C₁ occipitalization; Type II: atlas posterior arch incurving type, 3.0%(1/33), C₁ posterior arch incurves towards spinal canal, without C₁ occipitalization; Type III atlas occipitalization type, 12.1% (4/33), furtherly divided into: type IIIa with normal C₁ posterior arch morphology; type IIIb with incurving C₁ posterior arch. Conclusion The normal value of C₁ inner sagittal diameter in adults was from 24.05 to 33.50 mm. The criteria of C₁ inner sagittal diameter ≤ 25.91 mm can be used as the radiographic diagnostic value of C₁ developmental canal stenosis. C₁ developmental canal stenosis in CVJ anomalies can be classified according to the JST classification system.

To examine the ability of intrastriatal gene transfer of vascular endothelial growth factor 165 mediated by adenoviral vector to rescue dopaminergic neurons in a rat model of Parkinson's disease (PD), we constructed recombinant replication-deficent adenoviral vectors carrying the gene of VEGF165 (Ad-VEGF), and injected Ad-VEGF (or Ad-LacZ and PBS as controls) into the striatum of rats 7 days after the lesion by 6-hydroxydopamine. The rat rotational behavior analysis and tyrosine hydroxylase (TH) immunohistochemistry were performed to assess the change of dopaminergic neurons. Our results showed that the rats receiving Ad-VEGF injection displayed a significant improvement in apomorphine-induced rotational behavior and a significant preservation of TH-positive neurons and fibers compared with control animals. It is concluded that intrastriatal gene transfer by Ad-VEGF may rescue the dopaminergic neurons from degeneration in a rat model of PD.

To systematically construct a guideline to provide a methodological guide for researchers to develop patient decision aids.

Objective:To systematically evaluate the effect of cognitive behavioral therapy (CBT) in elderly patients with depression.Methods:The randomized controlled trials on the effect of CBT in elderly patients with depression, published until December 15, 2022, were searched in PubMed, CINHAL, Cochrane Library, China Biology Medicine, China National Knowledge Infrastructure, WanFang Data, and VIP. Two researchers independently screened the literature, extracted data, and used the revised Cochrane risk of bias tool for randomized trials (ROB 2.0) to evaluate the quality of the included studies. Statistical analysis was conducted using Stata 16.0, and the quality of evidence was rated using Appraisal of Guidelines for Research and Evaluation (GRADE) predictor software.Results:A total of 11 randomized controlled trials were included, with a total of 833 elderly patients with depression. Randomized effect models were used to analyze outcome indicators such as depression, anxiety, and quality of life by combining effect quantities. Meta-analysis and GRADE evidence quality showed that compared to the control group, medium quality evidence showed that CBT could relieve depression in elderly depression patients with a statistical difference [ SMD=-1.58, 95% CI (-2.16, -0.99), P<0.05]. Low quality evidence suggested that CBT could alleviate anxiety in elderly depression patients also with a statistical difference [ SMD=-2.25, 95% CI (-4.04, -0.47), P<0.05]. Very low quality evidence indicated that CBT did not significantly improve the quality of life in elderly depression patients compared to conventional or pharmacological treatment [ SMD=-0.09, 95% CI (-2.07, 1.88), P>0.05] . Conclusions:Existing evidence suggests that CBT can alleviate depression and anxiety in elderly depression patients, but its improvement in quality of life is not yet significant. Treatment feedback and forms of CBT may become a research focus in recent years on intervention for elderly depression patients.

Objective To investigate and analyze the characteristics of blood physiological and biochemical parameters of Tibetan chickens bred in Guangzhou. Methods Blood samples of Tibetan chickens bred in Guangzhou were collected,and the physiological and biochemical parameters were measured. Results (1)The blood RBC,PLT,PDW, RDW-SD and P-LCR were not significantly different in the males than females(P > 0.05).(2)HCT(P < 0.05), MCHC(P< 0.05),MPV(P< 0.05),HGB(P< 0.01),MCV(P< 0.01)and MCH(P< 0.01)were significantly higher between the males and females.(3)RDW-CV was significantly lower in the blood physiological parameters of males than females.(4)AST,TRIG,ALKP,ALT,Ca,CHOL,CREA,GLU,PHOS and TBIL were not remarkably different in the blood of males than females(P > 0.05).(5)The blood AMYL(P < 0.05)and TP(P < 0.01)were significantly higher in the males than females.(6)The blood ALB(P< 0.01),UREA(P< 0.05), and GLOB(P<0.01)were significantly lower in the males than females. Conclusions The essential data of blood physiological and biochemical indexes of Tibetan chickens bred in Guangzhou are obtained.

The morbidity of inflammatory bowel diseases (IBD) is rising rapidly but no curative therapies to prevent its recurrence. Cell death is crucial to maintaining homeostasis. Necroptosis is a newly identified programmed cell death and its roles played in IBD need to be explored. Necroptosis is mediated by receptor interacting protein kinase 1 (RIPK1), RIPK3, and mixed lineage kinase domain-like protein (MLKL), which resulted in cell swelling, plasma membrane rupture, intracellular content leaking, and eventually cell death as well as the promotion of inflammation. Studies have found that inhibiting necroptosis alleviated IBD in animal models and IBD patients with an increased level of necroptosis in inflammatory tissues, indicating that necroptosis is related to the pathogenesis of IBD. However, due to the complexity in regulation of necroptosis and the involvement of multiple functions of relevant signaling molecules, the specific mechanism remains elusive. Necroptosis may play a vital regulatory role in the pathogenesis of IBD, which provides a new idea and method for further exploring the therapeutic target of IBD.

Background::Gestational weight gain (GWG) is associated with the risk of gestational diabetes mellitus (GDM). However, the effect of weight gain in different trimesters on the risk of GDM is unclear. This study aimed to evaluate the effect of GWG on GDM during different trimesters.Methods::A birth cohort study was conducted from 2017 to 2020 in Shenzhen, China. In total, 51,205 participants were included comprising two models (early pregnancy model and middle pregnancy model). Gestational weight (kg) was measured at each prenatal clinical visit using a standardized weight scale. Logistic regression analysis was used to assess the risk of GDM. Interaction analysis and mediation effect analysis were performed in the middle pregnancy model.Results::In the early pregnancy model, the risk of GDM was 0.858 times lower (95% confidence interval [CI]: 0.786, 0.937) with insufficient GWG (iGWG) and 1.201 times higher (95% CI: 1.097, 1.316) with excessive GWG after adjustment. In the middle pregnancy model, the risk of GDM associated with iGWG increased 1.595 times (95% CI: 1.418, 1.794) after adjustment; for excessive GWG, no significant difference was found ( P = 0.223). Interaction analysis showed no interaction between GWG in early pregnancy (GWG-E) and GWG in middle pregnancy (GWG-M) ( F = 1.268; P = 0.280). The mediation effect analysis indicated that GWG-M plays a partial mediating role, with an effect proportion of 14.9%. Conclusions::eGWG-E and iGWG-M are associated with an increased risk of GDM. Strict control of weight gain in early pregnancy is needed, and sufficient nutrition should be provided in middle pregnancy.