Objective To investigate the clinical efficacy of percutaneous kyphoplasty(PKP) in treatment of elderly osteoporotic vertebral compression fractures(OVCF).Methods 122 elderly OVCF patients from Oct.2009 to Oct.2013 in Lihuili Hospital of Ningbo Medical Center were selected,and were randomly divided into group A,and group B.There were 61 cases in each group.Group A received percutaneous kyphoplasty(PKP),and group B were treated with percutaneous vertebroplasty(PVP).The two groups were observed in terms of pain,activity,vertebral compression rate and Cobb angles after treatment.The two groups were followed up at least for 3 months.The postoperative side effects were recorded and analyzed.Results After the treatment,the two groups significantly improved in VAS score and activity(P ＜ 0.05),but no significant difference was found between the two groups (P ＞ 0.05).After the treatment,vertebral compression rate and Cobb angle got better than before in the two groups,but group A recovered more obviously than group B,and the difference had statistical significance (P ＜ 0.05).The postoperative recurrence rate was 18.03 ％ (11/61) in the observation group and 9.84 ％ (6/61) in the control group,and the difference had statistical significance (P ＜ 0.05).Conclusion PKP and PVP can significantly relieve pain,but PKP had better effect than PVP in vertebral body and spinal kyphosis improvement,which is worth of clinical application.

Objective To explore the effects of human umbilical cord mesenchymal stem cells (HUC?MSCs) on podocytic apoptosis and injury induced by high glucose (HG) and the underlying mechanisms. Methods Podocytes were divided into six groups according to treatment: ⑴ normal glucose group (NG);⑵high glucose group (HG);⑶mannitol control group (NG+Ma);⑷HUC?MSC co?culture group (HUC?MSCs); ⑸ recombinant human hepatocyte growth factor treatment group (rhHGF);⑹ neutralizing antibody group(HGF?NtAb). Cytometry and Hoechst staining were used to detect the apoptosis rates. Western blot was used to measure the ratio of active PARP to total PARP and the level of Bcl?2. Immunofluorescence was used to study podocytic apoptosis and injury. Neutralizing antibody (NtAb) was used to block its function and the recombinant cytokine was added to induce its function. Results High glucose induced podocytic apoptosis in a time?dependent manner, HUC?MSCs co?culture decreased the podocytic apoptosis rate and the expression of PARP (all P﹤0.05), increased the expression of Bcl?2, prevented the reduced expression and maintained the normal arrangement of podocytic podoplanin. The rhHGF prevented podocytic apoptosis and injury similarly to HUC?MSCs, the beneficial effect of HUC?MSC decreased when blockade of HGF. Conclusions HUC?MSCs co?culture ameliorates podocytic apoptosis and injure induced by HG, probably through secreting soluble HGF.

Objective To extract the Ginseng polysaccharide (GPS), polysaccharides of Tricholoma matsutake (PTM)and polysaccharide of Lentinus edodes (PLE)from gingeng, tricholoma matsutake and lentinus edodes respectively,and to analyze and identify their structures,and to prepare their complex,and to study the indirect antitumor activity invitro of polysaccharide complex.Methods The polysaccharides were extracted with hot water and precipitated by ethanol.The carbohydrate levels were determined by the method of phenol-sulfuric acid.The m-hydroxyphenyl method was used to determine the levels of uronic acid, and the national standard method was used to determine the levels of starch.Infrared spectroscope and chemical methods were performed to analyze their structures. Orthogonal experiment was used to study mixing methods. Cytotoxic T lymphocyte experiment and LDH release assay were performed to detect the influence of polysaccharide complex of GPS,PTM,and PLE in the CTL killing activity,and its indirect killing effect on the P815 cells.Results The extraction rates of GPS,PTM, and PLE were 8.85%,9.40%,and 10.50%;the levels of total polysaccharides were 62.96%,59.13%,and 33.86%;the levels of uronic acid were 16.44%,9.37%,and 16.44%;the starch levels were 7.26%,2.80%,and 3.77%,respectively.The identification results showed that the polysaccharides were obstrained.When the quality ratio of the three kinds of polysaccharides was 1∶1∶1 and the concentration was 600 mg·L-1 ,the CTL cytotoxicity was the highest.Conclusion The polysaccharide complex is obtained,identified and characterized. Polysaccharide complex can enhance the cytotoxicity of CTL and has the indirectly inhibitory effect on the proliferation of P815 cells.

Objective To investigate the iodine intake level and the prevalence of thyroid nodules in Harbin City,and to study the correlation between the concentration of urinary iodine and the prevalence of thyroid nodules.Methods In Harbin,18 communities were randomly selected and specimens were collected from fasting morning urine from 2015 to 2017.The urine iodine concentration (UIC) was detected by arsenic cerium catalytic spectrophotometry,and the thyroid nodule was examined by B ultrasound.Results A total of 2 552 residents aged (45.79 ± 12.06) years old agreed to participate in the study,including 371 males and 2 181 females.The median UIC in all participants was 159.8 μg/L,there was a significant difference in urine iodine frequency distribution among age groups (x2 =40.097,P ＜ 0.01).Furthermore,the median UIC in male was 166.6 μg/L,and in female was 156.2 μg/L.There was a significant difference in UICs between male and female (U =2.122,P ＜ 0.05).The prevalence of total thyroid nodules in all participants was 48.75％ (1 244/2 552),and the standardized rate was 40.55％.Significant difference in the detection rate of thyroid nodules was observed among age groups (x2 =114.922,P ＜ 0.01),and there was a positive and significant correlation between the detection rate of thyroid nodules and increasing age (xtrand =111.746,P ＜ 0.01).Furthermore,in male,41.24％ (153/371) had thyroid nodules,with standardized prevalence rate of 41.13％,and in female,50.02％ (1 091/2 181) had thyroid nodules,with standardized prevalence rate of 49.20％.Likewise,there was a significant difference in the detection rate of thyroid nodules between male and female(x2 =9.790,P ＜ 0.01).The detection rate of thyroid nodules in the iodine deficient population (urinary iodine was 0-＜ 100 μg/L) was 55.58％ (244/439),and the incidence of thyroid nodules in the iodine adequate or optimal population (urinary iodine was 100-＜ 200 μg/L) was 46.68％ (591/1 266).Conclusions The total iodine level of the population in Harbin City of Heilongjiang Province is at adequate level.The detection rate of thyroid nodules is high and it is increased with age.The detection rate of thyroid nodules is higher in female than male.Regular detection of urine iodine and adjusting iodine nutrition will help prevent thyroid nodules.

Objective:To investigate the clinical efficacy of parathyroidectomy for secondary hyperparathyroidism (SHPT), and to analyze the changes and trends of perioperative intact parathyroid hormone (iPTH), serum calcium and serum phosphorus, and the predictive value of intraoperative parathyroid hormone (ioPTH) measurement for surgical completion. To provide practical theoretical basis and reference for postoperative treatment of SHPT.Methods:Data of 479 SHPT patients admitted to the First Hospital of Harbin from Dec. 2012 to Dec. 2022 were retrospectively analyzed. According to the admission criteria, 457 patients were screened out and divided into PTX group and incomplete PTX group based on whether the level of postoperative parathyroid hormone was reduced to the normal standard. The levels of iPTH, serum calcium and phosphorus during the perioperative period in the two groups were statistically analyzed. SPSS 26.0 statistical software was used for data processing. P<0.05 indicated statistically significant difference. Results:In the analyzed group of 457 patients, the average age was (45.43±11.25) years and the average dialysis age was (90.3±35.8) months. Hypercalcemia, hyperphosphatemia, hyperkalemia and high alkaline phosphatase levels accounted for 41.79%, 94.31%, 20.35% and 75.50%, respectively. Bone loss and osteoporosis accounted for 35.45% and 62.36%, respectively. The incidence of restless leg syndrome was 7.67%. IoPTH and post-operative iPTH level in the PTX group were significantly lower than those in the incomplete PTX group ( P=0.001, P<0.001). IoPTH≤150 pg/mL can predict surgical success, and 58.33% of cases can predict surgical failure by ioPTH being 30% higher than preoperative iPTH. There were significant differences in serum calcium and phosphorus levels between the two groups at 3 hours and 2 days after operation. The incidence of hypocalcemia was 43.19% and 82.49% on the day of operation and within 3 days after operation, and the incidence of hungry bone syndrome was 62.12% in the PTX group. The incidence of postoperative hyperkalemia, arteriovenous fistula thrombosis, temporary hoarseness, bleeding and in-hospital mortality was 43.33%, 1.75%, 0.66%, 0.44% and 0.22%, respectively. Conclusions:Parathyroidectomy is an effective and safe treatment for secondary hyperparathyroidism, and ioPTH plays an important role in predicting the success of surgery. Timely and effective calcium supplementation is an important measure to prevent the serious occurrence and morbidity of bone hunger syndrome.

BACKGROUNDRegulatory T-cells (Treg) play key roles in suppressing cell-mediated immunity in cancer patients. Little is known about perioperative Treg fluctuations in nonsmall cell lung cancer (NSCLC). Video-assisted thoracoscopic (VATS) lobectomy, as a minimal invasive procedure for treating NSCLC, may have relatively less impact on the patient's immune system. This study aimed to observe perioperative dynamics of circulating Treg and natural killer (NK) cell levels in NSCLC patients who underwent major lobectomy by VATS or thoracotomy.

METHODSTotally, 98 consecutive patients with stage I NSCLC were recruited and assigned into VATS or thoracotomy groups. Peripheral blood samples were taken on 1-day prior to operation, postoperative days (PODs) 1, 3, 7, 30, and 90. Circulating Treg and NK cell counts were assayed by flow cytometry, defined as CD4 + CD25 + CD127 low cells in CD4 + lymphocytes and CD56 + 16 + CD3- cells within CD45 + leukocytes respectively. With SPSS software version 21.0 (SPSS Inc., USA), differences between VATS and thoracotomy groups were determined by one-way analysis of variance (ANOVA), and differences between preoperative baseline and PODs in each group were evaluated by one-way ANOVA Dunnett t-test.

RESULTSIn both groups, postoperative Treg percentages were lower than preoperative status. No statistical difference was found between VATS and thoracotomy groups on PODs 1, 3, 7, and 30. On POD 90, Treg percentage in VATS group was significantly lower than in thoracotomy group (5.26 ± 2.75 vs. 6.99 ± 3.60, P = 0.012). However, a higher level of NK was found on all PODs except on POD 90 in VATS group, comparing to thoracotomy group.

CONCLUSIONSLower Treg level on POD 90 and higher NK levels on PODs 1, 3, 7, 30 in VATS group might imply better preserved cell-mediated immune function in NSCLC patients, than those in thoracotomy group.

Aged ; Carcinoma, Non-Small-Cell Lung ; immunology ; surgery ; Female ; Flow Cytometry ; Humans ; Killer Cells, Natural ; immunology ; Male ; Middle Aged ; Postoperative Period ; T-Lymphocytes, Regulatory ; immunology ; Thoracic Surgery, Video-Assisted ; methods ; Thoracotomy ; methods

OBJECTIVETo explore the CT features of ground-glass nodules (GGN) including preinvasive lesions [atypical adenomatous hyperplasia (AAH) and adenocarcinoma in situ (AIS)], minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC).

METHODSNinety-seven GGN lesions confirmed by operation pathology were included in this study. The lesions were divided into three groups: preinvasive lesion group (24 cases), MIA group (39 cases), IAC group (34 cases). The lesion size, 3-dimensional ratio, 2-dimensional ratio in axial images, lesion density, shape, speculation, lobulation, air-containing space and pleural indentation on the preoperative CT images in the three groups were analyzed and compared with pathological results. The data were statistically analyzed using SPSS 17.0.

RESULTSAll preinvasive lesions presented as pure GGN on CT image, most showed round-like shape, clear and smooth border. MIA presented as pure GGN or mixed GGN on CT image, most showed round-like shape, with a clear and smooth border. IAC most presented as mixed GGN on CT image, often showed irregular shape. Speculation, lobulation, air-containing space and pleural indentation displayed gradually increasing from preinvasive lesions to MIA and IAC. There were statistically significant differences in lesion size, CT density, shape, air-containing space, speculation, pleural indentation and long diameter of solid component between the MIA and IAC groups (P < 0.05 for all). There were statistically significant differences in CT density values and long diameters of solid component of the lesions between the preinvasive lesion group and MIA group (P < 0.05). The AUC of solid component of the preinvasive lesion group and MIA group was 0.705, and that of the MIA and IAC groups was 0.814.

CONCLUSIONComprehensive analysis of the CT image features of GGNs, especially the solid component in the lesions, may help to the preoperative and differential diagnosis of preinvasive lesions, MIA and IAC.

Adenocarcinoma ; diagnostic imaging ; pathology ; Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Hyperplasia ; Lung ; diagnostic imaging ; pathology ; Lung Neoplasms ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; Precancerous Conditions ; diagnostic imaging ; pathology ; Solitary Pulmonary Nodule ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

Objective To investigate the basic status of HIT human resources in Ningxia Hui Autonomous Region and to analyze the existing problems.Methods Sampling and site surveys were executed over the HIT staffs from levels of medical facilities and colleges in the community,town,county,city and province.Results The problems were pointed out from the aspects of information organization function positioning,professional discipline construction,amount of HIT staffs,continuous education and knowledge structure of HIT staffs,absence of senior or leading talents in medical informatization,excessive dependence on software company,personnel title and etc.Conclusion A team of comprehensive,professional and normalized HIT staffs proficient in business management and information technology has to be obtained to facilitate informatization.

OBJECTIVE To evaluate the clinical effects of TCM diagnosis and treatment project for patients with MODS gastrointestinal dysfunction of abdominal distension and fullness disease.METHODS TCM diagnosis and treatment project (draft protocol)for abdominal distention and fullness disease was decided according to MODS diagnosis criteria which was for-mulated in the 3rd CSCCM.Seventy-eight patients with abdominal distension and fullness disease included in ICU of the affilia-ted hospital of Nanjing University of Chinese Medicine from July,2012 to December,2016 were enrolled in this study,and were randomly divided into the control group(n=35)and the treatment group(n=43).Basic treatments such as active anti-infection,functional support of organs,immuno-nutrition supplement were performed for both groups.For the treatment group,patients who were diagnosed as the syndrome of middle-heat obstruction were treated with the modified Dahuang Huan-glian Xiexin decoction to eliminate stagnation,clear away heat and detoxify.patients who were diagnosed as the syndrome of qi stagnation and blood stasis were treated with the modified Xuefu Zhuyu decoction to regulate qi and dredge fu-organs,activate blood circulation and remove blood stasis,and patients who were diagnosed as the qi deficiency of lung and spleen were treated with the self-formulated Yiqi Tongfu decoction to supplement qi,invigorate spleen and purge fu-organs.In addition,all syn-dromes were also treated with acupuncture and moxibustion and acupoints application.gastrointestinal function related indexes such as abdominal symptoms,signs,intra-abdominal pressure,ICU stays and mortality during hospitalization in both groups were recoded and compared on the 7th and 14th day before and after the treatment.RESULTS TCM Symptom score,abdomi-nal signs score,intra-abdominal pressure level in both groups showed a downward trend after the treatment,but all indexes in the treatment group decreased more significantly on the 7th and 14th day compared with those of the control group,the differ-ences had statistical significance(P<0.05),and the TCM symptom score and abdominal signs score decreased more signifi-cantly on the 14th day(P<0.01).The mortality rate of two groups during 28 days showed no significant difference,but the mean ICU stays in treatment group was lower than that in the control group(P<0.05).Treatment group Analysis showed that the proportion of the middle-heat obstruction patients was the highest,and the recovery rate of whom was obviously higher than that of patients belong to syndromes of qi stagnation and blood stasis,qi deficiency of spleen and lung,while the ineffec-tive rate was lower than those of the other two syndromes(P<0.05).CONCLUSIONS For hospitalized patients with abdom-inal distention and fullness disease,the application of TCM diagnosis and treatment project can significantly improve the clinical effect and decrease ICU stays.

Post-stroke cognitive impairment(PSCI)is a prevalent functional impairments following stroke that seriously affects patients'quality of life and daily activities.Studies indicate a close relationship between intestinal microflora dysbiosis and central nervous system diseases.Intestinal microflora profoundly impacts on human physiological health,contributing to the stability of nervous,metabolic and immune systems through regulation of the gut-brain axis.An increasing number of studies confirmed the important role of the gut microbiome-gut-brain axis in the occurrence and development of stroke and its associated PSCI,and regulation of microbiome-gut-brain could be potential target to treatment of PSCI.This review summarizes research progress on gut microbiome-gut-brain axis and PSCI to provide a reference for exploration of related mechanisms and clinical prevention and treatment strategies.