BACKGROUND:Percutaneous kyphoplasty for the treatment of vertebral compression fractures has gained good clinical results and it is characterized as smal trauma, less bleeding and very low rate of complications. The vast majority of elderly patients can tolerate it, but this method cannot prevent fracture replase in the elderly. OBJECTIVE:To evaluate clinical outcomes of percutaneous kyphoplasty combined with anti-osteoporosis drug for the treatment of acute osteoporotic vertebral compression fractures METHODS:According to strict inclusion and exclusion criteria, 137 patients, including 26 males and 111 females, mean age of (75.55±6.96) years, with a total of 198 acute osteoporotic vertebral compression fractures treated by kyphoplasty that involves injection of polymethyl methacrylate cement under radiologic control into a treated vertebral body were conducted in this study. Al patients were asked to take anti-osteoporosis drugs for 3 post-treatment months. The primary outcomes were visual analogue scale, ertebral restoring rate, Oswestry disability index, Cobb angle at different time (pre-operation, 1 week and 3 months after operation). In addition, the rate of complications and the replase rate of vertebral compression fractures after operation were recorded. RESULTS AND CONCLUSION:There were significant differences in the mean visual analog scale scores, vertebral restoring rate, Oswestry disability index, Cobb angle at pre-procedure and post-procedure (at 1 week and 3 months) (P<0.001). In addition, the rate of postoperative complications was 0.7%and there were no vertebral compression fractures during 3-month fol ow-up period. Our study suggests that percutaneous kyphoplasty combined with anti-osteoporosis drug for the treatment of acute osteoporotic vertebral compression fractures can gain good clinical results.

Objective To investigate the neuroprotection of delayed treatment of thoracic acute spinal cord injury with recombinant human erythropoietin (rhEPO) in rat model of compressive injury. Methods Sixteen adult male Sprague-Dawley rats were randomly divided into two groups: control group (compressive injury group) and experimental group (rhEPO group), In the compressive injury group,the animals recived 0.9% saline treatment at 2 h, day 1 and day 3 after the injury, while in the rhEPO group, rhEPO (3 000 U/kg) was given to rats at 2 h, day 1 and day 3 after the injury. All the rats were observed in 4 days after the injury. The primary outcomes were evaluated by BBB scale, apoptotic index, inflammatory index and electron microscopy. Results Delayed treatment of thoracic acute spinal cord injury with rhEPO could reduce apoptosis, regulate inflammation, improve motor function and promote regeneration of the spinal cord. Conclusion Our study suggests that delayed treatment of thoracic spinal cord compressive injury with rhEPO could exert neuroprotection.

Objective To evaluate the effects of penehyclidine hydroehloride as an atropine alternative on angioearpy and glandular secretions when premedieated in ketamine complex total intravenous anesthesia(TIVA)in children.Methods Forty patients aged 3-10 years undergoing ketamine and propofol complex TIVA were randomly divided into two groups.Penehyclidine hydrochloride(group P,n=20)or atropine(group A,n=20)was premedicated intramuscularly 30 min before anesthesia.Heart rate(HR),mean arterial pressure(MAP),breath rate(R)and the amount of saliva secretion(SS)were recorded before premedication(0 min),10 min,20 min,30 min,60 min and 150 min after.Results (1)SS reduced significantly 20 min,30 min and 60 min after premedication in both groups(P＜0.01),and in 150 min,it was still in a significantly reduced level in group P(P＜0.01),which was significantly lower than that in group A(P＜0.01).(2)MAP,HR and R in group P showed no significant differences before and after premedication(P＞0.05).But in group A,HR increased significantly at 20 min,30 min and 60 min after premedication(P＜0.05 or＜0.01),MAP increased significantly at 30 min and 60 min after premedication(P＜0.01),and meanwhile of them were also significantly higher than those in group P(P＜0.05 or＜0.01).Conclusions Penehychdine hydrochloride can effectively reduce respiratory glandular secretion with longer persistence,and nearly has no influence on HR and blood pressure,which suggests it could be a superior to atropine alternative as an anesthesia premedication in children.

Objective To identify molecular typing of Brucella abortus isolates in Xinjiang,and determine the identification ability of multiple locus variable-number tandem repeat analysis (MLVA).Methods The optimized Brucella AMOS-PCR was used for identification of Brucella (n =7) genus and species in Xinjiang from 2010-2015,and MLVA-16 was used to further identify the isolates.Results were compared with the data of the Brucella standard strain provided by the http://mlva.u-psud.fr database.Cluster analysis was carried out with Bionumerics 6.6.Results The results of AMOS-PCR and MLVA-16 were identical,all were Brucella abortus.Further classification results of the MLVA-16 showed that the strain in Xinjiang was type 3 of Brucella abortus,which was basically the same as that of the domestic Brucella.Conclusions The molecular typing of isolates separated in Xinjiang is type 3 of Brucella abortus.MLVA can identify Brucella at the level of species,and highly sensitive to Brucella biotype and isolates differences,which provides a basis for the traceability and evolution of brucellosis epidemic strains.

Objective To investigate the effect of erythropoietin(EPO)on the proliferation of neural stem cells(NSCs)derived from central canal of adult rat spinal cord in vitro ,so as to provide a theoretical basis for clinical treatment of spinal cord injury by autotransplanting or allograft transplanting of adult spinal cord NSCs. Method NSCs were isolated from the central canal of the adult rats spinal cord by microsurgical method,and Nestin(nestin)and Sox2 immunofluorescence stain were used to identify the cells. After cells were treated with different dose of EPO,5,10,20 and 40 U/mL,respectively,the optical treatment concentration and time were determined by CCK8 assay. The effect of EPO on the cell count and the expression of Cyclin D1 in NSCs were detected at the treatment time 96 h. Result The NSCs derived from the central canal of adult SD rats spinal cord could stably express protein Nestin and transcription factor Sox2. As the results of CCK8 test,cell counts and real-time quantitative PCR showed the optimal treatment of concentration and time maybe 20 U/mL and 96 h. Conclusions This study shows that EPO can promote the proliferation of NSCs derived from central canal of adult rat spinal cord,and the optimal treatment of concentration and time for proliferation might be 20 U/mL and 96 h.

Purpose: Oxidized cellulose is available in many forms, but manufactured using either a regenerated or non-regenerated process. In this study, we evaluated the effects of 2 different hemostatic agents for the treatment of local bleeding in patients undergoing hepatic resection. Methods: This was a monocentric, parallel-group, randomized, and controlled clinical trial to compare oxidized regenerated cellulose gauze (ORCG) with oxidized non-regenerated cellulose gauze (ONRCG) in patients undergoing hepatectomy. The primary endpoint was the time to hemostasis at the target bleeding site. The secondary endpoints were the postoperative drainage volume on the first 2 days after surgery and the hospital stay. Results: There was no significant difference between the ORCG and ONRCG groups in time to hemostasis from column analysis (238.8 ± 121.6 seconds vs. 193.7 ± 85.3 seconds, P = 0.068), and there were no differences in the rates of hemostatic success between the 2 groups at 120 seconds (18.4% vs. 24.3%; odds ratio [OR], 0.703; 95% confidence interval [CI], 0.231–2.136) and 300 seconds (71.1% vs. 89.2%; OR, 0.298; 95% CI, 0.085–1.041). However, the ONRCG group was superior to the ORCG group in hemostasis according to the survival analysis (log-rank test, P = 0.044). Moreover, there were also no significant differences between the 2 groups in postoperative drainage volume on the first 2 days (P = 0.436, P = 0.381) and hospital stay (P = 0.537, P = 0.200). Conclusion ONRCG was not inferior to ORCG as a hemostatic agent in patients undergoing liver resection.

Purpose: Oxidized cellulose is available in many forms, but manufactured using either a regenerated or non-regenerated process. In this study, we evaluated the effects of 2 different hemostatic agents for the treatment of local bleeding in patients undergoing hepatic resection. Methods: This was a monocentric, parallel-group, randomized, and controlled clinical trial to compare oxidized regenerated cellulose gauze (ORCG) with oxidized non-regenerated cellulose gauze (ONRCG) in patients undergoing hepatectomy. The primary endpoint was the time to hemostasis at the target bleeding site. The secondary endpoints were the postoperative drainage volume on the first 2 days after surgery and the hospital stay. Results: There was no significant difference between the ORCG and ONRCG groups in time to hemostasis from column analysis (238.8 ± 121.6 seconds vs. 193.7 ± 85.3 seconds, P = 0.068), and there were no differences in the rates of hemostatic success between the 2 groups at 120 seconds (18.4% vs. 24.3%; odds ratio [OR], 0.703; 95% confidence interval [CI], 0.231–2.136) and 300 seconds (71.1% vs. 89.2%; OR, 0.298; 95% CI, 0.085–1.041). However, the ONRCG group was superior to the ORCG group in hemostasis according to the survival analysis (log-rank test, P = 0.044). Moreover, there were also no significant differences between the 2 groups in postoperative drainage volume on the first 2 days (P = 0.436, P = 0.381) and hospital stay (P = 0.537, P = 0.200). Conclusion ONRCG was not inferior to ORCG as a hemostatic agent in patients undergoing liver resection.

Objective To explore the drug sensibility of Brucella from bovine and sheep in Xinjiang.Methods Using paper diffusion method,19 drugs of 8 kinds of antibiotics including aminoglycosides,macrolides,sulfonamides,tetracyclines,β-lactams,fluoroquinolones,chloramphenicols and rifamycins,were tested.Drug sensitivity test was conducted on 57 Brucella strains isolated from bovine and sheep in Xinjiang from 2010 to 2016.Results The 57 Brucella strains were highly sensitive to doxycycline,tetracycline,streptomycin,tobramycin,gentamicin,amikacin,amoxicillin,ofloxacin,fleroxacin,ciprofloxacin and chloramphenicol,with the sensitivity rates were all higher than 90％;and they were highly resistance to azithromycin,clarithromycin and bactrim,with the drug resistance rates were all higher than 80％.Conclusion Brucella from bovine and sheep in Xinjiang is sensitive to tetracyclines,aminoglycosides,β-1actams,fluoroquinolones and chloramphenicols.

Objective:To investigate the correlation between the muscle mass loss and severe postoperative pulmonary complications(PPC)in elderly patients with non-small cell lung cancer(NSCLC).Methods:Elderly patients with NSCLC undergoing lobectomy at the Lung Cancer Institute and the Department of Thoracic Surgery of Guangdong Provincial People's Hospital were recruited from Feb.2019 to Dec.2019.Data of the body composition, lung function, respiratory muscle strength test, cardiopulmonary exercise test were collected before operation.All patients were grouped into two groups: with versus without severe PPC at 30 d after operation.The differences of the above parameters were compared between the two groups.A multiple logistic regression analysis was used to analyze the risk factors for severe PPC.Results:In this study, 120 elderly NSCLC patients undergoing lobectomy were recruited, All evaluations were completed in 113 patients(aged 68.13±7.01 years)in whom, 21(18.58%, 21/113)patients had serious PPC.Compared with patients without PPC, patients with severe PPC had a lower appendicular skeletal muscle mass index(ASMI)(5.67±0.90 kg/m 2vs.7.71±1.40 kg/m 2, t=3.900, P=0.001), a lower forced expiratory volume in 1 second(FEV 1)(1.85±0.40 L vs.2.12±0.57 L, t=2.412, P=0.027), a lower maximal mid-expiratory flow(MMF)(1.40±0.69 L/s vs.2.11±1.09 L/s, t=2.502, P=0.021), a lower maximum inspiratory pressure(Pimax)(55.13±32.52 cmH 2O vs.64.71±20.60, t=0.778, P=0.047, 1 cmH 2O=0.098 kPa), a lower maximal oxygen consumption(Vo 2max)(1.14±0.41 L/min vs.1.40±0.34 L/min, t=0.779, P=0.046), a lower peak O 2 consumption(Vo 2max@kg)(20.00±1.91 L·min -1·kg -1vs.22.33±2.37 L·min -1·kg -1, t=0.813, P=0.041). Multiple logistic regression analysis showed that in addition to FEV 1( OR=2.824, 95% CI: 1.127-5.158, P=0.001)and Vo 2max@kg( OR=3.149, 95%CI: 1.829-6.592, P<0.001), ASMI was also an independent risk factor for serious PPC( OR=1.919, 95% CI: 1.604-3.466, P=0.006), in which the best cut-off value was 6.295 kg/m 2, the sensitivity and specificity were 0.816 and 0.818 respectively, and the area under the receiver operating characteristic(ROC)curve(AUC)was 0.887(95% CI: 0.793-0.981, P<0.0001). Conclusions:Muscle mass loss can increase the risk for the occurrence of severe PPC within 30 days after lobectomy in elderly patients with NSCLC.

Objective To explore the clinical features of critical cases of coronavirus disease 2019 (COVID-19). Methods The clinical data of nine patients who were diagnosed with critical COVID-19 in Hainan General Hospital from January 21, 2020 to February 6, 2020 were retrospectively analyzed. RT-PCR testing for 2019 novel coronavirus (2019-nCoV) was performed with multi-sites synchronize specimens including pharyngeal swab, blood, excrement, and urine. The serum levels of leucocyte, C-reactive protein, procalcitonin and lactic acid between the improved group (five cases) and the deteriorated group (four cases) were compared. The t test was used for comparison of normally distributed continuous data between groups. Results There were eight males (88.9%) and 1 female enrolled. The patients aged 28-77 years old, with an age of (52.9±18.0) years. By March 4, 2020, all five cases in improved group were cured and discharged, three cases in deteriorated group died and 1case remained in critical condition. All multi-sites specimens of patients in improved group turned negative in 2-4 weeks of illness onset, while those of cases in deteriorated group showed sustained viral nucleic acid positive (up to 48th day of illness onset). The white blood cell counts ((13.52±8.24)×10 9 /L vs (10.49±4.46) ×10 9 /L), C-reactive protein ((139.71±87.46) mg/L vs (78.60±55.40) mg/L) and procalcitonin ((2.32±4.03) ng/mL vs (0.28±0.58) ng/mL) , lactic acid ((3.70±4.14) mmol/L vs (2.33±0.53) mmol/L) in deteriorated group were all significantly higher than those in improved group ( t =2.908, 5.009, 4.391 and 2.942, respectively, all P <0.01). A rapid rise of serum IL-6 level up to 8 500 pg/mL was observed in one patient three days prior to death. Conclusion Among the patients with critical COVID-19, serum levels of inflammatory cytokines of the death cases are higher than those of improved and discharged cases.