Objective:To evaluate the effect of oblique lateral interbody fusion (OLIF) combined with posterior fixation on segmental alignment in the treatment of degenerative spondylolisthesis (DS).Methods:The clinical data of 40 patients with DS who underwent OLIF combined with posterior fixation from July 2017 to December 2019 were retrospectively analyzed. There were 7 males and 33 females, aged 45-81 years, with an average age of 65.7±9.06 years. The total number of slip segments was 43, including 37 levels at L 4, 5, 5 levels at L 3, 4, and 1 level at L 2, 3. According to the decompression methods, the patients were divided into two groups. 22 patients with 23 levels were treated with direct decompression combined with laminectomy, and 18 patients with 20 levels were treated with indirect decompression without laminectomy. All patients underwent preoperative and intraoperative imaging examination. The disc height (DH), slip ratio (SR) and segmental lordosis (SL) were measured by preoperative CT and intraoperative fluoroscopy images. One-way repeated measures ANOVA was used to compare the radiographic parameters of the segmental alignment prior to cage implantation, following cage insertion and posterior fixation. Bonferroni test was used to compare the radiographic parameters between groups. Results:In the OLIF combined with the posterior fixation, there were statistically significant differences in the radiographic parameters of segmental alignment at different stages of operation [DH ( F=147.786, P<0.001) , SR ( F=83.754, P<0.001) , SL ( F=38.296, P<0.001) ]. DH increased from 7.99±1.39 mm to 11.69±1.72 mm ( P<0.001), SR decreased from 10.67%±4.67% to 8.66%±4.50% ( P=0.001) and SL increased from 7.26°±2.73° to 7.85°±2.30° ( P=0.425). After combined posterior fixation, SR further decreased from 8.66%±4.50% to 2.07%±4.00% ( P<0.001), SL further increased from 7.85°±2.30° to 10.72°±3.08° ( P<0.001), and DH had no significant change ( P=1.000). There was no significant difference in radiographic parameters between the direct decompression group and the indirect decompression group when prior to cage implantation, following cage insertion and following posterior fixation, respectively. Conclusion:OLIF combined with posterior fixation in the treatment of DS can further reduce the slip rate of patients with lumbar degenerative spondylolisthesis and increase the lordosis angle of the surgical segment. At the same time, the direct decompression combined with laminectomy has no significant effect on the segmental alignment.

Objective:To explore the correlation between early inflammation indicators and the severity of coronavirus disease 2019 (COVID-19).Methods:A retrospective study was conducted. Patients with COVID-19 admitted to Wenzhou Central Hospital from January 17 to February 14, 2020 were enrolled. The general information, chest CT before admission, the first laboratory parameters and chest CT within 24 hours after admission were collected. Patients were followed up for 30 days after the first onset of dyspnea or pulmonary imaging showed that the lesions progressed more than 50% within 24 to 48 hours (according to the criteria for severe cases) as the study endpoint. According to the endpoint, the patients were divided into two groups: mild type/common type group and severe/critical group, and the differences in general information and inflammation index of the two groups were compared. Logistic regression was used to analyze the inflammation index and the severity of COVID-19. Receiver operating characteristic (ROC) curve was draw to evaluate the predictive value of early inflammation indicators for severe/critical in patients with COVID-19.Results:A total of 140 patients with COVID-19 were included, 74 males and 66 females; the average age was (45±14) years old; 6 cases (4.3%) of mild type, 107 cases (76.4%) of common type, and 22 cases (15.7%) of severe type, 5 cases (3.6%) were critical. There were significantly differences in ages (years old: 43±13 vs. 57±13), the proportion of patients with one chronic disease (17.7% vs. 55.6%), C-reactive protein [CRP (mg/L): 7.3 (2.3, 21.0) vs. 40.1 (18.8, 62.6)], lymphocyte count [LYM (×10 9/L): 1.3 (1.0, 1.8) vs. 0.8 (0.7, 1.1)], the neutrophil/lymphocyte ratio [NLR: 2.1 (1.6, 3.0) vs. 3.1 (2.2, 8.8)] and multilobularinltration, hypo-lymphocytosis, bacterial coinfection, smoking history, hyper-tension and age [MuLBSTA score: 5.0 (3.0, 5.0) vs. 5.0 (5.0, 7.0)] between mild/common group and severe/critical group (all P < 0.05). Univariate Logistic regression analysis showed that CRP, NLR, MuLBSTA score, age, and whether chronic diseases were associated with the severity of COVID-19 [odds ratio ( OR) and 95% confidence interval (95% CI) were 1.037 (1.020-1.055), 1.374 (1.123-1.680), 1.574 (1.296-1.911), 1.082 (1.042-1.125), 6.393 (2.551-16.023), respectively, all P < 0.01]. Further multivariate Logistic regression analysis showed that CRP and MuLBSTA score were risk factors for the development of COVID-19 to severe/critical cases [OR and 95% CI were 1.024 (1.002-1.048) and 1.321 (1.027-1.699) respectively, both P < 0.05]. ROC curve analysis showed that the area under the curve for CRP and MuLBSTA score to predict severe/critical cases were both 0.818, and the best cut-off points were 27.4 mg/L and 6.0 points, respectively. Conclusion:CRP and MuLBSTA score are related to the severity of COVID-19, and may have good independent predictive ability for the development of severe/critical illness.

To explore the characteristics of hematological abnormalities in patients with systemic lupus erythematosus (SLE) through retrospective analysis.A total of 445 SLE patients were recruited and divided into 5 groups of low white blood cell,immune thrombopenic purpura,anemia,pancytopenia and control without hematological abnormalities.Among them,351 (78.9％) had hematological abnormalities and 94 (21.1％) without hematological abnormities.The prevalence of anemia,leucocytopenia,thrombocytopenia and pancytopenia were 56.0％ (246/445),27.6％ (123/445),13.5％ (60/445) and 8.5％ (38/445) respectively.The incidence of renal damage in anemia group was significantly higher than that in control group (P ＜ 0.01).SLE patients with hematological abnormalities had lower complement C3 levels (P ＜ 0.05) and higher systemic lupus erythematosus disease activity index (SLEDAI) (P ＜ 0.01).Anemia is the most common findings in SLE patients with hematological abnormalities who have lower complement C3 levels and higher SLEDAI.

From January 2014 to June 2014,a total of 178 primiparas and biparas scheduled for a 42-day postpartum follow-up visit at our hospital were examined.And their pelvic floor dysfunctions were evaluated according to the surveys of incontinence impact questionnaire,short form (IIQ-7),pelvic floor impact questionnaire-7 (PFIQ-7) and pelvic organ prolapse/urinary incontinence sexual questionnaire (PlSQ.12).And 130 primiparas and 48 biparas lacked an understanding of performance,prevention and treatment for postpartum pelvic floor dysfunction.And two groups showed no significant difference.The selfdiscovery and detection rates of decreased pelvic myodynamic were 9.2％ and 14.6％ in primiparas versus 10.4％ and 16.7％ in biparas.The self-discovery and detection rates of pelvic organ prolapse were 0.8％ and 2.3％ in primiparas versus 0.0％ and 8.3％ in biparas.And the difference was statistically significant.Most related knowledge came from parents and colleagues in 53.1％ (95/178) and doctors and nurses in 15.5％ (27/178).Only about 44.4％ (12/27) women with prominent symptoms of pelvic floor dysfunction requested treatments.Therefore the related knowledge of postpartum pelvic floor dysfunction should be strengthened.

Objective To investigate the effects of different durations of methamphetamine abuse on spatial cognitive processing.Methods The mental rotation task was used to evaluate the spatial processing function of 35 methamphetamine abusers and 30 healthy subjects.The methamphetamine abusers are divided into 2 groups according to their abuse durations,group 1 contains 16 abusers with an average duration of 1 year and group 2 contains 19 abusers with an average duration of 3 years.Participants were asked to judge the right hand/food or the left hand/food of the experimental stimuli at difference angles.The reaction time (RT) and the accurate rate (AR) of the mental rotation task were recorded.Results Compared with the control group,RT of group 1 methamphetamine abusers was longer at the angle of 0°((1469±318)ms) and 180°((1718±412)ms) (P＜0.05),RT of group 2 was longer at the angle of 0°((1466±243) ms),60°((1497±294) ms) and 180°((1708±288) ms) (P ＜0.05).And the AR of methamphetamine abusers was higher at every angle (P＜0.05).Conclusion Long-term dependence on methamphetmine can damage the abuser's spatial processing function.

ObjectiveTo investigate the effect of bone marrow-derived mesenchymal stem cells (MSCs) on gene and protein expression of toll-like receptor, TLR2/4 of the rat alveolus macrophages so as to discuss the effect of MSCs transplantation on the early inflammatory mediators and the regulatory mechanism of the inflammatory cascade.MethodsThe alveolus macrophages were randomly divided into the PBS control group (n = 24), MSCs control group (n = 24), lipopolysaccharide (LPS) control group (n=24) and LPS + MSCs treatment group (n =24).All groups were taken time-points of 1, 3,6, 12 hours.Positive cell rate of MSCs with surface mark and the expression level of TLR2/4 protein on macrophage were detected by flow cytometry.The mRNA level of TLR2/4 expression on macrophage was detected by RT-PCR and the concentrations of TNF-o in cell culture supernatants by ELISA at the different time points.ResultsCompared with the PBS control group and MSCs control group, TLR2/4 mRNA and protein levels were significantly up-regulated, markedly increased at one hour and peaked at 12 hours (P ＜0.01) and the TNF-α concentrations in cell culture supernatants were significantly up-regulated and peaked at 6 hours in the LPS control group (P ＜ 0.01).Compared with the LPS control group, mRNA and protein level of TLR2/4 and TNF-o concentrations in the cell culture supernatants of the LPS + MSCs group were markedly down-regulated (P ＜ 0.01).ConclusionsWith LPS stimulation, TLR2/4 mRNA and protein expressions as well as TNF-αt concentration increase, when the peak of the TNF-αt concentration appears slightly earlier, indicating that there may be a positive feedback loop between TLR2/4 expression and TNF-ot.MSCs can significantly reduce TLR2/4 mRNA and protein expressions as well as TNF-α concentration after LPS stimulation, indicating that MSCs can break up the positive feedback loop.

Objective To evaluate the effects of serum procalcitonin (PCT)-guided antibiotic therapy in elderly patients with early-onset stroke-associated pneumonia (EOP).Methods Totally 179 eligible elderly patients with EOP were randomly devided into 2 groups:standard therapy group (standard group,n=88) and PCT-guided group (PCT group,n=91).Patients in standard group received antibiotics according to antibiotics guidelines in China by the treating physicians.Patients in PCT group were treated with antibiotics for 5 days,then the antibiotic treatment was based on serum PCT levels as follows:discouraged if PCT＜0.25 μg/L and encouraged if PCT≥0.25 μg/L.Length of hospitalization,duration of antibiotics,costs of hospitalization and antibiotics,clinical efficacy,andmortality,National Institutes of Health Stroke Scale (NIHSS) score and Barthel index (BI) on the 28th day were observed.Results There were no significant differences in clinical efficacy,mortality,NIHSS score and BI between the two groups on the 28th day [(85.7％ vs.86.3％),(8.8％ vs.7.9％),10.1 (7.8,16.2) vs.9.8 (6.0,15.5),60.1(42.5,82.3) vs.57.9 (39.2,84.8),respectively,all P＞ 0.05].The length of hospitalization,antibiotic duration,costs of hospitalization and antibiotics were lower in PCT group than in standard group [19 (10,38) d vs.26(17,42) d,10 (7,14) dvs.15 (6,21) d,3350 (2052,6163) yuanvs.10355 (6877,15421) yuan,7532 (4810,12116) yuan vs.5358 (3089,8144) yuan,respectively,all P＜0.05].Conclusions PCT guidance of antibiotic therapy is effective and safe for the treatment of early-onset stroke associated pneumonia in elderly patients.It can reduce the antibiotic duration and costs of hospitalization.

OBJECTIVETo provide theoretical basis for artificial cross breeding of Angelica dahurica from Sichuan and Hebei Province, the characteristics of stigma receptivity and the viability and life-span of pollen were studied.

METHODThe viability and life-span of pollen were evaluated by TTC (2, 3, 5-triphenyl tetrazlium chloride) test, and the stigma receptivity was estimated by benzidine-H2O2 method.

RESULTThe pollen viability of A. dahurica from Sichuan and Hebei provinces was increased gradually since the bud stage, but those levels had since subsided after the pollen release from craze antheral. There was a little difference in the pollen viability of A. dahurica from Sichuan at different branches. While the order of the pollen viability of A. dahurica from Hebei was main stem < first-order branching < second-order branching. At room temperature, the pollen viability of both decreased during time of anthers dehiscing but also above 50% after 5 days. Compared with 4 degrees C and room temperature, conservation at - 20 degrees C could extend life of the pollen. The stigma had receptivity in 4th day and reached the highest level in the 6th day after blooming.

CONCLUSIONThe optimum artificial pollination times of A. dahurica was 6 days after blooming and choose the pollen in the peak stage of anthers dehiscing.

Objective To investigate the effects of the serum from rats with hemorrhagic shock and Shenfu injection, on the expression of endothelial cell protein C receptor (EPCR) in human umbilical vein endothelial cells (HUVECs) cultured with rat serum. Method The soluble endothelial protein C receptor (sEPCR) in supernatant, the expression of EPCR mRNA and protein level of EPCR in HUVECs were detected by using enzyme linked immunosorbent assay ( ELISA), reverse transcription polymerase chain reaction (RT-PCR), and western bloting (WB) in normal control group, hemorrhagic shock serum (3 h, 12 h, 24h, 72 h) group, and Shenfu-treated (3 h, 12 h, 24 h, 72 h) group, respectively. Results The mean levels of sEPCR and the expression of EPCR mRNA were significantly higher in hemorrhagic shock serum (12 h, 24 h) group, and Shenfu -treated(24 h)group than those in normal control group (all P ＜0.01 ),the mean levels of sEPCR and the expressions of EPCR mRNA were significantly higher in Shenfu-treated ( 12 h) group than those in normal control group ( all P ＜0. 05 ), while the levels of protein were lower in hemorrhagic shock serum ( 12 h, 24 h) group and in Shenfu-treated(24 h)group than those in normal control group ( both P ＜0.01 ), and the level of EPCR protein was lower in Shenfu-treated( 12 h) group than that in normal control group ( P ＜ 0. 05) . The mean levels of sEPCR and the expressions of EPCR mRNA were significantly lower in Shenfu-treated ( 12 h, 24 h) group than those in hemorrhagic shock serum ( 12 h,24 h) group (all P ＜0.05), while the levels of EPCR protein were higher in Shenfu-treated ( 12 h, 24 h)group than those in hemorrhagic shock serum ( 12 h, 24 h) group ( P ＜ 0.05 ). Conclusions These data suggest that Shenfu injectio could affect the expression of EPCR mRNA and the level of EPCR protein, thereby it might be effective in prevention of development of hemorrhagic shock.

Objective To evaluate the application value of the blastocysts derived from non-pronucleus (0PN) zygotes by the good quality blastocyst formation rate and the clinical outcomes of frozen-thawed blastocyst transfers. Methods The good quality blastocyst formation rate derived from 0PN zygotes was compared with that derived from2 pronucleus(2PN)zygotes in in vitro fertilization(IVF)or intracytoplasmic sperm injection (ICSI) cycles from January 2015 to December 2016. In addition, the clinical pregnancy, embryo implantation and live birth rates of frozen-thawed blastocyst transfers with blastocysts derived from 0PN and 2PN zygotes were analyzed on corresponding dates. Results (1)In IVF cycles, the high quality blastocysts formation rate of 2PN embryos was significantly higher than that of 0PN (46.64% versus 42.42%, P<0.01). In ICSI cycles, the high quality blastocysts formation rate of 2PN embryos was markedly higher than that of 0PN(41.96% versus 21.73%, P<0.01).(2)In frozen-thawed embryo transfer cycles for IVF, the clinical pregnancy, implantation and live birth rates of D5 0PN blastocysts were significantly higher than those of D6 2PN(52.64% versus 46.78%, 49.91% versus 41.20%, 46.54% versus 39.56%, all P<0.05), however, the abortion and newborn abnormal rates of D5 0PN blastocysts were lower than those of D6 2PN blastocysts(17.37% versus 23.36%, 1.31% versus 4.21%, both P<0.05); the clinical pregnancy, implantation and livebirth rates of D5 2PN blastocysts were significantly higher than those of D5 0PN(59.73% versus 52.64%, 55.95% versus 49.91%, 53.03% versus 46.54%, all P<0.05), but newborn abnormal rate was a little higher than that of D5 0PN(3.90% versus 1.31%, P<0.05);the clinical pregnancy, implantation and live birth rates of D5 2PN blastocysts were significantly higher than those of D6 2PN(59.73% versus 46.78%, 55.95% versus 41.20%, 53.03% versus 39.56%, all P<0.05), and the abortion rate of D5 2PN blastocysts was lower than that of D6 2PN blastocysts(18.23% versus 23.36%, P<0.05). Conclusions Although the blastocysts derived from 0PN could be transffered, the blastocysts derived from 2PN zygotes are preferred in all cycles. In IVF cycles, the good quality blastocysts derived from 2PN or 0PN zygotes will be transferred.