ObjectivesTo evaluate the learning curve for percutaneous endoscopic transforaminal discectomy（PETD）at L4/5 level and L5/S1 level respectively， and to evaluate the differences of learning curve for PETD between the two levels. MethodsTwo batches of the first 51 cases who were each treated with PETD for L4/5 or for L5/S1 disc herniation respectively in the department between December 2019 and November 2020 were reviewed. The operation time， radiation exposure time， VAS score， preoperative ODI score， and the postoperative follow-up were reviewed. Each level was divided into three groups： for the earliest stage， Patients #1~17 were assigned to Group A； for the middle stage， Patients #18~34 were assigned to Group B； and for the latest stage， Patients #35~51 were assigned to Group C. ResultsAll patients were observed postoperatively for 8.4 months ［range： 6 months-12 months， M （P₂₅~P₇₅） = 8.0（7.0~9.3）months］. Significant differences were observed in the mean operation time for L4/5 level both between Group A and Group B （P=0.006） and between Group A and Group C （P=0.000）， while for the average operation time for L5/S1 level there was significant difference between Group A and Group C （P=0.000）， but not between Group A and Group B （P=0.344）. Compared with the operation time at L4/5 level， the operation time at L5/S1 was significantly longer for each stage （Group A： P=0.080， Group B： P=0.000， Group C： P=0.016， Total： P=0.000）. The average X-ray exposure period at each Group A L4/5 level was shortened successively， and there were significant differences between Group A and Group B （P=0.000）， also between Group A and Group C （P=0.000）. However， the mean radiation time of the three stages in L5/S1 level improved less rapidly than that in L4/5 level， in which significant difference was not observed between Group A and Group B （P=0.995）， but was between Group A and Group C （P=0.000）. The radiation exposure time at L5/S1 was significantly longer than L4/5 level for each stage （Group A： P=0.000， Group B： P=0.000， Group C： P=0.000， Total： P=0.000）. In the improvement of VAS score among 3 stages for L4/5 level， no significant differences were observed neither between Group A and Group B （P=0.967） nor between Group A and Group C （P=0.927）. Higher improvement in the ODI score was observed in L4/5 level both between Group A and Group B （P=0.036） and between Group A and Group C （P=0.011）. There was no significant difference in the improvement of VAS score for L5/S1 level neither between Group A and Group B （P=0.397） nor between Group A and Group C （P=0.960）； neither was there any significant difference in the improvement of ODI score both between Group A and Group B （P=0.207） and between Group A and Group C （P=0.109）. ConclusionsThe learning curve in the L4/5 level is steeper than that in the L5/S1 level. Suitable patient selection is of much importance for shortening the learning curve for PETD.

OBJECTIVETo study the flavonoids from the leaves of Santalum album.

METHODThe sample was extracted with 70% ethanol by continuous thermal reflux. The extraction was separated and purified by column chromatography over macroporous adsorption resin, polyamide and sephadexlh-20. Their structures were identified by detailed spectroscopic analysis.

RESULTEight flavonoids were isolated and identified as vicenin-2 (1), vitexin (2), isovitexin (3), orientin (4), isoorientin (5). chrysin-8-C-beta-D-glucopyranoside (6), chrysin-6-C-beta-D-glucopyranoside (7), and isorhamnetin (8).

CONCLUSIONAll compounds were isolated from this plant for the first time.

Flavonoids ; analysis ; Plant Leaves ; chemistry ; Santalum ; chemistry

OBJECTIVETo observe the clinical effects of partial revascularization on elderly patients with coronary artery diseases(CAD) METHODS: Percutaneous coronary interventions (PCI) of the most likely culprit vessels were performed in 37 patients over 80 years old with multivessel coronary artery diseases (CAD).

RESULTSThe success rate of PCI was 100% in these elderly patients without serious complications. The in-hospital mortality rate was 2.7%, and all the other patients recovered and were discharged.

CONCLUSIONPartial revascularization for elderly CAD patients can achieve satisfactory clinical results, and close attention should be given to the heart and kidney function of these patients.

Age Factors ; Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary ; methods ; Coronary Artery Disease ; therapy ; Female ; Humans ; Male ; Risk Factors ; Stents

OBJECTIVETo investigate the correlation of microalbuminuria (MA) and fibrinogen (Fib) to the severity of coronary artery lesions in patients with metabolic syndrome (MS).

METHODSEighty-five patients with MS undergoing coronary artery angiography were divided, according to the number of vessels involved, into multivessel disease group and non-multivessel disease group, and also according to the modified Gensini score, into severe lesion (Gensini score>20) and non-severe lesion group. The correlations of MA and Fib to the number of involved vessels and the severity of the lesions were analyzed.

RESULTSThe urinary albumin to creatinine ratio (ACR) and Fib were significantly different between the multivessel and non-multivessel disease groups (P<0.05), and were found to be positively correlated to the number of coronary artery lesion (r=0.378, P=0.000; r=0.327, P=0.002). ACR, Fib, sex, smoking history and HDL-C differed significantly between severe lesion and non-severe lesion groups (P<0.05), and ACR and Fib showed positive correlations to the Gensini score (r=0.337, P=0.002; r=0.286, P=0.008). Logistic regression analysis identified ACR as an independent predictor of multivessel disease (B=2.655, P=0.000) and Gensini score (B=1.803, P=0.009), independent of sex, age, body mass index, smoking history, diabetes mellitus, LDL-C and HDL-C.

CONCLUSIONMA and Fib are positively correlated to the severity of coronary artery lesion, and MA is an independent predictor of multivessel disease and Gensini score in patients with MS.

Aged ; Albuminuria ; Coronary Artery Disease ; diagnosis ; pathology ; Female ; Fibrinogen ; metabolism ; Humans ; Male ; Metabolic Syndrome ; blood ; urine ; Middle Aged

Background and Objectives: Stroke is the most common cause of human death and functional disability, resulting in more than 5 million deaths worldwide each year. Bone marrow mesenchymal stem cells (BMSCs) are a kind of stem cell that are able to self-renew and differentiate into many types of tissues. Therefore, BMSCs have the potential to replace damaged neurons and promote the reconstruction of nerve conduction pathways and connective tissue. However, it remains unknown whether transplanted BMSCs promote angiogenesis or improve the tissue microenvironment directly or indirectly through paracrine interactions. This study aimed to determine the therapeutic effect of BMSCs on ischemic stroke with hypertension in a rodent model and to explore the possible mechanisms underlying any benefits. Methods: and Results: Middle cerebral artery occlusion was used to establish the experimental stroke model. The area of cerebral infarction, expression of vascular endothelial growth factor (VEGF) and glial cell line-derived neurotrophic factor (GDNF), and increment of astrocyte were measured by TTC staining, western blot, real-time quantitative polymerase chain reaction (RT-qPCR) and immunocytochemistry. The results showed a smaller area of cerebral infarction and improved neurological function scores in animals treated with BMSCs compared to controls. The results of RT-qPCR and western blot assays showed higher expression of VEGF and GDNF in BMSC-treated animals compared with controls. Our study also showed that one round of BMSCs transplantation significantly promoted the proliferation of subventricular zone and cortical cells, especially astrocytes, on the ischemic side following cerebral ischemia. Conclusions Above findings support that BMSCs have therapeutic effects for ischemic stroke complicated with hypertension, which may occur via up-regulated expression of VEGF and GDNF and reduction of neuronal apoptosis, thereby promoting the recovery of nerve function.

【Objective】 To explore the effectiveness and safety of polyglycolic acid (PGA) and hydroxypropyl methylcellulose (HPMC) composite materials in distal pancreatectomy postoperative suturing. 【Methods】 We selected 36 healthy adult beagles and divided them randomly into observation group and control group, with 18 distal pancreatectomy surgeries in each group. The observation group used PGA+HPMC composite materials for incision reinforcement while the control group used NEOVEIL for incision reinforcement. 3 days before surgery, 3 days after surgery, and before dissection, blood routine tests were performed on each group of experimental dogs. Observation periods of 2-week, 4-week and 8-week were set, and six animals at each observation point were evaluated for histological examination of heart, liver, spleen, lung, and kidney tissues, hard tissue slice pathological diagnosis, and safety evaluation. 【Results】 There was no significant difference between the observation group and the control group in the preoperative blood routine test. Repeated measures ANOVA results showed differences in the mean values of white blood cell count (WBC) ( F=14.875, P=0.001), mean corpuscular hemoglobin concentration (MCHC) (F=5.049,P=0.009), neutrophil percentage (Neu%) (F=4.794, P=0.011), red blood cell count (RBC) (F=6.591, P=0.002), hemoglobin (HGB) (F=8.154, P=0.001), hematocrit (HCT) (F=5.281, P=0.007), platelet count (PLT) (F=6.560, P=0.014), red blood cell distribution width coefficient of variation (RDW-CV) (F=33.950, P=0.039), or lymphocyte percentage (Lym%) (F=3.299, P=0.043) at different time points. However, the observation group and the control group did not differ, and the interaction between time and group had no significant effect on the above indicators, suggesting that both groups of dogs had inflammatory response or surgical stress. For the 8-week postoperative hard tissue pathological section score, there was no significant difference between the observation group and the control group in the inflammation and necrosis related score, fibrosis, repair or other related scores and total score (P>0.05). In the dissection at 8 weeks after surgery, no obvious damage to the heart, liver, spleen, lung, kidney, or other organs was found in both groups, nor was there any residual suture material, pancreatic fistula, or pancreatitis, indicating that the suture materials in both groups had been completely absorbed and metabolized, and the incision healed well without causing adverse effects on the visceral organs. 【Conclusion】 PGA and HPMC are effective and safe postoperative suture materials, with good biodegradability, biocompatibility, suture strength, and wound healing quality. They can be comparable to traditional absorbable reinforcement materials in distal pancreatectomy postoperative suturing, thus providing scientific basis for their clinical application.

ObjectiveTo analyze the mental health status of non-psychiatric inpatients in a general hospital， and to explore the relevant influencing factors， so as to provide references for the screening of mental health problems and the construction of intervention models among non-psychiatric inpatients. MethodsA cross-sectional study was conducted among 916 non-psychiatric inpatients in a third grade class A general hospital in Guangzhou， and all the inpatients were assessed using Patient Health Questionnaire-9 item （PHQ-9）， Generalized Anxiety Disorder-7 item （GAD-7）， Athens Insomnia Scale （AIS） and Columbia-Suicide Severity Rating Scale （C-SSRS） to detect their depression， anxiety， insomnia and suicide risk status. Thereafter， univariate and multivariate Logistic regression analysis were used to screen the risk factors affecting the mental health of inpatients. ResultsA total of 339 （37.0%） inpatients with positive mental health problems were screened， and the screening results for each dimension revealed 218 cases （23.8%） of depression， 141 cases （15.4%） of anxiety， 257 cases （28.1%） of insomnia， 42 cases （4.6%） of suicidal ideation and 7 cases （0.8%） of suicidal behavior. Binary Logistic regression analysis showed that female （OR=1.379， P<0.05） was a risk factor for positive screening of mental health problems. Ordinal Logistic regression analysis denoted that age above 60 years old （OR=1.542， P<0.05） and singlehood （OR=2.055， P<0.05） were risk factors affecting the severity of depression， while senior high school to junior college education （OR=0.524， P<0.05） was a protective factor of depression， meantime， female （OR=1.472， P<0.05） was a risk factor affecting the severity of insomnia. ConclusionMental health problems are quite common among non-psychiatric inpatients in general hospitals， and are mainly affected by factors such as gender， age， marital status and educational background.

OBJECTIVE: To retrospectively analyze non-invasive prenatal screening (NIPS) data from two centers. METHODS: The NIPS results of 10 840 samples were analyzed, including 21/18/13 trisomies (T21/T18/T13), sex chromosome and other autosomal aneuploidies, and copy number variants (CNVs). The maternal age, gestational week, body mass index and concentration of free fetal DNA (cffDNA) were also analyzed. RESULTS: The average gestational age of the 10 840 pregnant women was (32.34±5.04) year old, and the average gestational week for NIPS was (17.60±3.55) week. The overall false positive rate for T21/T18/T13 was 0.11%, sensitivity was 100%, specificity was 99.89%, and positive predictive value was 81.5%. The positive predictive values for sex chromosome and other autosomal aneuploidies and CNVs were 56.67%, 11.76% and 83.33%, respectively. The incidence of T21/T18 in the elder women (35 years or elder) was 2.12 times(P<0.01) and 1.81 times (P> 0.05) that of young women. cffDNA was in proportion to gestational week (r = 0.207) and in inverse proportion to body mass index (r = -0.177). It has increased slowly before 15 weeks of gestation and thereafter at a rate of 0.5% per week after the 16th week. CONCLUSION The performance of NIPS in this study is by large close to the reported in the literature, and the results can provide a reference for further study.

Objective:To discuss the value of real-time three-dimensional speckle tracking imaging(RT3D-STI) in the evaluation of the left atrial (LA) volume and function in end-stage renal disease (ESRD) patients with different dialysis methods.Methods:Eighty-three ESRD patients who were treated in the Affiliated Hospital of Qingdao University from February to August 2019 were enrolled and divided into non-dialysis group ( n=25), hemodialysis group (HD group, n=31) and peritoneal dialysis group (PD group, n=27). And 30 healthy volunteers were enrolled as control group. Subsequently, the LA volume indexs including LA maximal volume index (LAVImax), LA minimal volume index (LAVImin) and LA presystolic volume index (LAVIpre), the LA function parameters including LA ejection fraction (LAEF), LA passive ejection fraction(LApEF) and LA active ejection fraction (LAaEF) and the LA global strain parameters including global longitudinal strain(GLS), global radial strain(GRS) and global circumferential strain(GCS) were obtained by RT3D-STI. The differences of the parameters among these groups were compared and the correlations between the myocardial strain parameters and dialysis time were analyzed. Results:①The LAVImax, LAVImin and LAVIpre of the non-dialysis group, PD group and HD group were higher than those in the control group, while the LAEF, LApEF, GLS, GRS and GCS were lower than those in the control group(all P<0.05); the LAVImin of the PD group as well as the LAVImin, LAVIpre and LAVImax of HD group were higher than those of non-dialysis group, while the LAEF, LApEF, GLS, GCS of the PD group and the LAEF, LApEF, GLS, GRS, GCS of HD group were lower than those of non-dialysis group (all P<0.05). The LAVImax, LAVImin, LAVIpre of HD group were higher than those of PD group, while the LAEF, LApEF, GLS, GRS and GCS of HD group were lower than those of PD group (all P<0.05). ②The GLS and GCS in PD group were negatively correlated with the dialysis time( r=-0.670, -0.596, all P<0.05), and the GLS, GCS and GRS in HD group were negatively correlated with the dialysis time( r=-0.624, -0.631, -0.551, all P<0.05). Conclusions:RT3D-STI can assess the LA volume and function of ESRD patients with different dialysis methods effectively and can further evaluate the prognosis of patients and guide timely clinical intervention.

OBJECTIVE： To study the mechanism of Cistanche deserticola in the treatment of osteoporosis by network pharmacology. METHODS： The active components of C. deserticola were retrieved and obtained by TCM system platform （TCMSP）. Reverse molecular docking server DRAR-CPI and related databases GeneCards and OMIM were used to screen the target of C. deserticola active ingredients in the treatment of osteoporosis. The “component-target”network of C. deserticola was constructed by Cytoscape software， and the interaction between targets was plotted by String database and Cytoscape software. The combination activity of target and active ingredient was evaluated via molecular docking with Systems Dock WebSite server. GO classification and enrichment analysis and KEGG pathway enrichment analysis were conducted for target genes using DAVID database. RESULTS： Totally 13 active ingredients were screened out from C. deserticola， such as verbascoside， leonurine， geniposidic acid. There were 43 active ingredient-treated potential targets， such as RUNX2， VEGF， IL-6， BGP， TNF. Multiple signaling pathways were involved in target action， such as WNT （Wingless/Integrated）， VEGF， TNF. CONCLUSIONS： This study preliminarily explores and validates the main targets and pathways of C. deserticola in the treatment of osteoporosis， which lay the foundation for further study of its mechanism.