Objective To summarize the imaging features of the thoracic canal stenosis caused by ossification of ligamentum flavum, and to evaluate its clinical results of a novel decompression of total laminotomy and autografting in-situ. Methods 31 patients underwent total laminotomy, autografting in-situ and decompression to treat the ossification of thoracic ligamentum flavum. In the study, there were 18 males and 13 females; the average age was 45.7 years (rang, 26 to 73). 3 patients were associated with cervical stenosis, 5 with lumbar stenosis, and 2 with both cervical and lumbar stenosis. 9 were associated with anterior compression by thoracic disc herniation or OPLL. The vertebrae affected were 1 level in 3 patients, 2 levels in 12, 3 levels in 11 and more than 4 levels in 5. 23 affected segments were located at the upper thoracic spine(T1-T4), 19 at the mid-thoracic spine(T5-T8) and 52 at lower-thoracic spine(T9-T12). All the patients underwent total laminotomy and autografting in-situ, 9 patients with thoracic disc herniation or OPLL received discectomy and internal fixation at one stage. The postoperative outcomes were evaluated according to Epstein criteria. Results The patients were followed up 6 to 63 months (mean, 15 months). The clinical outcomes were excellent in 14 cases, good in 7 cases, and fair in 3 cases, and the excellent and good rate was 87.5%. One case experienced neurological complication with Frankel C grade improved to Frankel D grade treated with neurotrophic drug and hyperbaric oxygen and to Frankel E grade at 5 months after operation. 2 presented with lower limb intravenous thrombosis, and CSF leakage happened in 1 case and cured with re-operation. The osteotomy of total laminotomy was bony healed at average of 5.5 months, and there was not new formed ossification anterior to re-implanted vertebral lamina and spinal cord compression. Conclusion MRI combined with CT scanning is a most useful imaging modality for the diagnosis of ossification of thoracic ligamentum flavum. The novel surgical procedure designed by the authors is safe and effective in treating ossification of thoracic ligamentum flavum.

OBJECTIVE:To study on the effect of iodine (I2) on the acid content titration in the preparations,and establish a method of eliminating I2 for accurate determination of total acid content. METHODS:Taking an example of Onychomycosis paint,I2 was reduced by sodium sulfide(Na2S)before titration analysis and compared with the standard method of traditional titration. Ac-cording to the two methods of consumption of different sodium hydrate(NaOH)volume,the effect of I2 on the determination of to-tal acid content in preparation was explored. RESULTS:Reduction method of Na2S can eliminate the effect of I2,the color of indica-tor changed acutely. The determined total acid and theoretical values were the same;the linear range of the concentration of total ac-id in onychomycosis paint was 3.926-7.290 mol/ml(r=0.9999);RSDs of precision,stability and reproducibility tests were no more than 0.04%;average recovery was 99.91%-100.10%(RSD=0.036%,n=6). CONCLUSIONS:I2 has effect on the determina-tion of total acid content,the disproportion reaction of I2 can generate hydriodic acid that can interfere acid-base titration's results, and the generated hydriodic acid can oxidize indicator to make the end point is not sensitive or even invariant color. Using Na2S can eliminate the effect of iodine on the preparation of acid titration,which has improved precision and reproducibility with accurate and reliable determination results.

Objective To evaluate the clinical effect of the individualized treatment of congential entropion.Methods Totally 150 patients (285 eyes) with congenital entropion were analyzed,the individualized procedures were performed,including the simple incision and suture surgery for simple congenital entropion,removing the redundant skin of lower eyelid for congenital entropion with redundant skin of lower eyelid but without epicanthus,the correction of entropion combined withY-V epicanthoplasty for congenital entropion with epicanthus and the recession of lower eyelid retractor for congenital entropion with lower eyelid retraction.The clinical effect,the percentage of cure and the complication of these cases were evaluated.Results The excellent results were achieved and no relapse or complications occurred in all cases.The total cure rate was 98.6％ (281 of 285 eyes).The cure rate of simple congenital entropion was 92.0％ (23 of 25 eyes).The cure rate of congenital entropion with redundant skin of lower eyelid was 100％ (41 of 41 eyes).The cure rate of congenital halflength entropion accompanied by epicanthus was 99.4 ％ (179/180 eyes).The cure rate of congenital entropion associated with lower eyelid retraction was 97.4％ (38 of 39 eyes).Conclusions Individualized operations not only have well curative effect for various congenital entropions,but recurrence rate and complications have been reduced.

To identify and analyze the virulence of a bacteria strain isolated from the blood of a patient with suspected Streptococcus suis (S.suis) infection in a hospital of Beijing,we inoculated the bacteria strain isolated from the blood of the patient to the Columbia with sheep blood agar plate,after Gram staining and microscopical examination,serum agglutination test,VITEK 2 Compact microbial identification system test and matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) test,S,suis species specific gene 16SrRNA,S.suis species serotype 2 specific virulence gene capsule polysaccharide 2J (cps2J) and virulence gene muramidase-released protein (mrp),hemolysin (sly),extracellular factor protein (ef),glutamate dehydrogenase (gdh) genes,fibronectin-binding protein (fbps),glyceraldehyde-3-phosphate dehydrogenase (gapdh) genes and virulence correlated gene orf2 were further detected by PCR.Results showed that the suspicious bacteria strain of S.suis was identified as S.suis type 2 (S.suis 2) by conventional methods,MALDI-TOF-MS and PCR.PCR results showed that cps2J,sly,ef,gdh,fbps,gapdh and or f2 genes were positive,and mrp gene was negative.In conclusion,the bacteria strain isolated from the patient's blood is sly+/ef+/mrp-virulent S.suis 2.

Objective:To explore the clinical outcomes of articulating spacers in the treatment of chronic knee periprosthetic joint infection (PJI).Methods:A retrospective study was conducted of the 38 patients who had undergone stage-two revision for chronic knee PJI from January 2014 to January 2020 at Department of Articular Surgery, The First Affiliated Hospital to Fujian Medical University. They were 8 men and 30 women, aged from 37 to 84 years (average, 66.2 years). The PJI was unilateral in all, affecting 19 left sides and 19 right sides. According to the kind of spacers used in the stage-one revision, they were divided into 3 groups: metal-polyethylene one (10 cases), metal-cement one (15 cases) and cement one (13 cases). In the stage-two revision following infection control, the spacers were removed for sonication and microbial culture. Infection control, range of motion (ROM), Knee Society Score (KSS), and complications were followed up.Results:The 38 patients were followed up for an average of 30.8 months (from 13 to 75 months). All patients underwent spacer implantation at stage-one revision and infection was controlled in 37 of them (97.4%, 37/38). After stage-one revision, metal-polyethylene, metal-cement and cement groups achieved 95.0°±11.3°, 92.9°±8.3° and 75.5°±11.9° in ROM, 79.4±6.1, 77.3±4.0 and 73.0±7.2 in clinical KSS and 67.5±11.8, 69.0±10.4 and 60.8±11.0 in functional KSS, showing significant improvements in the above indexes between preoperation and postoperation ( P<0.05). The ROMs for the metal-polyethylene and metal-cement groups were significantly better than for the cement group ( P<0.05). A total of 32 patients completed stage-two revision, with 7 in the metal-polyethylene group, 12 in the metal-cement group and 13 in the cement group. Respectively, ROMs after stage-two revision were 104.6°±9.8°, 98.5°±8.7° and 86.1°±8.9°, clinical KSSs 85.3±4.6, 82.7±4.3 and 78.0±4.8 and functional KSSs 78.6±6.9, 77.3±8.2 and 69.5±8.3 for the metal-polyethylene, metal-cement and cement groups, showing significant improvements after stage-one revision ( P<0.05). The postoperative sonication fluid culture showed negative results in all. Conclusions:Articulating spacers can effectively control knee PJI and improve the knee function during revision interval and after revision. Metal spacers may lead to a better range of motion than traditional cement ones.

Objective To investigate the effect of daily behavior,life habits,mental status of the resident population in Beijing City on thyroid nodules.Methods A questionnaire survey was conducted using stratified sampling method to investigate the resident population in physical examination organization of Xicheng,Chaoyang,Mentougou and Shunyi districts,who lived in Beijing for more than 15 years,ages between 45-50 years old,and they did not know whether suffered from thyroid nodules.A 1:1 case-control study was used to analyze the relationships between thyroid nodules and mobile phone using time,exercise,sleep and mental stress in males and females.Logistic regression analysis was used to analyze relationships between various factors and thyroid nodule in single factor analysis,and if the influence factors in the single factor analysis had statistical significance they will be further analyzed in the multiple factors analysis.Results The total prevalence of thyroid nodules was 35.06％ (331/944),males and females were 27.91％ (144/516) and 43.69％ (187/428),respectively.The prevalence of female was higher than that of male (x2 =25.60,P ＜ 0.05).Logistic regression analysis showed that mental stress (males,females:OR =2.106,1.653,95％CI:1.158 ～ 3.831,1.042 ～ 2.622) and using the phone ＞ 3 h (males,females:OR =12.863,5.315,95％CI:1.540 ～ 107.444,1.359 ～ 20.794) were risk factors for thyroid nodules in the male and female populations.Conclusion The occurrence of thyroid nodules maybe related to mental status and using the phone for a long time,but its mechanism needs to be further explored.

Objective To investigate the inhibitory effect of apigenin-7-o-glucoside (AGL) on the viability of Huh7 cells and tumor growth in Huh7-xenograft tumor nude mice. Methods CCK-8 was used to detect the proliferation inhibitory effect and the half inhibitory concentration of AGL on Huh7 cells. The mitochondrial membrane potential measurement was used to analyze the early apoptosis of Huh7 cells after AGL treatment. Flow cytometry was used to analyze the effect of AGL on Huh7 cell apoptosis, and Western blot was used to explore the expression level of the proteins associated with apoptosis and inflammation, as well as the possible related mechanism. In Huh7-xenograft tumor nude mice, vernier caliper was used to measure tumor volume to analyze the effect of AGL on tumor growth rate. HE staining was used to observe the pathological state of mouse organs, and the inflammation-related factors in serum were detected with ELISA. Results After Huh7 cells were treated with AGL, the mitochondrial membrane potential reduced, the content of ROS increased and the apoptosis rate was increased to 25.23% by 50 μmol/L AGL treatment; while the expression levels of Bax, Bad, Cleaved Caspase-3 and Cleaved Caspase-9 increased, and the expression levels of Bcl2 and Bcl-x^L decreased, the phosphorylation level of NF-κB, IKKα/β and IκBα decreased; the tumor growth rate decreased, the serum IL-6 and TNF-α levels significantly decreased, while the IL-2 and IL-10 levels increased. Conclusion AGL could promote the apoptosis of Huh7 cells and relieve the tumor development in Huh7-xenograft tumor nude mice, which may be related to the NF-κB pathway.

Objective To investigate the clinical significance of soluble Semaphorin 5A(Sema 5A) in patients of rheumatoid arthritis(RA) and the effect of Sema 5A on osteoclastogenesis in RAW264.7 cells.Methods (1)Soluble Sema 5A was detected in the serum of 62 RA patients,30 osteoarthritis(OA) patients and 48 healthy controls(HC) by enzyme-linked immunosorbent assay(ELISA).The relationships between serum Sema 5A and disease activity,radiographic severity and laboratory parameters were investigated in RA patients.(2)RAW264.7 cells were treated with different concentrations of Sema 5A(0,0.5,1,2.5,5 μg/ml).After 7 days,tartrate-resistant acid phosphate(TRAP) staining was performed.The mRNA levels of TRAP,cathepsin-K and matrix metallopeptidase 9(MMP-9) were tested using real-time polymerase chain reaction (RT-PCR).(3)Bone resorption area of dentine slides cultured with RAW264.7 cells was calculated after Sema 5A (5μg/ml) treatment.Results (1)The serum Sema 5A in RA patients[(5.24±0.59)μg/L] was significantly higher than those in healthy controls[(2.93±0.34)μg/L,P＜0.01] and OA patients[(2.68±0.47)μg/L,P＜0.05].The Sema 5A level in RA patients was positively correlated with disease activity score with 28 joint using C-reactive protein(DAS28-CRP),clinical disease activity index (CDAI),C-reactive protein(CRP) and sharp scores(P＜0.05 or P＜0.01).In addition,the serum Sema 5A in RA patients with positive anti-cyclic citrullinated peptide(CCP) antibody was significantly greater than that of anti-CCP antibody-negative patients (P＜0.05).(2)After RAW264.7 cells were treated with Sema 5A,the number of TRAP positive osteoclasts increased according to the increase of Sema 5A concentration with maximal effect at 5 μg/ml.Meanwhile,Sema 5A promoted mRNA expression of TRAP,Cathepsin-K and MMP-9.(3)Bone resorption area increased when RAW264.7 cells were treated with Sema 5A(5 μg/ml).Conclusions Serum Sema 5A is elevated in RA patients and correlated with disease activity and radiographic severity.Sema 5A promotes osteoclastogenesis of RAW264.7 cells.

Objective To explore the treatment of unilateral blepharoptosis caused by oculomotor nerve paralysis with pseudo-Graefe phenomenon after craniocerebral trauma or operation.Methods Three patients suffered from blepharoptosis caused by oculomotor nerve paralysis with pseudo-Graefe phenomenon were collected in this study and the modified levator resection technique was applied to correct ptosis.The observation index after operation included the height of upper palpebral margin,the radian of double eyelid,the change of eye movement and the corresponding upper eyelid height,the eye closure function and the incidence of exposure keratitis.Results One case of oculomotor nerve palsy with moderate ptosis achieved an ideal height of upper eyelid after surgery,two cases of oculomotor nerve palsy with severe ptosis were undercorrection.All the three patients had smooth double eyelid radian,no obvious change of eye movement and corresponding upper eyelid height compared with preoperative.The two severe ptoses could close eyes well,but the moderate ptosis patient couldnot close eyes completely.Conclusions The technique of modified levator resection is an effective method to treat the moderate ptosis caused by oculomotor nerve paralysis with pseudo-Graefe phenomenon,but the results are unfavorable in the treatment of severe ptosis.

Objective To examine short-term outcomes and long-term survival of elderly patients (aged over 80 years) with colorectal cancer who received laparoscopic versus open surgery. Methods A total of 313 patients over 80 years old with colorectal cancer who underwent radical surgery were included.According to the surgical method, all patients were divided into open-surgery group (n=143) and laparoscopic surgery group (n=170).Baseline data were balanced between the two groups by using propensity score matching.Kaplan-Meier was used to draw the survival curve, and survival was compared by Log rank tests.Cox proportional risk model was used to analyze the effects of all factors on overall survival (OS) and disease-free survival (DFS). Results After matching, 93 patients were included in each group.The mean intraoperative blood loss, the incidence of overall postoperative complications and gradeⅠ-Ⅱ complications in the laparoscopic surgery group were significantly lower than those in the open surgery group (all P < 0.05).The time to first flatus, the time to oral feeding, and postoperative hospital stays in the laparoscopic surgery group were significantly shorter than those in the open surgery group (all P < 0.05).The mean number of lymph-node dissection was also significantly higher in the laparoscopic surgery group than in the open surgery group (P=0.030).Patients in both groups had similar 5-year OS (P=0.594) and DFS (P=0.295).Multivariate Cox prognostic analysis showed that CEA level > 5 ng/ml, pathological TNM stage Ⅲ, and perineural invasion were independent risk factors for poor OS and DFS. Conclusion Compared with open surgery, laparoscopic surgery can provide better short-term advantages and similar long-term outcomes for colorectal cancer patients over 80 years of age.