Objective T o explore the casual relationship and the significance of identification am ong the injury, disease and dam age consequence in the disability evaluation of lum bar spondylolysis by the stan-dard for identifying grading of disability caused by w ork-related injuries. Methods T he general data, in-jury m anner, clinical treatm ent and the im aging exam ination of 32 lum bar spondylolysis cases w ere col-lected and retrospectively analyzed. A ccording to the degree of participation in the injury and dam age consequence, the identification and assessm ent of casual relationship w as m ade, and the grading of dis-ability w as assessed. Results For 32 cases, injury had no effect on dam age consequence in 7 cases, slight effect in 5 cases, secondary effect in 13 cases, equivalent effect in 4 cases, and com plete effect in 3 cases. A ccording to the related item s in the standard for identifying grading of disability caused by w ork-related injuries, 3 cases w ere rated level 7, 5 cases w ere level 8, 6 cases w ere level 9, 11 cases w ere level 11 am ong the cases w hich existed causal relationship. Conclusion T he form ation of lum bar spondylolysis is connected to the factors of age, anatom y, occupation and injury m anner etc. T he degree of disability should be accessed com prehensively after the analysis of the casual relationship am ong the injury, disease and dam age consequence.

Objective To evaluate the role of hippocampal phosphatidylinositol 3-kinase/serinethreonine kinase/glycogen synthase kinase-3 beta (PI3K/Akt/GSK-3β) signaling pathway in dexmedetomidine-induced reduction of long-term cognitive decline caused by propofol in neonatal rats.Methods A total of 110 clean healthy male Sprague-Dawley rats,aged 7 days,weighing 10-15 g,were divided into 11 groups (n=10 each) using a random number table:normal saline group (NS group),fat emulsion group (F group),10％ dimethyl sulfoxide (DMSO) group (D2 group),dexmedetomidine group (DEX group),TDZD-8 group (TDZD group),10％ DMSO group (D1 group),LY294002 group (LY group),propofol group (P group),dexmedetomidine plus propofol group (PD group),LY294002 plus dexmedetomidine plus propofol group (LYPD group) and TDZD-8 plus dexmedetomidine plus propofol group (TDPD group).Normal saline,fat emulsion,10％ DMSO 100 μl,dexmedetomidine 75 μg/kg and TDZD-8 1 mg/kg were intraperitoneally injected in NS,F,D2,DEX and TDZD groups,respectively.10％ DMSO 5 μ1 and LY294002 25 μg/5 μl were injected via the lateral cerebral ventricle in D1 and LY groups,respectively.Propofol 50 mg/kg was intraperitoneally injected,and an increment of propofol 50 mg/kg was given after recovery of righting reflex in group P.Dexmedetomidine 75 μg/kg was intraperitoneally injected and 30 min later propofol was injected in group PD.LY294002 was injected,30 min later dexmedetomidine was injected,and 30 min later propofol was injected in group LYPD.In group TDPD,TDZD-8 was injected and the other treatment was similar to those previously described in group LYPD.Then the rats were fed to 9 weeks old after returning to the state of consciousness.Morris water maze test was performed to evaluate the cognitive function.Rats were then sacrificed and their hippocampi were harvested for detection of the expression of PI3K,Akt,GSK-3β and PSD95 mRNA (using real-time polymerase chain reaction) and expression of Akt,pAkt(ser473),GSK-3β,pGSK-3β(ser9) and PSD95 (by Western blot).Results Compared with NS group,the escape latency was significantly prolonged,the number of crossing the original platform was reduced,the expression of PI3K,Akt and PSD95 mRNA was down-regulated,the expression of GSK-3β mRNA was up-regulated,p-Akt(ser473)/Akt ratio was decreased,the expression of PSD95 was downregulated,and pGSK-3β (ser9)/GSK-3β ratio was increased in P group (P＜ 0.05).Compared with P group,the escape latency was significantly shortened and the number of crossing the original platform was increased in PD,LYPD and TDPD groups,the expression of PI3K,Akt and PSD95 mRNA was up-regulated,and the expression of GSK-3β mRNA was down-regulated in PD group,and pAkt(ser473)/Akt ratio was increased,the expression of PSD95 was up-regulated,and pGSK-3β (ser9)/GSK-3β ratio was decreased in PD and TDPD groups(P＜0.05).Compared with PD group,the escape latency was significantly prolonged,the number of crossing the original platform was reduced,the expression of GSK-3β mRNA was up-regulated,the expression of PSD95 mRNA was down-regulated,pAkt (ser473)/Akt ratio was decreased,the expression of PSD95 was down-regulated,and pGSK-3β (ser9)/GSK-3β ratio was increased in LYPD group,and the escape latency was significantly shortened,the number of crossing the original platform was increased,the expression of GSK-3β mRNA was down-regulated,the expression of PSD95 mRNA was up-regulated,pGSK-3β(ser9)/GSK-3β ratio was decreased,and the expression of PSD95 was up-regulated in TDPD group(P＜0.05).Conclusion Hippocampal PI3K/Akt/GSK-3β signaling pathway is involved in dexmedetomidine-induced reduction of long-term cognitive decline caused by propofol in neonatal rats.

【Objective】 To explore the application value of different language assessment tools in the assessment of language development of 12-month-old high-risk infants, and to screen out simple and valid language assessment tools. 【Methods】 A total of 217 11- to 13-month-old high-risk infants who were followed up at the outpatient service for high-risk infants at the child health clinic of Guiyang Maternal and Child Health Hospital from March 2022 to May 2023 were selected as the study subjects. Their language was evaluated by Early Language Milestone Scale (ELMS), Putonghua Communicative Development Inventory (PCDI) and Ages and Stages Questionnaire-Third Edition (ASQ-3). With Gesell as the gold standard for the assessment of language, the area under receiver operating characteristic curve (AUC), sensitivity, specificity, accuracy, positive predictive value, negative predictive value, Youden index and Kappa value of the three tools were calculated. Spearman correlation analysis was used to analyze the correlation between the different language assessment scales. The Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was used to evaluate the three tools. 【Results】 1)Among 217 high-risk infants, 78 preterm infants was the most (35.94%). The rate of delayed language development detected by Gesell, ELMS, PCDI-comprehension, PCDI-expression, ASQ-3 were 5.5%, 7.8%, 36.4%, 30.0% and 11.5%, respectively. 2)ASQ-3 had the strongest correlation with Gesell language region (rs=0.607, P<0.01) and it had the most AUC (AUC=0.812, P<0.05). The consistency between ASQ-3 and Gesell was moderate (Kappa=0.56, P<0.01). ASQ-3 had the highest sensitivity(91.7%), accuracy(93.1%), negative predictive value(99.5%) and Youden index(0.85), and ELMS had the highest specificity(94.6%). 3) Comprehensive evaluation of three tools by the TOPSIS indicated that ASQ-3 was the best, followed by ELMS and PCDI-comprehension was the worse. 【Conclusion】 Among the three assessment tools, ASQ-3 has the highest value in assessing the language development of 11- to 13-month-old high risk infants, and it may be necessary to expand the age range and establish a national norm of ELMS and PCDI in the future.