Pedicle screw loosening and axial dislocation are main reasons for spinal internal fixation failure. Screw loosening and dislocation is caused by screw extraction force,and the screw withdrawl force is related to screw diameter,screw thread design,bone density,and operation skills. Withdrawl intensity is increased with screw diameter and length. Pedicle screw stability can be decreased by osteoporosis. For osteoporotic patients,it is difficult to increase screw diameter alone,so polymethyl methacrylate bone cement is used to enhance screw stability and anti-flexion intensity. However,polymerization heat may induce tissue injury,and long-term stay may produce toxicity and exhibit cancerogenesis. Novel additive materials with good biocompatibility such as hydroxyapatite and calcium phosphate bone cement are gradually replacing polymethyl methacrylate bone cement. In addition,screw entrance point,direction and exact location during screw implantation can decrease pullout strength reducation caused by screw re-twisting and improve screw extraction intensity and stability.

Intestinal barrier dysfunction and autophagy abnormality play important roles in the mechanism of inflammatory bowel disease, however, whether autophagy has effect on intestinal barrier dysfunction has not been reported.Aims: To explore the effect of autophagy inducer pp242 on intestinal barrier dysfunction induced by tumor necrosis factor-α (TNF-α).Methods: Model of intestinal epithelial monolayer barrier was established with Caco-2 cells in Transwell chambers, and then randomly divided into four groups: control group (without any intervention), TNF-α group (10 ng/mL TNF-α), pp242 group (1 μmol/L pp242), TNF-α+pp242 group (10 ng/mL TNF-α+1 μmol/L pp242).The intestinal barrier function was evaluated by transepithelial electrical resistance (TEER) and flux of FITC-dextran.The protein expressions of autophagy related protein LC3B-Ⅱ and p62 were detected by Western blotting.Results: Compared with control group, TEER was significantly decreased (P<0.05), flux of FITC-dextran, protein expressions of LC3B-Ⅱ and p62 were significantly increased in TNF-α group (P<0.05).Compared with TNF-α group, TEER was significantly increased (P<0.05), protein expression of LC3B-Ⅱ was significantly increased (P<0.05) while protein expression of p62 was significantly decreased in TNF-α+pp242 group (P<0.05).Conclusions: Autophagy inducer pp242 relieves TNF-α-induced intestinal epithelial barrier dysfunction via activating autophagy flux.

Objective To evaluate the diagnostic value of dynamic contrast-enhanced MR angiography(DCE MRA)of the renal arteries.Methods 18 patients suspected with renal arterial diseases underwent DCE MR Angiography examinations.After 20 ml(0.15～0.20 mmol/kg)Gd-DTPA being injected quickly via cubital vein,a scaning and data acquisition with coronal three-demensional fast spoiled gradient(FSPGR)sequence was performed in a breath-hold time,the source images were introduced into work station for post processing,including maximum intensity projection(MIP)and multiplanner reconstruction(MPR),finally 3D DCE MRA images were obtained.Results A comparative study on renal artery stenosis and its degree between DCE MR angiography and DSA was done in 25 arteial segments of 12 cases.In 12 normal renal arteries shown by DSA,DCE MRA found 11 normal and one mild stenosis;Four moderate and one severe stenosis was shown by DCE MRA in five renal arteries with moderate stenosis identified by DSA;DCE MRA found five severe stenosis and three occlusion of renal anteries,which had accordance with DSA findings.Conclusion Dynamic contrast-enhanced MR angiography can accurately assess renal arterial diseases,the accuracy was especially higher in patients with severe arterial stenosis and occlusion.

Objective To explore the significance of changes of matrix metalloproteinase-9 (MMP-9),interleukin-6 (IL-6),and tumor necrosis factor-alpha (TNF-oα) protein level in the cerebrospinal fluid (CSF) of children with viral encephalitis (VE).Methods The concentration of neuron-specific enolase (NSE),structural proteins 100B (S100B),and MMP-9,IL-6,TNF-α in the CSF of VE children were detected by an enzyme linked immunosorbent assay,and the correlations of them were analyzed.Results NSE,S100B,MMP-9,IL-6,TNF-α protein expression could be found significantly higher than those in the control group,and there were significant differences according to statistics expression trends(all P ＜0.05).The NSE protein expression was significantly positive related with S100B in the VE group (r =0.467,P =0.009),and the concentration was markedly negative related with the duration of viral encephalitis (r =-0.472,P =0.008).MMP-9,IL-6 protein expression were significantly positive related with NSE,S100B respectively (r =0.698,P =0.00 ; r =0.559,P =0.00 ; r =0.812,P =0.00 ; r =0.664,P =0.00).TNF-α protein expression was positive related with CSF S100B(r =0.363,P =0.049),but there was no correlation between TNF-α and NSE (r =0.245,P =0.193).Conclusions The neurons and the neuroglial cells are damaged in the viral encephalitis children.MMP-9,IL-6,TNF-α protein may participate in the pathological damage process of nerve cells in VE children in different degrees.

A total of 64 patients with lumbar spondylolisthesis were enrolled from Department of Bone Surgery in the People's Hospital of Haian Province between January 2002 and December 2007, including 19 males and 45 females. They aged 26-73 years with a mean of 48.5 years. Their disease course was 1-15 years with a mean of 4 years. All patients complained about the repeated low back pain accompanied with lower limb radiating pain and intermittent claudication (50-300 m). Fifty-nine patients suffered from lumbar spondylolysis, including L3 Ⅰ degree in 3 cases, L4 Ⅰ degree in 31 cases,L4, Ⅱ degree in 13 cases, Ls Ⅰdegree in 9 cases and L5 Ⅱ degree in 3 cases. The remaining 5 cases were present with lumbar degenerative pseudo-spondylolysis. All patients were processed into whole laminectomy for decompression or vertebral canal decompression by fenestration, domestic vertebral internal fixation, reduction and interbody fusion. Fifty-five patients were followed up for an average of 3.1 years whereas 9 patients were lost. According to Steffee clinical effect grading, the curative effect was evaluated as excellent in 28 cases and good in 19 cases, the rate of excellence and good accounted for 85.5%. Within one week following bone graft, all patients were rechecked with X-ray plain film, 28 of them had shown complete reduction and 36 cases were present with part reduction. The fusion rate of interbody graft was 100%. These findings demonstrated that vertebral internal fixation system possesses a simple structure, convenient operation and solid fixation, resets the slipped vertebral body and significantly increases the fusion rate of vertebral graft.

Objective To observe any effect of low intensity pulsed ultrasound (LIPUS) on the expression of integrin-focal adhesion kinase (FAK)-mitogen-activated protein kinase (MAPK) mechanochemical transduction pathway-related proteins in the chondrocytes of rabbits with knee osteoarthritis (OA).Methods Of the 18 New Zealand white rabbits selected for the study,twelve received knee anterior cruciate ligament transection to model OA.The remaining 6 rabbits served as normal controls.At the 4th week after modeling the rabbits were sacrificed and chondrocytes were isolated and cultured in vitro.All the cultured cells were randomly divided into three groups:a normal control group (NC),an OA model group (OA) and an OA model plus LIPUS group (OA + LIPUS).When the cells had been cultured to the 2nd passage,the NC group and OA group cells had received no treatment.The OA + LIPUS group cells were exposed to 40 mW/cm2 of LIPUS for 20 min,once a day for 6 days.The expression of collagen protein type Ⅱ,aggrecan,MMP-13,integrin β1 p-FAK and p-p38,p-ERK1/2 and p-JNK Mapks were detected by Western blotting.Results Compared with the NC group,the expression of collagen type Ⅱ and aggrecan was significantly lower in the OA and OA + LIPUS groups,with more significantly lower expression of collagen type Ⅱ and aggrecan in the OA group than in the OA + LIPUS group.Compared with the NC group,the expression of MMP-13 was significantly higher in the OA and OA + LIPUS groups,with a significantly larger increase in the OA group.Compared with the NC group,the expression of integrin β1 and p-FAK was also significantly higher in the OA and OA + LIPUS groups,with a significantly larger increase in the OA + LIPUS group.Compared with the NC group,the expression of p-p38,p-ERK1/2 and p-JNK was also significantly higher in the OA group,but compared with the OA group,the expression of those kinases was,on average,significantly lower in the OA + LIPUS group.Conclusions LIPUS can inhibit the degradation of collagen type Ⅱ and aggrecan,and inhibit the expression of MMP-13,p-p38,p-ERK1/2 and p-JNK in OA chondrocytes,at least in vitro.At the same time,LIPUS can increase the expression of integrin β1 and p-FAK.The results show that LIPUS may activate an integrin-FAK-MAPK mechanochemical transduction pathway to induce changes in the extracellular matrix of chondrocytes.

Objective:To systematically assess the effectiveness and safety of acupuncture for spastic hemiplegia after ischemic stroke. Methods:Randomized controlled trials(RCTs)of acupuncture treatment for spastic hemiplegia after ischemic stroke meeting the inclusion criteria in Cochrane Library,Medline,Excerpta Medica Database(EMBASE),PubMed,China National Knowledge Infrastructure(CNKI),SinoMed,Chongqing VIP Database(VIP),and Wanfang Data Knowledge Service Platform(Wanfang)published from each database's inception to February 2023 were retrieved by computer.Two reviewers independently extracted data and evaluated the risk of bias using Cochrane's risk of bias tool.Review Manager 5.4 was used for data analysis.Continuous data were evaluated using mean difference(MD)with a 95%confidence interval(CI),and dichotomous data were analyzed using risk ratio(RR). Results:A total of 24 trials,including 1 970 participants,were included in the study.The meta-analysis of 7 trials showed that compared to the rehabilitation therapy,acupuncture therapy was more effective in improving the simplified Fugl-Meyer assessment score after 1-month treatments[MD=10.52,95%CI(7.81,13.23),P<0.001].The meta-analysis of 2 articles showed the same tendency after 6-month treatments[MD=19.18,95%CI(11.34,27.02),P<0.001],and the 6-month treatment course resulted in better outcomes than the 1-month course.The meta-analysis of 8 trials showed that acupuncture had a better improvement on the Barthel index score than rehabilitation therapy after 1-month treatments[MD=10.78,95%CI(8.91,12.64),P<0.001].The meta-analysis of 2 articles showed the same tendency after 6-month treatments[MD=19.94,95%CI(19.02,20.87),P<0.001],and the 6-month course was better than the 1-month course.The meta-analysis of 2 trials showed that the effective rate of the modified Ashworth scale score improvement was more notable in the acupuncture group after 1-month treatments[RR=1.20,95%CI(1.02,1.40),P=0.020].One trial reported no adverse event,and 1 trial reported 3 adverse events without severe influence. Conclusion:Acupuncture might be an effective and safe therapy for spastic hemiplegia after ischemic stroke,but more high-quality,large-sample objectively-evaluated RCTs are needed to validate the conclusion.

This study aims to learn drug resistance situation of four first-line anti TB drugs among 251 Mycobacterium tuberculosis isolates from Qinghai and to explore their relationships with genotypes by Spoligotyping,so as to provide basis for effective prevention of tuberculosis.Isolates of 251 M.tuberculosis were tested susceptibilities of four first-line drugs including isoniazid (INH),rifampicin (RFP),streptomycin(SM) and ethambutol (EMB) by using conventional proportion method and genotyped by Spoligotyping.Relationship between drug resistance and genotypes was analyzed statistically.Results showed the total drug resistance rate was 56.2％ (141/251) among 251 M.tuberculosis isolates.Resistance rates of four first-line drugs were 43.0％ (108/251) for INH,37.1％ (93/251) for RFP,39.0％ (98/251) for SM,27.9％ (70/251) for EMB respectively.Rate of multidrug-resistant TB (MDR TB) was 31.5％ (79/251).All 251 isolates of M.tuberculosis were typed by spoligotyping.The 185 (73.7 ％) were Beijing genotypes and 66 (26.3.％) were non-Beijing genotypes,and no statistical association was found with drug resistance.This paper concludes that isolates of M.tuberculosis prevail in Qinghai have both high rates of drug resistance and MDR and dominant isolates are Beijing genotypes by spoligotyping.

Objective:To investigate whether etomidate affects inflammatory response and apoptosis of PC12 cells induced by hypoxia by regulating miR-142-3p.Methods:PC12 cells were pretreated with different doses(2,6,12 μmol/L)of etomidate to establish hypoxia model;PC12 cells that transfected with miR-142-3p mimics or inhibitors were pretreated with 0 or 12 μmol/L of etomidate to establish hypoxia model.Cell viability,apoptosis and protein(CyclinD1,Cleaved-caspase-3)expressions were detected by CCK-8 method,flow cytometry and Western blot,respectively.ELISA was used to detect levels of inflammatory factors TNF-α,IL-1β,IL-6.Expression of miR-142-3p was detected by RT-qPCR.Results:Etomidate increased hypoxia-induced PC12 cells activity and expres-sion of CyclinD1 protein and miR-142-3p,while decreased cell apoptosis rate,Cleaved-caspase-3 protein expression and levels of inflammatory factors TNF-α,IL-1β,IL-6(P<0.05).Up-regulation of miR-142-3p increased activity and expression of CyclinD1 pro-tein of hypoxia-induced PC12 cells,while decreased cell apoptosis rate,Cleaved-caspase-3 protein expression and levels of inflamma-tory factors TNF-α,IL-1β,IL-6(P<0.05).Down-regulation of miR-142-3p reversed effects of etomidate on hypoxia-induced PC12 cell activity,apoptosis and expressions of inflammatory factors(P<0.05).Conclusion:Etomidate can reduce inflammatory response and apoptosis of PC12 cells induced by hypoxia,and its mechanism may be related to the up-regulation of miR-142-3p expression in cells.

Polycystic ovary syndrome (PCOS) is a common reproductive endocrine and metabolic disease, and its pathogenesis is closely related to inflammation, insulin resistance, and metabolic disorders. Bilirubin is the final product of the destruction and degradation of senescent red blood cells in the body. In addition, bilirubin can be not only used to evaluate liver function damage and cytotoxicity, but also can anti-inflammatory, antioxidant, alleviate metabolic disorders, etc. Recently, studies have found a certain correlation between low levels of bilirubin and PCOS: the level of bilirubin in patients with PCOS is low, and the anti-inflammatory and antioxidant properties of bilirubin may play a protective role in the pathogenesis of PCOS.