BACKGROUND:The combination of anterior and posterior approaches for severe cervical intervertebral disk herniation, posterior longitudinal ligament calcification and ligament flava hyperplasia can completely reduce compression. Simultaneously, cage implantation and anterior plate fixation partial y recover vertebral interspace and physiological curvature of cervical vertebra.
OBJECTIVE:To compare the effects of cervical posterior single-door laminoplasty for cervical spondylosis and anterior cage-assisted fusion on curvature, stability and axial symptoms after treatment.
METHODS:Clinical data of 50 patients, who received surgical treatment for cervical spondylosis, were retrospectively analyzed. 22 cases underwent I-stage spinal decompression by the combination of anterior and posterior approaches (anterior fusion cage+steel plate fixation) (combination group). 28 cases underwent cervical posterior single-door laminoplasty (posterior windowing rivet fixation) (posterior approach group). They were fol owed up for 6 to 24 months. The recovery of neurological function, incidence of axial symptoms, cervical curvature index, and slipping degree of affected intervertebral segments were analyzed statistical y.
RESULTS AND CONCLUSION:The neurological functions were greatly improved according to Japanese Orthopaedic Association in both groups. Incidence of axial symptoms was relatively low in the combination group. Cervical curvature index was obviously improved in the combination group compared with the posterior approach group. The slipping degree of affected intervertebral segments was relatively greater in the posterior approach group than that in the combination group. Results suggested that fusion cage, anterior steel plate and posterior rivet for spinal decompression in I-stage combination of anterior and posterior approaches can effectively maintain cervical physiological curvature and the balance of sagittal level, reduce incidence of axial symptoms, and play a key effect on keeping posttreatment long-period cervical stability.

Objective:To explore the expression of ADAR1 and AZIN1 in cancer tissues and adjacent tissues of gastric cancer patients and study their clinical significance.Methods:116 patients with stage I-III gastric cancer treated in the Department of Gastroenterology and Oncology from Jan. 2020 to Jan. 2021 were recruited as research subjects. All patients were treated with surgical resection and confirmed by histopathological analysis. All patients signed the protocol informed consent upon inclusion in the study. The relationship between ADAR1 and AZIN1 expression and clinicopathological characteristics in gastric cancer tissues of patients was analyzed. The expression of ADAR1 and AZIN1 mRNA in gastric cancer and adjacent tissues was analyzed by qPCR. The expression of ADAR1 and AZIN1 in gastric cancer and adjacent tissues was analyzed by immunohistochemistry. The relationship between ADAR1, AZIN1 and patient survival rate 3 years after surgery was analyzed. Multivariable Logistic regression was used to analyze factors affecting the poor prognosis of gastric cancer patients. ROC curve was used to analyze the diagnostic performance of ADAR1 and AZIN1 expression levels in the prognosis of gastric cancer patients.Results:ADAR1 and AZIN1 had higher expression levels in undifferentiated gastric cancer tissue, patients with lymph node metastasis, and higher TNM staging, indicating that the high expression of these two genes was closely related to the malignancy of gastric cancer. QPCR analysis showed that the expression of ADAR1 mRNA in gastric cancer tissue and adjacent tissue was 1.96 ± 0.18 and 1.12 ± 0.03, respectively. The expression of AZIN1 mRNA in gastric cancer tissue and adjacent tissue was 1.85 ± 0.16 and 1.04 ± 0.02, respectively. The expression of ADAR1 mRNA in gastric cancer tissue was higher than that in adjacent tissue ( P<0.05). ADAR1 and AZIN1 positive patients were associated with lower 3-year survival rates ( P<0.05). In the multivariate logistic regression analysis of poor prognosis in gastric cancer patients, low differentiation, deepening of infiltration, lymph node metastasis, higher TNM staging, positive expression of ADAR1 and AZIN1 all significantly increased the risk of poor prognosis in gastric cancer ( P<0.05). The sensitivity and AUC value of joint detection were higher than those of ADAR1 and AZIN1 alone detection ( P<0.05) . Conclusions:The expression of ADAR1 and AZIN1 in gastric cancer tissues is significantly higher than that in para-cancerous tissues, especially in patients with undifferentiated tumors, lymph node metastasis and high TNM stage. The high expression of these two genes is closely related to the poor prognosis of gastric cancer patients, and the combined detection shows higher diagnostic efficiency. Therefore, ADAR1 and AZIN1, as key biomarkers for the development and prognosis of gastric cancer, provide new targets for gastric cancer treatment.

Objective To investigate the correlations of postoperative serum levels of soluble CD40 ligand(sCD40L)and CC-chemokine ligand 3(CCL3)with postoperative deep venous throm-bosis(DVT)in patients with multiple rib fractures.Methods A total of 110 patients with multiple rib fractures were selected as the study subjects and divided into non-DVT group(n=79)and DVT group(n=31)based on the occurrence of postoperative DVT.Enzyme-linked immunosorbent assay was used to determine the expression levels of serum sCD40L and CCL3.Pearson correlation analysis was employed to analyze the correlations of serum sCD40L,CCL3 with coagulation function indicators.Logistic regression analysis was conducted to identify the influencing factors of postoperative DVT in pa-tients with multiple rib fractures.Receiver operating characteristic(ROC)curves were plotted to eval-uate the predictive value of serum sCD40L and CCL3 for postoperative DVT.Results The expres-sion levels of serum sCD40L and CCL3 in the DVT group were significantly higher than those in the non-DVT group(P＜0.05).There were statistically significant differences in D-dimer,prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT)and fibrinogen(FIB)between the two groups(P＜0.05).In the DVT group,serum levels of sCD40L and CCL3 were positively correlated with D-dimer and FIB,and negatively correlated with PT,TT and APTT(P＜0.05).D-dimer,PT,APTT,FIB,sCD40L and CCL3 were identified as influencing factors for postoperative DVT in patients with multiple rib fractures(P＜0.05).The area under the curve(AUC)of serum sCD40L and CCL3 alone for predicting postoperative DVT in patients with multiple rib fractures was 0.753 and 0.754,respectively,which was significantly smaller than 0.863 of their combined prediction(P＜0.05).Conclusion Postoperative DVT in patients with multiple rib fractures is associated with high levels of serum sCD40L and CCL3,which have certain predictive value for postoperative DVT.

Objective To investigate the correlations of postoperative serum levels of soluble CD40 ligand(sCD40L)and CC-chemokine ligand 3(CCL3)with postoperative deep venous throm-bosis(DVT)in patients with multiple rib fractures.Methods A total of 110 patients with multiple rib fractures were selected as the study subjects and divided into non-DVT group(n=79)and DVT group(n=31)based on the occurrence of postoperative DVT.Enzyme-linked immunosorbent assay was used to determine the expression levels of serum sCD40L and CCL3.Pearson correlation analysis was employed to analyze the correlations of serum sCD40L,CCL3 with coagulation function indicators.Logistic regression analysis was conducted to identify the influencing factors of postoperative DVT in pa-tients with multiple rib fractures.Receiver operating characteristic(ROC)curves were plotted to eval-uate the predictive value of serum sCD40L and CCL3 for postoperative DVT.Results The expres-sion levels of serum sCD40L and CCL3 in the DVT group were significantly higher than those in the non-DVT group(P＜0.05).There were statistically significant differences in D-dimer,prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT)and fibrinogen(FIB)between the two groups(P＜0.05).In the DVT group,serum levels of sCD40L and CCL3 were positively correlated with D-dimer and FIB,and negatively correlated with PT,TT and APTT(P＜0.05).D-dimer,PT,APTT,FIB,sCD40L and CCL3 were identified as influencing factors for postoperative DVT in patients with multiple rib fractures(P＜0.05).The area under the curve(AUC)of serum sCD40L and CCL3 alone for predicting postoperative DVT in patients with multiple rib fractures was 0.753 and 0.754,respectively,which was significantly smaller than 0.863 of their combined prediction(P＜0.05).Conclusion Postoperative DVT in patients with multiple rib fractures is associated with high levels of serum sCD40L and CCL3,which have certain predictive value for postoperative DVT.

Objective:To investigate the relationship between enlarged perivascular space (EPVS) and retinal vessel abnormalities in transient ischemic attack (TIA) and mild stroke patients.Methods:TIA and mild cerebral infarction (National Institutes of Health Stroke Scale score≤3) patients were enrolled from March to August 2019 in Changzhou Second People′s Hospital. Magnetic resonance imaging and retinal fundus photography were performed in all patients. Retinal arteriovenous diameter was semi-automatically measured, and retinal arteriosclerosis grades, vascular curvature, hemorrhages, microangioma, hard exudation, soft exudation, arteriovenous nicking and venous beads were assessed. Patients were divided into two groups according to the existence of EPVS: EPVS group and non-EPVS group. The baseline data of the two groups were compared and further multivariate Logistic regression was carried out. After normal transformation of the number of EPVS, the correlation between the grades of EPVS and converted EPVS was analyzed. The relationship between the number of converted EPVS and the grades and retinal fundus vascular lesions was further analyzed.Results:A total of 123 patients were included, including 99 patients with cerebral infarction, 24 patients with TIA; 52 patients without EPVS and 71 patients with EPVS. The EPVS group was more than the non-EPVS group in age ((68.61±12.71) years and (63.37±13.53) years, t=-2.198, P=0.030), history of hypertension (52 (73.2%) and 25 (48.1%), χ 2=8.118, P=0.004), hemangioma (17 (23.9%) and 5 (9.6%), χ 2=4.196, P=0.041), arteriovenous nicking (50 (70.4%) and 8 (15.4%), χ 2=36.488, P<0.05) and arteriosclerosis grades (1 (1, 2) and 0 (0, 1), Z=-7.454, P<0.05), and less than the non-EPVS group in central retinal artery equivalent (CRAE; (106.31±15.02) mm and (113.89±11.86) mm, t=3.014, P=0.003) and arteriole-to-venule ratio (AVR; 0.54±0.07 and 0.59±0.05, t=4.553, P<0.05). Multivariate Logistic regression analysis showed arteriosclerosis grades ( OR=7.781, 95 %CI 2.876-21.055, P<0.05) and hypertension ( OR=3.203, 95 %CI 1.049-9.777, P=0.041) were related factors for EPVS. Adjusting for age, sex, hypertension and diabetes, the normally transformed EPVS was found positively correlated with arteriovenous nicking ( B=0.556, 95 %CI 0.203-0.910, P=0.003) and arteriosclerosis grade ( B=0.417, 95 %CI 0.259-0.576, P<0.05), and negatively correlated with AVR ( B=-4.213, 95 %CI-6.712--1.714, P=0.001). The grades of EPVS were positively correlated with arteriosclerosis ( r=0.764, P<0.05), and negatively correlated with CRAE ( r=-0.287, P<0.05) and AVR ( r=-0.422, P<0.05). Conclusions:Hypertension and retinal arteriosclerosis are related factors of EPVS in mild stroke and TIA patients. EPVS is correlated with retinal vessel abnormalities. The more serious of EPVS is, the more serious of retinal arteriosclerosis is, the higher ratio of arteriovenous nicking is, the smaller of CRAE and AVR are.