Objective To investigate the selection and curative effect of surgical approach for thoracolumbar fractures. Methods A retrospective analysis was conducted on 212 patients with thoracolumbar fractures treated surgically from January 1995 to January 2009 to observe the spinal column and the neurological function recovery. Results Anterior surgery was performed in 73 patients and posterior surgery in 139. The patients were followed up for average 23.7 months ( range, 12-52 months). The height of injury vertebral, the Cobb' s angle and the volume of vertebral canal were improved significantly (P <0.01 ). The patients with incomplete paralysis all got nerve function recovery at different extents ( from one grade to three grades). Conclusions Surgical treatment for thoracolumbar fractures can effectively recover the spine structure and promote the nerve function recovery. The surgical approach should be selected based on the fracture type.

Objective To investigate the clinical effect of the bone graft fusion of the posterior lumbar interbody fusion (PLIF) combined with posterolateral fusion(PLF) in treating lumbar spondylolisthesis .Methods 63 cases of lumbar spondylolisthesis were performed the posterior unilateral or bilateral vertebral plate resection ,nerve root canal decompression ,clearing the slippage space , reduction ,fixation short-segment vertebral pedicle nail-stick system for reduction and fixation ,bone graft fusion with the interverte-bral space Cage and posterior-lateral bone graft fusion ,vertebral pedicle isthmus cracking was performed the clearance and bone graft fusion(PLIF combined with PLF ) .The JOA scores ,lumbar lordosis ,segment lordosis ,intervertebral space height ,slippage rate and complications were recorded before operation ,in postoperative 1 week ,6 ,12 months .Results All cases had no serious complications .The JOA scores were increased to some different degrees from the beginning of postoperative 1 week ,with the reha-bilitation time extension ,the JOA scores were gradually increased ,the improvement rate of the postoperative JOA score averaged 85 .00% .The lumbar lordosis ,segment lordosis ,intervertebral space height and slippage rate after operation were significantly im-proved compared with before operation ,the fusion failure rate was 4 .76% .Conclusion The bone graft fusion of PLIF combined with PLF is one of ideal methods to treat lumbar spondylolisthesis .

Objective To optimize immunodominant protein combinations for serological screening for Cblamydia trachomatis (Ct) infection.Methods Both serum and genital swab samples were collected from 50 patients with Ct infection confirmed by colloidal gold immunochromatographic assay (GICA),and 30 GICA-negative clients without Ct infection at a sexually transmitted disease (STD) clinic in Tianjin Medical University General Hospital.The 30 serum samples from GICA-negative clients were also negative for microimmunofluorescence (MIF) assay.Eight Ct immunodominant proteins,including Pgp3,CPAF,CT143,CT101,CT694,CT875,CT813 and IncA,were selected as antigens to detect corresponding antibodies in the serum samples by enzyme-linked immunosorbent assay (ELISA) with the Ct proteins Hsp60 and major outer membrane protein (MOMP) as references.The results of ELISA were compared with those of the traditional gold standard method MIF assay to determine the immunodominant protein combination with the highest sensitivity and specificity.Results Of the 50 serum samples from patients with Ct infection,44 were positive and 6 negative by MIF.The results of ELISA with the combination of immunodominant proteins Pgp3,CT694 and CT875 as antigens were 97.73％ (43/44) consistent to those of MIF assay.Of the 30 serum samples from GICA-negative clients,all were negative by MIF.Meanwhile,no antibody was detected against any of the immunodominant proteins Pgp3,CT694 and CT875 in any of the serum samples from GICA-negative clients.Conclusions The ELISA with the combination of immunodominant proteins Pgp3,CT694 and CT875 as antigens has good sensitivity and specificity for serological screening for Ct infection,and is simple to operate and easy to popularize.

Objective To investigate the capability of empathy for pain in bipolar disorder (BD). Methods Thirty-two patients with BD (16, 8 and 8 in depressed, manic and remitted phases, respectively) and 32 healthy controls matched for age, gender and education were recruited. Empathy for pain paradigm were used. Subjects were required to judge whether the person in the picture felt painful and rate pain degree regarding to painful and neutral pictures. Accuracy, reaction time and ratings of pain degree were used as indicators of empathy for pain. Chinese version of Interpersonal Reactivity Index (IRI-C) were used to measure empathy. Results Compared to controls, accuracy of painful pictures was significantly lower in patients [(0.74±0.16) vs.(0.83±0.10), P<0.05]. Reaction time for both painful [(903.84±167.49) ms vs. (765.06±108.21) ms] and neutral [(880.44 ± 190.36) ms vs. (750.31 ± 103.15)ms] pictures were significantly longer in patients (P<0.05). Pa?tients showed lower scores in factors of perspective taking [(9.20±5.43) vs. (12.43±4.13)], fantasy [(11.85±4.57) vs. (15.50± 5.56)] and empathy concern [(14.59±5.35) vs. (17.63±3.37)] in IRI-C (P<0.05). Accuracy of painful pictures was positively correlated with scores in fantasy (r=0.37, P=0.04) and reaction time was positively correlated with duration of disease in pa?tients (r=0.64, P<0.01). Conclusion Bipolar disorder has deficit in the capability of empathy for pain.

Objective:To summarize the clinical experiences of managing patients with novel coronavirus(2019-nCoV) infection after kidney transplantation.Methods:Clinical data were retrospectively analyzed for two patients with 2019-nCoV infection after renal transplantation in January 2020. Case 1 was a 48-year-old male with CMV pneumonia secondary to 2019-nCoV infection at 4 months post-transplantation. CT imaging showed multiple patchy ground-glass opacities of both lungs. Case 2 was a 59-year-old male who screened positive for 2019-nCoV nucleic acid due to fever at 9 days post-transplantation and he showed no clinical manifestations of pneumonia. After a definite diagnosis, case 1 was transferred to a designated hospital for isolation. Treatment regimens: cefoperazone sulbactam sodium plus linezolid for anti-infection, gamma globulin for enhancing immunity, methylprednisolone for controlling inflammatory responses and antiviral regimens of arbidol tablets plus lopina-velitonavir tablets. Case 2 was isolated in a single room. The treatment plan included cefoperazone sulbactam sodium for anti-infection, gamma globulin for enhancing immunity, arbidol for antiviral therapy and other symptomatic measures.Results:During a follow-up period of 3 weeks, case 1 recovered with renal dysfunction, nucleic acid test of nasopharyngeal swab turned negative and pulmonary imaging improved. Case 2 showed no obvious clinical symptoms and nucleic acid test of nasopharyngeal swab turned negative thrice.Conclusions:Renal transplant recipients should take precautions to avoid exposure to high-risk environments. A definite diagnosis should be made on the basis of clinical manifestations and results of nucleic acid test and pulmonary imaging. Currently there is no effective antiviral agent and symptomatic treatment is a major option.

Objective: To investigate the impact of parental conflict perception on adolescent anxiety and the therapeutic effect of family therapy on adolescent anxiety. Methods: A total of 120 adolescent anxiety patients who attend the psychological clinic of the fourth renming hospital in Hefei were selected and were divided into two groups, the treatment group and control group, impact clinical medication while the treatment group recevied both clinical medication and family therapy(for three months). Parents Conflict Consciousness Scale(CPIC), Hamilton Anxiety Scale (HAMA) was used to assess parents conflict consciousness of adolescent anxiety. Effects of family therapy on teenagers anxiety and CPIC, HAMA score were analyzed. Results: CPIC conflict intensity, threats of cognitive conflict and content for adolescent anxiety were positively correlated with HAMA scores(r=0.26, 0.20, 0.18, P<0.05), At the end of the three-month treatment, the score on HAMA and CPIC of the treatment group (HAMA: 9.23±1.98, CPIC: 9.52±2.35) was significantly lower than that of the control group(HAMA: 14.52±2.66, CPIC:11.98±2.55)(t=11.88, 5.48, P<0.01). HAMA and CPIC scores of patients in both groups significantly decreased compared to before treatment(control group t=13.88, 16.84; treatment group t=20.50, 21.89, P<0.01). Conclusion Parental conflict perception shows impact on adolescent anxiety, and family therapy can reduce parental conflict perception and relieve adolescent anxiety.

Objective:To study the neurodevelopmental prognosis and risk factors for adverse outcomes of neonatal seizure.Methods:From December 2019 to November 2020, infants with neonatal seizure diagnosed in our hospital were enrolled in this retrospective study. Based on survival or not, mental development index (MDI), psychomotor development index (PDI) and seizure episodes at the age of 12 months, the infants were assigned into adverse outcome group and normal outcome group. The risk factors for adverse outcomes were statistically analyzed.Results:A total of 75 infants were enrolled,including 39 cases in adverse outcome group and 36 in normal outcome group. 69 cases showed abnormal amplitude-integrated electroencephalogram(aEEG), including 38 mildly abnormal cases,23 moderately abnormal cases and 8 severely abnormal cases, The incidences of adverse outcomes and mortality rates were significantly different ( P<0.05) among infants with different severity levels of aEEG abnormalities and the severity levels of aEEG abnormalities were positively correlated with adverse outcomes ( r=0.367, 0.471, P<0.05).Univariate analysis showed that adverse outcome group had significantly higher incidences of chorioamnionitis, seizure onset age ≤3 d, 5 min Apgar score ≤3, cranial ultrasound abnormalities, brain MR abnormalities and aEEG abnormalities than normal outcome group ( P<0.05).Logistic regression analysis showed that seizure onset age ≤3 d ( OR=3.988, 95% CI 1.376-11.674), abnormal brain MR ( OR=3.296, 95% CI 2.383-17.377) and bilirubin encephalopathy ( OR=3.792,95% CI 2.110-13.216) were independent risk factors for adverse outcomes of neonatal seizure. Conclusions:For neonatal seizure, the infants with more severe abnormal aEEG will have higher incidences of adverse outcomes and mortality. Seizure onset age ≤3 d, brain MR abnormalities and bilirubin encephalopathy were independent risk factors for adverse outcomes of neonatal seizure.

Objective To explore the correlation between peripheral blood monocyte levels and postoperative cognitive dysfunction(POCD)in elderly patients.Methods A total of 96 elderly patients undergoing elective total hip arthroplasty under general anesthesia in the Affiliated Hospital of Xuzhou Medical University from October 2021 to March 2022 were enrolled in the prospective observational stud-y,and the patients were divided into POCD group(26 cases)and Non-POCD group(70 cases)according to the mini-mental state ex-amination(MMSE)score.Peripheral blood monocyte levels and other relevant indicators were recorded.Receiver operating characteristic(ROC)curve were applied to analyze the predictive value of peripheral blood monocyte levels for POCD with total hip arthroplasty in eld-erly patients.Univariate and multivariate Logistic regression analyses were used to evaluate risk factors.Results The optimal cut-off value for preoperative monocyte levels predicting POCD in elderly patients with total hip arthroplasty was 0.55×109/L,and area under the curve value was 0.729.Univariate Logistic regression analysis showed that lower education level,higher American Society of Anesthe-siologists(ASA)grade,and preoperative and postoperative elevated monocyte levels were the risk factors for POCD;multivariate Logistic regression analysis showed that preoperative monocyte levels were independently associated with the occurrence of POCD.Conclusion Preoperative peripheral blood monocyte levels are associated with the occurrence of POCD,and preoperative elevated monocyte level is a risk factor for POCD,helping to predict the potential risk of POCD.

Objective:To analyze the epidemiological characteristics of respiratory syncytial virus (RSV) infection in children in Tianjin, and provide reference for the prevention and treatment of RSV infection in children.Methods:Clinical data of 2 743 children with acute respiratory infections treated at the Tianjin Fifth Central Hospital from January 2022 to January 2024 were collected. Multiplex fluorescent PCR was used to detect the nucleic acid fragments of six respiratory pathogens including Mycoplasma pneumoniae, human rhinovirus, adenovirus, influenza A virus, influenza B virus and RSV in the throat swabs of the patients. A retrospective analysis was performed on the epidemiological and clinical data of RSV-RNA positive cases. Results:The positive rate of RSV-RNA in the 2 743 children was 15.09% (414/2 743). The positive rate of RSV-RNA was 9.29% (73/786) in 2022 and 16.53% (302/1 827) in 2023, with a statistically significant difference between the two years (χ 2=23.45, P<0.05). The incidence of RSV infection in winter and spring was significantly different from that in summer and autumn (χ 2=19.46, P<0.05). The highest and the lowest infection rates of RSV were found in winter (19.32%, 193/999) and autumn (9.43%, 45/477), respectively. There was a significant difference in RSV infection rate among different age groups (χ 2=71.38, P<0.05), with the highest infection rate in the age group of 0-2 years (21.18%, 230/1 086), and the lowest infection rate in the age group of 6-8 years (6.29%, 27/429). Among the 414 children with RSV infection, 359 cases (84.97%) were infected with RSV alone, while the other 55 cases (13.29%) were infected with mixed pathogens. Fifty-two cases had co-infection of RSV and one other pathogen. The most common pathogens in co-infection cases were human rhinovirus (4.83%, 20/414) and Mycoplasma pneumoniae (6.04%, 25/414). Conclusions:The RSV infection rate among children with acute respiratory tract infection in Tianjin from 2022 to 2024 was 15.09%, with the highest infection rate in spring and the lowest infection rate in autumn. RSV infection can occur in children of all ages, with the highest infection rate in children aged 0-2 years and the lowest infection rate in children aged 6-8 years. RSV infection is often complicated by other respiratory pathogens, and the most common pathogens are human rhinovirus and Mycoplasma pneumoniae.

Objective To study the risk factors and outcome of symptomatic BAAS.Methods Eighty symptomatic BAAS patients served as a BAAS group and 80 symptomatic anterior circulation stroke (ACS) patients served as a ACS group in this study.The risk factors for symptomatic BAAS were compared.The symptomatic BAAS patients were further divided into mild-moderate stenosis group (n =43) and severe stenosis group (n=37),progressive stenosis group (n =34) and non-gressive group (n=46),survival group (n=42) and death group (n=38) respectively.The relationship between risk factors and outcome of symptomatic BAAS was analyzed.Results The rate of male patients and the incidence of hypertention were significantly higher in BAAS group than in ACS group (75.0％ vs 57.5％,80.0％ vs 66.3％,P＜0.01).The history of ischemic stroke and smoking was related with the severity of BAAS (P＜0.05).Premonitory symptoms were re lated with the progression of BAAS (P＜0.01).Pulmonary infection and tracheal intubation or tracheotomy were related with the outcome of BAAS (P＜0.01).Conclusion Male gender,hypertension,and history of ischemic stroke and smoking are the independent risk factors for symptomatic BAAS which is less likely to progress in patients with premonitory symptoms.Pulmonary infection and tracheal intubation or tracheotomy are the independent risk factors.