OBJECTIVETo provide a theoretical basis for designing of lumbar intervertebral disc prosthesis by collecting the data of the lumbar endplate morphology.

METHODSA total of 100 healthy adults were measured about the following parameters: lumbar lordosis, the Cobb angle of each segment, the concavity depth (ECD) of the endplate, the location of concavity apex (ECA) of the endplate. And a correlation analysis on lumbar lordosis and ECD, ECA was made, respectively.

RESULTSIn total, 100 volunteers were measured. The mean age of the volunteer was 40 years (range 20 - 50 years); the average depth of ECD was (2. 37 ± 1. 42) mm, the average location of ECA was (52. 21 ± 9. 70) %; the average depth of ECD of inferior endplate (IEP) was (2. 81 ± 1. 52) mm (0. 54 - 7. 60 mm), and the parameter of the superior endplate (SEP) was (1. 94 ± 1. 16)mm(0. 39 - 6. 10 mm). The average depth of ECD of the IEP was bigger than of the SEP for each lumbar vertebral body. Most of the location of ECA was at the back of the intervertebral body, the average location of ECA of IEP was (49. 60 ± 8. 78) % (22. 57% - 75. 58%), and the parameter of the SEP was (55. 03 ± 9. 90) % (16. 03% -75. 58%); the mean angle of lumbar lordosis was 39. 760 11. 25°(13. 8° - 72. 00°). There was no obvious correlation between the lumbar lordosis and the ECD (r -0. 193, P =0. 195), neither was the location of ECA(r =0. 080, P =0. 592).

CONCLUSIONMost of the location of ECA is at the back of the intervertebral body, the average depth of ECD is 2. 37 mm, the average location of ECA is 52. 21%.

Adult ; Humans ; Intervertebral Disc ; Lumbar Vertebrae ; anatomy & histology ; Lumbosacral Region ; anatomy & histology ; Middle Aged ; Prostheses and Implants ; Reference Standards ; Spine ; anatomy & histology ; Young Adult

Objective:To study the levels of individual dose of radiation workers in a steel enterprise in Baotou City from 2018 to 2022, and analyze the main factors affecting the annual dose, and provide basic data for revising relevant standards.Methods:According to the requirements of occupational external exposure personal monitoring standards (GBZ 128-2019), the personal dose monitoring of workers working in a steel enterprise in Baotou City from 2018 to 2022 was carried out, three months for a period, continuous monitoring 4 periods, and the results were analyzed.Results:A total of 1 360 workers from 10 employers within the enterprise were surveyed. The annual doses were in the range of 0.500 - 0.844 mSv, with an average annual individual dose of 0.676 mSv. Especially, the average annual individulal effective dose to workers for safety management and inspection was 0.986 mSv, hiher than 0.698 mSv to rolling workers, pump operators, and continuous casters ( Z = 56.89, P < 0.001). Additionally, female worders working with the radiation generators had a higher average annual individual effective dose of 0.821 mSv, than 0.691 mSv to the male workers who were exposed to sealed sources possibly in many cases as needed, with a statistically significant difference ( Z =-5.53, P < 0.001). Conclusions:The average annual individual effective dose to radiation workers in an iron and steel enterprise in Baotou City meets the requirements of the relevent national standard. The annual dose of women and some workers is relatively high, so the management of radiation workers should be strengthened and the radiation protection measures in the workplace should be improved.

Spontaneous renal artery dissection is a rare disease with unknown etiology, confounded clinical manifestations, and easy to be misdiagnosed as urinary tract infection. The diagnosis mainly depends on imaging examinations. Intravascular interventional therapy is a safe and effective treatment. This study reported a case of spontaneous renal artery dissection , which treated by intravascular interventional therapy of renal artery , and had achieved good therapeutic effect.

Objective:To explore the prevalence and risk factors of exit-site infection (ESI) in elderly peritoneal dialysis (PD) patients.Methods:The status of exit-site was evaluated in elderly PD patients (≥60 years) who had catheter insertion in our center between January 1, 2009 and December 31, 2013, with follow-up for 1 year or withdrawing from peritoneal dialysis in this period. The patients were divided into ESI and non-ESI group. The data was collected including demographics, clinical features, and nursing care methods of the exit-site.Results:A total of 247 patients were recruited in this study, aged (68.6±6.2) years, among whom there were 132 male (53.4%) and 119 diabetes (48.2%). Median follow-up time was 12.0 months. Thirty-two patients had 34 episodes of ESI with a rate of 82.5 patient-months per episode (0.15 episodes per year). Coagulase-negative Staphylococcus was the main pathogen, accounting for 35.3% of the ESI. No bacterial growth was found in 8.8%. The exit-site nursing care status included that poor compliance of exit-site care 23.5%, poor catheter immobilization 62.3%, history of catheter-pulling injury 9.7%, mechanical stress on exit-site 5.3%, improper frequency of nursing care 29.6%, mupirocin usage 13.8%, patients taking exit-site care 26.7%, exit-site caregiver instability 16.6%. There were no differences in demographic (such as age, gender, primary disease, etc) and laboratory data (hemoglobin, serum albumin, blood potassium, etc) between the ESI and non-ESI groups. Poor compliance with exit-site care ( HR=2.352, 95% CI 1.008-5.488, P=0.048), poor catheter immobilization ( HR=3.074, 95% CI 1.046-9.035, P=0.041) and exit-site caregiver instability ( HR=2.423, 95% CI 1.004-5.845, P=0.049) were significantly correlated with increased risk of ESI. Conclusions:The prevalence of ESI in elderly PD patients was 0.15 episodes per year. Educating PD patients to improve the compliance with exit-site care, maintain catheter immobilization and do exit-site care by a stable and trained caregiver may reduce ESI events in elderly PD patients.

Renal subcapsular abscess(RSA) is a rare disease with unknown etiology and pathogenesis. CT is an important assistant examination for the diagnosis. In this study, we reported 2 cases of RSA. One case achieved good therapeutic effect by timely debridement and surgery drainage, and the other case refused to perform debridement and drainage, which lead to the death. This kind of disease develops quickly and progresses rapidly. The adequate debridement and surgery drainage are important in treating this disease.

Objective:To investigate the vaccination status, characteristics and prognosis of patients suffering from a combination of COVID-19 and chronic lymphocytic anemia (CLL) in China.Methods:Clinical data of 328 patients with chronic lymphocytic leukemia (CLL) who were first diagnosed with COVID-19 and treated in the Department of Hematology of Jiangsu Provincial People’s Hospital between November 2022 and February 2023 were retrospectively analyzed. Univariate and multivariate analysis of data of patients with severe/critical COVID-19 were conducted by applying the binary logistic regression model.Results:The median age of the CLL patients was 60 (24-87) years. 23.5% (77/328) of these patients suffered from severe/critical COVID-19 infection. Univariate analysis of the data demonstrated that a combination of factors including age >67 years ( OR=2.15, 95% CI 1.24- 3.73, P=0.006), diabetes ( OR=2.09, 95% CI 1.05-4.20, P=0.037), chronic hepatitis B ( OR=2.91, 95% CI 1.30-6.51, P=0.010), CLL progressive ( OR=3.79, 95% CI 1.57-9.15, P=0.003) and CD20 antibody-based treatments within three months prior to the COVID-19 infection ( OR=2.79, 95% CI 1.35-5.77, P=0.006) were the risk factors for severe/critical COVID-19. According to the multivariate analysis, CLL progressive ( OR=2.98, 95% CI 1.10-8.10, P=0.033) was an independent risk factor for severe/critical COVID-19 and administration of the BTK (Bruton tyrosine kinase) inhibitor monotherapy might exert a protective effect and influence a positive outcome of the COVID-19 infection ( OR=0.38, 95% CI 0.16-0.90, P=0.028). Among the 242 patients who were followed up until October 2023, 9.1% (22/242) had multiple subsequent COVID-19 infections (≥3), and 2.1% (5/242) had persistent COVID-19 infections (patients with persistent positive test for the SARS-CoV-2 antigen testing until missing follow-up for any reason). The peak value of the anti-SARS-CoV-2-IgG titres was observed between three and four months post symptom onset (median: 3.511 S/CO vs 1.047 S/CO, P<0.05). The levels of immunoglobulin A gradually decreased following infection with COVID-19, and its trough levels were attained between two to four weeks post infection (median: 0.30 g/L vs 0.74 g/L, P<0.05). According to this study the mortality of patients suffering from a combination of COVID-19 infection and CLL was 2.7% (9/328), and the main reason for their death was respiratory failure and heart failure. Conclusions:A low rate of COVID-19 vaccination and a high rate of severe/critical COVID-19 infection was observed in the CLL patients. CLL progressive was associated with severe/critical COVID-19. Anti-CD20-based treatments received within the past three months might be a risk factor for exacerbation of COVID-19 infection, whereas a monotherapy with BTK inhibitors exert a protective effect and improve outcome of COVID-19 infection.