Objective To explore the law of apoptosis of lumbar spinal cord neurons in cauda equina syndrome (CES). Methods Cauda equina of rats was compressed by a piece of silica gel stick. From day 1 to day 28, the lumbar spinal cord specimens were harvested and assessed by Nissl's staining and TUNEL staining. Results Compression of cauda equina caused lesion and apoptosis of neurons in lumbar spinal cord, and the extent of apoptosis reached the peak on 7th day after compression. Conclusion Apoptosis of neurons in lumbar spinal cord might be one of the reasons why patients with CES get poor prognosis.

Objective:To test the reliability and validity of Urban empty-nesters Home Safety Risk Factor Assessment Scale (Uen-HAS), in order to provide an instrument for assessing the safety risk factors of urban empty-nesters.Methods:Totally 530 urban empty-nesters from Fuzhou City, Fujian Province were employed by convenient sampling method for household survey, from August to October 2018. Item analysis and validity and reliability test were conducted.Results:The final version of urban empty nest elderly home safety risk factor assessment scale (Uen-HAS) contains 5 scales, 12 sub-scales and 55 items. The Cronbach α coefficient of the scale was 0.896. The content validity index (S-CVI) of the total scale was 0.881. The correlations of the scores between each item and the total scale ranged from 0.509 to 0.812 with statistical significance ( P<0.05). Conclusion:The scale has good reliability and validity. It could be an instrument to access safety risk factors of urban empty nesters.

The article analyzes chief physician SUN Wuquan's empirical characteristics in treating neck-type cervical spondylosis:disease differentiation combined with pattern differentiation,emphasizing the assessment of tendons and bones,with DING's Tuina(Chinese therapeutic massage)manipulations and static Gongfa(Qigong exercise)as the predominant treatment,inherits the academic features of DING's Tuina school,"paying equal attention to tendons and bones,putting function first";thus provides a reference for treating neck-type cervical spondylosis with Tuina therapy.

Objective:To investigate the clinical effect of the medial perforator flap of the first plantar artery for repairing the soft tissue defect near the first metatarsophalangeal joint.Methods:From January 2016 to April 2018, 10 patients of soft tissue defect near the first metatarsophalangeal joint were treated in the Department of Orthopedics, Shandong Police General Hospital, including 6 males and 4 females, aged 22-61 years old, with an average age of 40 years. The defects of the feet were recovered by the medial perforator flap of the first plantar artery, and the flap donor defects were covered by split-thickness skin grafts.Results:All flaps and skin grafts of the patients were survived.All patients were followed up for 12-22 months postoperationly/after operation. The flaps were not swollen or ruptured, and the patients walked normally with full weight-bearing.Conclusions:The perforator artery of this flap is consistant, the harvesting of the flap is simple, and the texture of skin is similarwith surrounding tissue, there is no deficit to the flood supply of the foot after harvesting the flap. So, it is an ideal choice for repairing the defect of the soft tissue near the first metatarsophalangeal joint.

Objective:To investigate the clinical effect of the medial perforator flap of the first plantar artery for repairing the soft tissue defect near the first metatarsophalangeal joint.Methods:From January 2016 to April 2018, 10 patients of soft tissue defect near the first metatarsophalangeal joint were treated in the Department of Orthopedics, Shandong Police General Hospital, including 6 males and 4 females, aged 22-61 years old, with an average age of 40 years. The defects of the feet were recovered by the medial perforator flap of the first plantar artery, and the flap donor defects were covered by split-thickness skin grafts.Results:All flaps and skin grafts of the patients were survived.All patients were followed up for 12-22 months postoperationly/after operation. The flaps were not swollen or ruptured, and the patients walked normally with full weight-bearing.Conclusions:The perforator artery of this flap is consistant, the harvesting of the flap is simple, and the texture of skin is similarwith surrounding tissue, there is no deficit to the flood supply of the foot after harvesting the flap. So, it is an ideal choice for repairing the defect of the soft tissue near the first metatarsophalangeal joint.

Objective:To evaluate the efficacy of infra-acetabular screw placement assisted by orthopedic navigation robot in the treatment of acetabular fractures.Methods:The data of 34 patients who were treated and followed up from September 2021 to September 2022 were retrospectively analyzed. According to the fixation method, the patients were divided into the robot group (robot assisted placement of infra-acetabular screws) and the control group (placement of the pubis-ischium plate manually). There were 16 patients in the robot group, 7 males and 9 females, aged 57.00±6.00 years (range, 51-70 years). According to Letournel classification, there were 8 cases of both-column fractures, 4 cases of anterior column and posterior hemitransverse fractures, and 4 cases of T-shaped fractures. There were 18 cases in the control group, 8 males and 10 females, aged 54.22±8.95 years (range, 38-69 years). According to Letournel classification, there were 10 cases of both-column fractures, 6 cases of anterior column and posterior hemitransverse fractures, and 2 cases of T-shaped fractures. The intraoperative fluoroscopy times, total operation time, exposure time and screw placement (plate) time, blood loss, Matta evaluation, Majeed score, and screw placement accuracy rate (the degree of screw cutting-out was evaluated according to Lonstein criteria) were compared between the two groups.Results:All patients were followed up for 12.21±3.62 months (range, 6-17 months). In the robot group, the fluoroscopy frequency was 9.69±0.95 times (range, 8-11 times), the screw placement time was 34.32±5.28 min (range, 21-45 min), and the blood loss was 461.88±228.71 ml (range, 200-800 ml). The control group was 10.11±1.41 times (range, 7-13 times), 42.89±4.38 min (range, 36-55 min), 674.44±220.65 ml (range, 420-1,100 ml), respectively. There were significant differences in screw (plate) placement time ( t=5.18, P<0.001) and blood loss ( t=2.76, P<0.001). The accuracy of robot screw placement was 100%. According to Lonstein evaluation, there were 14 cases of grade 0 (87.5%, 14/16) and 2 cases of grade I (12.5%, 2/16). At 30 days of follow-up, all patients had good fracture ends and no internal fixation failure occurred. One week after surgery, the results of Matta evaluation in robot group were excellent in 11 cases, good in 3 cases, and poor in 2 cases, with an excellent and good rate of 87.5%. In the control group, 11 cases were excellent, 4 cases were good, and 3 cases were poor, with an excellent and good rate of 83.3%. There was no significant difference in the excellent and good rate of Matta evaluation between the two groups (χ 2=0.23, P=0.892). At last follow-up, the Majeed score of robot group was 87.81±8.82 (range, 71-98), including excellent in 10 cases, good in 5 cases, and fair in 1 case. The score of the control group was 86.22±6.85 (range, 70-95), including 12 cases of excellent, 4 of good, and 2 of fair. There was no significant difference in Majeed score between the two groups ( t=0.59, P=0.551). No complications related to the use of robot-assisted navigation or plate fixation were observed in both groups. Conclusion:Through the navigation planning and assistance of the robot, the infra-acetabular screws can be accurately and safely placed, which avoids the shortcomings of excessive exposure and bleeding during the application of the pubis-ischium plate, the outcome was similar to that of plate treatment.

Breast cancer-related lymphedema(BCRL)is one of the most common complications after multidiscipline treatment of breast cancer,which manifests as upper limb swelling and skin changes and significantly affects limb function and quality of life.The occurrence and development of BCRL are affected by many factors including surgery,radiotherapy,drugs,infection,trauma,and so on.Therefore,it is important to identify the potential risk factors to establish individualized prevention strategies.Evidence-based risk assessment models for BCRL could help clinicians to identify high-risk patients and apply prospective surveillance to treat BCRL at early stage.For patients with advanced lymphedema,conservative treatment and surgical treatment could be delivered to relieve symptoms and improve their conditions.This article comprehensively reviewed the risk factors,prospective surveillance,intervention,and research progress of BCRL,to provide reference for multidisciplinary collaboration as well as clinical diagnosis and treatment in this field.

Incontinence-associated dermatitis is one of the common complications in critically ill patients.This paper reviews the research progress of risk prediction models for incontinence-associated dermatitis in critically ill patients,introduces and compares the characteristics and application effects of different risk prediction models.The purpose is to provide ideas for constructing a localized risk prediction model and provide evidence for medical staff to identify risk factors of incontinence-associated dermatitis at an early stage and take preventive measures.

Objective To observe the functional recovery situation after prostate cancer radical opera-tion with maximal preservation of the periprostatic structures (MS-RARP).Methods Sixty-seven patients with localized prostatic cancer undergoing MS-RARP in the Second Affiliated Hospital of Army Military Med-ical University from June 2019 to June 2022 were selected as the study subjects.The changes of urinary con-trol function,erection function,quality of life and total prostate specific antigen (t-PSA) were compared at the time between before operation and postoperative 6 weeks,3 months,6 months,12 months.The expanded pros-tate cancer index composite index (EPIC-50) was used to evaluate the urinary control function,the interna-tional index of erectile function (IIEF-5) questionnaire was used to evaluate the erection function of the pa-tients,and EPIC-50 and the american urological associated symptom score rating scale (AUA-SS) were used to evaluate the life satisfaction of the patients.Results The urinary control function recovery rate,erection function recovery rate and life quality satisfaction rate in postoperative 6 weeks,3 months,6 months,12 months were 71.8％,95.5％,97.3％ and 98.1％;31.7％,38.1％,41.3％ and 44.4％;38.9％,83.6％,88.1％ and 97.0％,respectively.The median t-PSA was gradually decreased,which were 0.026(0.010,0.410),0.009 (0.003,0.060),0.006(0.001,0.050)and 0.004(0.001,0.006)ng/mL,respectively.The life quality satisfac-tion rates at various postoperative time points were significantly increased when compared with before opera-tion (P<0.05).t-PSA was significantly decreased compared with before operation (P<0.05).Conclusion RARP could protect the postoperative urinary function and sexual function,and increase the postoperative life quality of the patients.

Objective:To delve into the intricate relationship between common genetic variations across the entire genome and the risk of non-syndromic cleft lip with or without cleft palate(NSCL/P).Methods:Utilizing summary statistics data from genome-wide association studies(GW AS),a thorough investigation to evaluate the impact of common variations on the genome were undertook.This involved assessing single nucleotide polymorphism(SNP)heritability across the entire genome,as well as within specific genomic regions.To ensure the robustness of our analysis,stringent quality control measures were applied to the GWAS summary statistics data.Criteria for inclusion encompassed the absence of missing values,a minor allele frequency≥1％,P-values falling within the range of 0 to 1,and clear SNP strand orientation.SNP meeting these stringent criteria were then meticulously included in our analy-sis.The SNP heritability of NSCL/P was calculated using linkage disequilibrium score regression.Addi-tionally,hierarchical linkage disequilibrium score regression to partition SNP heritability within coding re-gions,promoters,introns,enhancers,and super enhancers were employed,and the enrichment levels within different genomic regions using LDSC(v1.0.1)software were further elucidated.Results:Our study drew upon GWAS summary statistics data obtained from 806 NSCL/P trios,comprising a total of 2 418 individuals from the Chinese population.Following rigorous quality control procedures,490 593 out of 492 993 SNP were deemed suitable for inclusion in SNP heritability calculations.The observed SNP heritability of NSCL/P was 0.55(95％CI:0.28-0.82).Adjusting for the elevated disease pre-valence within our sample,the SNP heritability scaled down to 0.37(95％CI:0.19-0.55)based on the prevalence observed in the general Chinese population.Notably,our enrichment analysis unveiled significant enrichment of SNP heritability within enhancer regions(15.70,P=0.04)and super enhan-cer regions(3.18,P=0.03).Conclusion:Our study sheds light on the intricate interplay between common genetic variations and the risk of NSCL/P in the Chinese population.By elucidating the SNP heritability landscape across different genomic regions,we contribute valuable insights into the genetic basis of NSCL/P.The significant enrichment of SNP heritability within enhancer and super enhancer re-gions underscores the potential role of these regulatory elements in shaping the genetic susceptibility to NSCL/P.This paves the way for further research aimed at uncovering novel genetic pathogenic factors un-derlying NSCL/P pathogenesis.