Objective To compare the clinical efficacy between bone cement-augmented pedicle screw fixation and bone filling vertebroplasty for stable osteoporotic thoracolumbar burst fracture (TBF).Methods From August 2014 to August 2017,48 patients with stable osteoporotic TBF but no neurological symptoms were treated at Department of Orthopedics,The First Affiliated Hospital to Chongqing Medical University.Those undergoing bone cement-augmented pedicle screw fixation were assigned into Group A while those undergoing bone filling vertebroplasty into Group B.The clinical efficacy was evaluated by comparing visual analogue scale (VAS) for pain assessment,Oswestry disability index (ODI),compression ratio of anterior vertebral height,and cobb kyphotic angle between preoperation and postoperation.The 2 groups were compared in terms of operation time,bone cement consumption,blood loss,hospital stay and relative medical costs.Results Of the 48 patients included in this study,27 were in Group A and 21 in Group B.The 2 groups were comparable as their baseline characteristics were insignificantly different (P ＞ 0.05).At 3 days after operation,the VAS (2.8 ± 1.0) and ODI (26.0 ±3.5) scores for group B were significantly lower than those for group A (4.6 ± 1.3 and 34.3 ± 2.9) (P ＜ 0.05).In group A at 3 months after operation and final follow-up,the VAS (2.9 ±0.9 and 2.3 ±0.7) and ODI (24.7 ±3.1 and 23.1 ±4.6) scores were significantly lower than those at 3 days after operation (4.6 ± 1.3 and 34.3 ± 2.9) (P ＜ 0.05).In group B at 3 months after operation and final follow-up,the VAS (2.8 ±0.9 and 2.3 ± 1.0) and ODI (23.8 ±3.7 and 22.8 ± 5.6) scores were insignificantly better than those at 3 days after operation (2.8 ± 1.0 and 26.0 ± 3.5) (P ＞ 0.05).At 3 days and 3 months after operation and final follow-up,group B had significantly smaller compression ratios of anterior vertebral height (81.1％ ± 3.7％,81.1％ ± 3.4％ and 75.6％ ± 5.8％) than group A did (91.4％ ±4.4％,90.1％ ±2.9％ and 83.5％ ±4.4％) but significantly larger cobb kyphotic angles (17.0° ± 4.0°,18.0° ± 3.5 ° and 22.1 ° ± 3.6°) than group A (14.0° ± 3.2°,14.3° ± 5.5° and 19.2° ± 3.2°) (P ＜ 0.05).The compression ratio of anterior vertebral height and cobb kyphotic angle at the final follow-up in all the patients were significantly improved compared with those at 3 days and 3 months after operation (P ＜ 0.05).Group B had significantly less operation time (51.5 ±7.3 min),blood loss (16.0 ± 8.2 mL),hospital stay (3.4 ±0.9 d) and medical costs per person (34,000 ±4,000 RMB yuan) than group A (91.5 ± 9.8 min,77.4 ± 16.5 mL,8.7 ± 2.2 d and 55,000 ± 9,000 RMB yuan),but significantly larger bone cement consumption (5.1 ± 0.7 mL) than group A (1.9 ± 0.7 mL) (P ＜ 0.05).Conclusion For patients with stable osteoporotic TBF,both bone cement-augmented pedicle screw fixation and bone filling vertebroplasty can lead to similar clinical outcomes,but the latter may have advantages of less invasion,faster recovery and lower medical costs.

Objective:To evaluate the safety and efficacy of the treatment for oppressive spinal by microwave ablation combined with percutaneous fixation and open decompression.Methods:From January 2015 to September 2018, 20 patients with 26 spinal metastatic were treated with microwave ablation combined with percutaneous fixation and open decompression, including 13 males and 7 females with an average age of 43.85±18.67 years (range, 16-79 years). The locations of the lesions included: 9 in the thoracic, 11 in the lumbar. The tumors' type: myeloma 2 cases, leukemia 1 case, liver cancer 4 cases, osteosarcoma 2 cases, lung cancer 5 cases, kidney cancer 1 case, esophagus cancer 1case, cervical cancer 1 case, intestinal cancer 1 case, prostate cancer 1 case, adenoid cystic cancer 1case. Preoperatively all the patients suffered with the local pain and the spinal cord or nerve root compression symptoms. All 20 cases were examined with CT or MRI to determine the lesions and the sizes of metastasis, as well as to evaluate the ablation zone. The entry of the pedicle screws were performed by Wiltse method through paravertebral muscles. After that the lesions were treated with partial resection for decompression of spinal cord or nerve root, and followed with microwave ablation at the metastasis site. Thermometer was used to monitor the temperature at the central and posterior edges of the vertebral body. The surrounding important tissue were cooled by ice saline. 13 patients were performed with vertebroplasty for enhancement the intensity of the vertebral body. The visual analogue scale (VAS) score was used to evaluate the effect of pain relief after surgery. The postoperative neurological function and performance status were evaluated using Frankel grading and Eastern Cooperative Oncology Group (ECOG).Results:Each lesion was heated for 5.43±2.07 min (range, 3-10 min). The power of microwave ablation was 40-60 W. The mean blood loss during operation was 852.50±514.40 ml (range, 100-1 700 ml). The mean operating time was 4.11±0.99 h (range, 2.5-6.0 h). The temperature inside the lesion was 70-85 ℃. The temperature of the surrounding tissue was maintained at<43 ℃ by repeated frozen saline flush. All cases were followed up for 8.45±2.01 months (range, 6-14 months) without any recurrence. The VAS score of the 20 patients at 48 h, 1 month, 3 months and 6 months after operation were 1.55±1.23, 2.70±0.87, 2.40±1.14 and 3.05±1.00 points, which were all statistically lowerthan the preoperative score 5.95±1.18 ( P<0.05). The Frankel grading of 14 patients had at least one grade improvement 6 months after operation. There were 8 patients shown markedly improved ECOG score 6 months after surgery. Only one case suffered from reduced myodynamiaof lower limb and covered in one month after system treatment. Conclusion:The microwave ablation combined with percutaneous fixation and open decompression could resolve the spinal and nerve compression, relieve the pain in metastatic spinal oppression, reconstruct the stability, and improve the quality of lives, which is a safe and effective palliative surgical method.

Objective To explore the method for measurement of tritium in nuclear power plant liquid effluent purified by a mixed ion-exchange resin, to verify the feasibility of the method by experiments, and to provide technical support for the development of standard methods for the measurement of tritium in liquid effluent of nuclear power plants. Methods The purification effect of the mixed ion-exchange resin was determined by measuring the quenching factor, conductivity, and β-nuclide adsorption efficiency of the samples purified using the resin. A comparison was made between the ion-exchange resin method and the atmospheric distillation method for tritium determination. The precision and accuracy of the method were verified by calculating the relative standard deviation and the recovery in repeated measurement of samples with different activity concentrations and spiked samples. Results There were no significant differences in quenching factor, conductivity, and tritium activity concentration between the two methods. The adsorption efficiencies of EC20MB resin for common β-nuclides such as carbon, iron, nickel, strontium, yttrium, and cesium ranged from 99.28% to 99.88%. Repeated measurement of the same sample showed relative standard deviations of 5.2%-9.4% and recoveries of 86.8%-107%. Conclusion There were no significant differences between the results of the ion-exchange resin purification method and the atmospheric distillation method. The precision and accuracy of the method met the requirements of the ecological and environmental management authorities for monitoring tritium in liquid effluent from nuclear power plants. This method can be widely used in daily monitoring work.

ObjectiveTo explore the characteristics of circadian rhythm of blood pressure in patients with masked hypertension （MH） and its relationship with twelve two-hour peirods， providing a basis for early detection and intervention of MH. MethodsPatients who underwent 24-hour ambulatory blood pressure examination in the ambulatory blood pressure room of Jiangsu Province Hospital of Chinese Medicine from January to December 2022 were enrolled， and according to their outpatient blood pressure measurements， 24-hour ambulatory blood pressure monitoring and follow-up survey results， the MH， essential hypertension （EH） and normal blood pressure groups were classified， with 50 cases in each group. The general data， office blood pressure and 24-hour ambulatory blood pressure monitoring data were collected. The circadian rhythm of blood pressure including 24-hour average systolic blood pressure （24h SBP）， daytime average systolic blood pressure （d SBP）， nighttime average systolic blood pressure （n SBP）， 24-hour average diastolic blood pressure （24h DBP）， daytime average diastolic blood pressure （d DBP）， and nighttime average diastolic blood pressure （n DBP） were compared among the groups， and the nighttime blood pressure dipping percentage was calculated. The type of circadian rhythm was determined based on the nighttime blood pressure dipping percentage. The variability of blood pressure including 24h SBP standard deviation （24h SBP-SD）， d SBP standard deviation （dSBP-SD）， n SBP standard deviation （nSBP-SD）， 24h DBP standard deviation （24h DBP-SD）， d DBP standard deviation （dDBP-SD）， and n DBP standard deviation （nDBP-SD） were compared among groups， and the corresponding coefficient of variation （CV）， that is， 24h SBP-CV， d SBP-CV， n SBP-CV， 24h DBP-CV， d DBP-CV and n DBP-CV， were calculated. Based on the 24-hour ambulatory blood pressure monitoring results， the twelve two-hour average SBP and DBP in each group were calculated and compared. Simultaneously， patients with EH were divided into grades 1， 2， and 3 for further stratified analysis. ResultsThe age of the MH group was significantly higher than that of the EH group and the normal blood pressure group （P＜0.01）. The body mass index （BMI） and the proportion of smoking and alcohol consumption in the MH group and the EH group were significantly higher than those in the normal blood pressure group （P＜0.05 or P＜0.01）. In the normal blood pressure group， there were 49 dipper patterns （98.0%） and one non-dipper pattern （2.0%）； in the MH group， there were two dipper patterns （4.0%）， 29 non-dipper patterns （58.0%） and 19 reverse-dipper patterns （38.0%）； in the EH group， there were 20 dipper patterns （40.0%）， 23 non-dipper patterns （46.0%） and seven reverse-dipper patterns （14.0%）. Compared to the normal blood pressure group， the groups of MH and EH had significantly decreased proportion of dipper pattern and increased proportion of non-dipper and reverse-dipper pattern （P＜0.01）； the proportion of dipper pattern in the MH group was lower than that in the EH group， while the proportion of reverse-dipper pattern was higher （P＜0.01）. Compared to those in the normal blood pressure group， n SBP and n DBP in the MH group， as well as the the average SBP and average DBP at Zi hour （子时， 23：00-1：00）， Chou hour （丑时， 1：00-3：00）， Yin hour （寅时， 3：00-5：00）， Mao hour （卯时， 5：00-7：00） and average SBP at Hai hour （亥时， 21：00-23：00） in the MH group increased，while the average DBP at Si hour （巳时， 9：00-11：00） decreased （P＜0.01）； 24h SBP， 24h DBP， d SBP， d DBP， n SBP， and n DBP，d SBP-SD， n SBP-SD，n DBP-SD increased， as well as the average SBP and average DBP at twelve two-hour periods increased in the EH group，while the 24h SBP-CV， 24h DBP-CV，and d DBP-CV in the EH group decreased（P＜0.05 or P＜0.01）. The EH group had higher 24h SBP， 24h DBP， d SBP， d DBP， n SBP， n DBP， 24h DBP-SD and n DBP-SD ， as well as higher average SBP and DBP at all twelve two-hour periods， and lower d DBP-CV than the MH group（P＜0.05 or P＜0.01）. The EH group had 18 cases of grade 1 （36.0％）， 19 cases of grade 2 （38.0％） and 13 cases of grade 3 （26.0％）， with no significant differences among groups （P＞0.05）. ConclusionThe circadian rhythm of blood pressure in MH patients are mostly non-dipper and reverse-dipper patterns， and the abnormal elevation of blood pressure is obvious at Zi hour， Chou hour， Yin hour and Mao hour （23：00-7：00）.