Objective To investigate the morphological regularity of the thoracic pedicle screw in 4 to 12 years old children by the digital technology,and to provide the theoreticl basis for thoracic pedicle screw fixation in children.Methods A total of 60 healthy children aged from 4 to 12 years old with computed tomography(CT) data of thoracic spine were divided into three groups by age,each group 20 cases.Then they were examined by MIMICS software and the parameters of pedicle width(PW),pedicle height(PH),the length of screw path(SL),e angle and f angle were measured.Results The pedicle width,pedicle height,the SL of the pedicle generally showed a rising trend with advancing age.There were significant differences in the PW,PH and LS between the three group(P<0.05).The PW decreased and then increased.The PH and the LS increased with the vertebral order increased.There was no significant difference in e angle and f angle between the three groups(P>0.05).E angle of the pedicle generally showed a decreasing trend with increasing vertebral order,and e angle of T11 to T12 showed negative angle.The f angle showed a wavy descending trend.Conclusion There was significant difference in correlation parameters of thoracic pedicle with increasing age in healthy children,which indicates that the pedicle screw fixation for the kind of children should be performed based on 'the Principle of individualization' to improve the success rate of surgery.

Chronic treatment with Salvia Miltiorrhiza preventing left ventricular hypertrophy (LVH) and its possible mechanism--inhibiting the action of cardiac aldosterone in spontaneously hypertensive rats (SHR) were investigated. Normotensive Wistar-kyoto (WKY) rats and SHRs were used. Part of SHRs was treated with Salvia Miltiorrhiza for 12 weeks. Systolic blood pressure (SBP) and left ventricular mass index were measured. Sections of heart tissue were stained with HE method and VanGieson method. Collagen volume fraction was determined in the left ventricle by automatically quantitative morphometry. Cardiac aldosterone concentration was measured by radioimmunoassay. The results indicated that compared with WKY rats, SHRs exhibited higher SBP, left ventricular collagen volume fraction, and aldosterone concentration (all P < 0.05). After the treatment with Salvia Miltiorrhiza, SBP, left ventricular collagen volume fraction, and aldosterone concentration in SHR were decreased as compared with control group (P < 0.05) except SBP. It was concluded that chronic treatment with Salvia Miltiorrhiza could prevent left ventricular hypertrophy in SHR, significantly inhibit collagen compositions in left ventricle. The mechanism was probably related with the inhibition of the cardiac aldosterone action.
Aldosterone ; metabolism ; Animals ; Drugs, Chinese Herbal ; pharmacology ; Hypertension ; metabolism ; physiopathology ; Hypertrophy, Left Ventricular ; metabolism ; prevention & control ; Male ; Myocardium ; metabolism ; Rats ; Rats, Inbred SHR ; Rats, Inbred WKY ; Salvia miltiorrhiza

OBJECTIVETo compare the prognostic value of lymph node ratio and N staging in stage III colorectal cancer.

METHODSThe clinicopathologic factors and follow-up data of 304 cases with stage III colorectal cancer from January 1998 to December 2011 were analyzed retrospectively. Multivariate analysis was performed using Cox proportional hazard regression model in forward stepwise regression. Patients were divided into different subgroups according to the number of lymph nodes sample.

RESULTSLNR and N stage were independent risk factors for stage III colorectal cancer, the prognostic value of LNR was better than that of N stage [Odds ratio were 1.838(95% CI:1.563~2.161) vs. 1.625 (95% CI:1.392~1.898)]. Subgroup analysis showed that, when the number of lymph nodes sample was less than 13, the prognostic value of LNR was better than that of N stage (Odds ratio were 1.836 vs. 1.639). But when the number of lymph nodes sample was more than 13, they were comparable (Odds ratio were 1.876 vs. 1.853).

CONCLUSIONSThe prognostic value of LNR and N stage were comparable for stage III colorectal cancer, but when the number of lymph nodes sample was less than 13, LNR was more valuable.

Objective:To evaluate the correlation of serum vitamin D (VitD) and parathyroid hormone (PTH) with insulin resistance and islet β-cell function in patients with type 2 diabetes mellitus (T2DM), and to analyze the role of serum VitD and PTH in the progression of T2DM.Methods:A total of 376 T2DM patients hospitalized in endocrinology department from January 2018 to January 2021 were selected. The baseline data were collected and the biochemical indexes were determined. Patients were divided into 3 groups according to serum VitD level, including 220 cases in deficiency group [25-(OH)D ≤ 20 μg/L], 107 cases in insufficiency group [25-(OH)D>20 and ≤ 30 μg/L] and 49 cases in sufficiency group [25-(OH)D > 30 μg/L]. Meanwhile, 31 of the patients were classified into PTH decreased group (PTH < 25.16 ng/L), 137 into normal PTH group (PTH ≥ 25.16 and < 38.35 ng/L) and 208 into PTH elevated group ( PTH ≥ 38.35 ng/L). According to body mass index (BMI), patients were divided into normal weight group (18.5 kg/m 2 ≤ BMI ≤ 23.9 kg/m 2), overweight group (BMI ≥24 and ≤ 27.9 kg/m 2) and obese group (BMI ≥ 28 kg/m 2). Results:Among the three groups defined by serum VitD level, comparisons of glucose metabolism and calcium and phosphorus metabolism indicators showed no significant differences in BMI, fasting insulin (FINS), fasting plasma glucose (FPG), homeostasis model assessment of insulin resistance index (HOMA-IR), serum calcium and phosphorus (all P > 0.05). The levels of glycated hemoglobin (HbA1c) and PTH in vitamin D deficiency group and sufficiency group were significantly lower compared with vitamin D deficiency group (both P < 0.05). Among the three groups defined by PTH level, there were no significant differences in BMI, FINS, FPG, HbAlc, HOMA-IR, and serum calcium (all P > 0.05). Serum phosphorus in the PTH elevated group was significantly lower compared with PTH decreased and normal PTH group ( P = 0.000), and VitD in the PTH elevated group was significantly lower compared with PTH decreased group ( P = 0.002). There were significant differences in age and blood phosphorus among the three groups defined by BMI level (all P<0.05). According to the analysis of clinical indexes of different nationalities, the level of VitD in Mongolians was significantly higher than that in Han nationality patients ( P <0.034). Spearman correlation analysis showed that VitD was negatively correlated with PTH and HOMA-IR and positively correlated with serum calcium. PTH was negatively correlated with serum calcium and phosphorus, and positively correlated with HOMA-IR. There was a significant negative correlation between normal PTH and VitD. Multiple linear regression analysis showed that HOMA-IR and homeostasis model assessment of β-cell function (HOMA-β) were protective factors, and FPG and FINS were risk factors for HOMA-IR and HOMA- β. Conclusion:There is a negative correlation between VitD and insulin resistance, and a positive correlation between PTH and insulin resistance, suggesting that VitD and PTH are possibly two impacting factors for T2DM pathogenesis.

Objective To compare the prognostic value of lymph node ratio and N staging in stage Ⅲ colorectal cancer. Methods The clinicopathologic factors and follow-up data of 304 cases with stage Ⅲ colorectal cancer from January 1998 to December 2011 were analyzed retrospectively. Multivariate analysis was performed using Cox proportional hazard regression model in forward stepwise regression. Patients were divided into different subgroups according to the number of lymph nodes sample. Results LNR and N stage were independent risk factors for stage Ⅲ colorectal cancer, the prognostic value of LNR was better than that of N stage [Odds ratio were 1.838(95% CI:1.563~2.161) vs. 1.625 (95% CI:1.392~1.898)]. Subgroup analysis showed that, when the number of lymph nodes sample was less than 13, the prognostic value of LNR was better than that of N stage (Odds ratio were 1.836 vs. 1.639). But when the number of lymph nodes sample was more than 13, they were comparable(Odds ratio were 1.876 vs. 1.853). Conclusions The prognostic value of LNR and N stage were comparable for stage Ⅲ colorectal cancer, but when the number of lymph nodes sample was less than 13, LNR was more valuable.

Objective To compare the prognostic value of lymph node ratio and N staging in stage Ⅲ colorectal cancer. Methods The clinicopathologic factors and follow-up data of 304 cases with stage Ⅲ colorectal cancer from January 1998 to December 2011 were analyzed retrospectively. Multivariate analysis was performed using Cox proportional hazard regression model in forward stepwise regression. Patients were divided into different subgroups according to the number of lymph nodes sample. Results LNR and N stage were independent risk factors for stage Ⅲ colorectal cancer, the prognostic value of LNR was better than that of N stage [Odds ratio were 1.838(95% CI:1.563~2.161) vs. 1.625 (95% CI:1.392~1.898)]. Subgroup analysis showed that, when the number of lymph nodes sample was less than 13, the prognostic value of LNR was better than that of N stage (Odds ratio were 1.836 vs. 1.639). But when the number of lymph nodes sample was more than 13, they were comparable(Odds ratio were 1.876 vs. 1.853). Conclusions The prognostic value of LNR and N stage were comparable for stage Ⅲ colorectal cancer, but when the number of lymph nodes sample was less than 13, LNR was more valuable.

Purpose: The current meta-analysis combining mid and low rectal cancer with no meta-analysis only for low rectal cancer was seen. This meta-analysis was to compare the short- and mid-term outcomes of the transanal total mesorectal excision (TaTME) vs. laparoscopic total mesorectal excision (LaTME) for low rectal cancer. Methods: A systematic literature search was conducted using the web-based databases; China National Knowledge Infrastructure, Chinese BioMedical Database, PubMed, Embase, Cochrane Central Register of Controlled Trials, and Wanfang Database. Randomized controlled trials (RCTs) were evaluated using the Jadad scale and non-RCTs (NRCs) were evaluated using the Newcastle-Ottawa Scale. Results: Ten studies (2 RCTs and 8 NRCs) involving 772 patients were included. Among them, 378 patients underwent TaTME and 394 patients underwent LaTME. Compared with the LaTME group, the conversion rate was low (risk ratio [RR], 0.25; 95% confidence interval [CI], 0.11–0.54; P < 0.001), the circumferential resection margin (CRM) involvement was low (RR, 0.48; 95% CI, 0.27–0.86; P = 0.010), and the hospital stay was short (mean difference, –1.72; 95% CI, –2.89 to –0.55; P = 0.004) in the TaTME group. No significant differences were seen in the mesorectal resection quality, CRM distance, distal resection margin (DRM) involvement, DRM distance, local R1 resection, intraoperative complications, morbidity, anastomotic leakage, severe morbidity, mortality, operative time, intraoperative blood loss, harvested lymph nodes, and local recurrence rate (P > 0.05). Conclusion The TaTME is a promising surgical technique and is fully a safe and efficacious option in managing low rectal cancer.

Objective To study the inner ear appearance on three-dimensional real inversion recovery(3D re-al IR)imaging in patients with sudden sensorineural hearing loss,and to investigate the relationship between blood-labyrinth barrier permeability and pathogenesis and prognosis of sudden hearing loss.Methods A total of 41 pa-tients with sudden sensorineural hearing loss received 3D real IR at 3.0 T MRI,and the signal intensity of inner ear were recorded.We respectively measured cochlear signal intensity in affected and healthy ears,and medullary signal intensity,and calculated the cochlear/medulla ratio(CM ratio)separately.On the basis of CM ratio,we evaluated hearing levels at initial and after treatment,and the relationship between CM ratio and hearing prognosis.Results Among the 41 patients,33 cases(occupying 80.48％)individually had a higher CM ratio in the affected ear than in the healthy one.The CM ratio of the affected side was not higher than that of the healthy side in 8 cases,and the ef-fective rate was 100％,eighteen cases had below 1.5 times the CM ratio in affected ears as in healthy ears,with 77.78％effective rate of treatment;seven cases had 1.5 to 1.75 times,with 100％effective rate;two cases had 1.75 to 2 times,with 50％effective rate;and the rest 14 cases had over 2 times,with 14.28％effective rate(P＜0.05).Conclusion The variation of blood-labyrinth barrier permeability in patients with sudden hearing loss can be read on the 3D Real IR,and it indicates that 80.48％patients have higher-intensity signals in lateral cochlea.The CM ratio can be adopted to evaluate the extent of inner ear damage of patients more accurately.As the CM ratio ri-ses,patients'prognosis become worse,and patients with over 1.75 times the CM ratio in the affected ear as in the healthy one,mostly suffer poor prognosis.

Objective: To investigate the prevalence of witnessing domestic violence,and to explore the relationship between witness domestic violence in childhood and college students’ injury and violence behaviors. Methods: In October 2018, self-made questionnaire on “Health and Risky Behaviors among University Students in Anhui Province” was conducted among 4 034 college students from 4 universities in Hefei. Multivariate Logistic regression models (control of confounding factors) were used to explore the impact of childhood witnessing domestic violence on college students’ injury and violence. Results: Among 4 034 college students,the prevalence of witnessing domestic emotional violence,mild physical violence and severe physical violence in childhood was 27.6%,22.4%,10.7%,respectively. Univariate analysis showed that students with experiences of witness domestic emotional violence,mild physical violence and severe physical violence had higher rates of self-injury,physical,emotional,and sexual violence compared to those without domestic violence witness(P<0.05). Multivariate Logistic regression analysis showed that witnessing domestic severe physical violence,emotional violence in childhood associated positively with self-harm (OR=1.53,95%CI=1.05-2.23; OR=2.15,95%CI=1.51-3.04) and emotional violence (OR=1.65,95%CI=1.16-2.35; OR=2.57,95%CI=1.87-3.53). Witnessing domestic severe physical violence showed positive association with physical violence (OR=4.99,95%CI=2.58-9.62) and sexual violence (OR=8.68,95%CI=3.30-22.81) among college students (P<0.05). Conclusion The experiences of witness domestic violence can increases the risk of college student’s injury and violence behaviors,especially witness domestic severe physical violence.

Objective:To explore the application effect of laparoscopic surgery skills training course in the standardized residency training of surgery.Methods:A total of 40 standardized trainees of surgical residents rotating in general surgery were selected as the research objects, and randomly divided into the experimental group and the control group. The experimental group was offered laparoscopic surgery skills training course. The course content includes theoretical teaching module, simulated teaching module, virtual teaching module and clinical surgery practice teaching module. The control group was taught by traditional theory teaching and clinical surgery practice teaching. At the end of the courses, the two groups of students were assessed for their skills in laparoscopic grasping and pass, suture and knotting. At the same time, a questionnaire survey was conducted among the students and teachers. The t-test was performed using SPSS 22.0 statistical software. Results:The theoretical scores of the experimental and control groups were (67.90±13.24) and (69.70±13.46), respectively, with no statistically significant difference ( P > 0.05). After the courses, the performance of grasping and pass, suture and knotting of the experimental group (15.25±3.24 and 5.45±2.14) was higher than that of the control group (11.25±2.12 and 2.75±1.16), and the difference was statistically significant ( P < 0.01).The questionnaire survey showed that the proportion of "better" feedback from students and teachers on laparoscopic skills training courses was significantly higher than that of "general" and "poor". Conclusion:The laparoscopic surgery skills training course can improve the laparoscopic surgery skills of the trainees in the standardized residency training of surgery, shorten the learning curve, and make the training standardized and homogeneous. It is worthy of wide promotion and application in the standardized training base.