Objective To examine the short-and middle-term efficacy and refracture rate in patients with thoracolumbar fracture having percutaneous kyphoplasty (PKP) and determine their correlation with the severity of osteoporosis.Methods A retrospective analysis was conducted on 247 patients with thoracolumbar fracture undergone PKP from January 2008 to February 2014.Mean age of the patients (94 males and 153 females) was 63.2 years (range,50-81 years).Ground-level falls occurred in 119 patients,traffic injuries in 72 patients and high falls in 56 patients.The patients were assigned to osteopenia group and osteoporosis group based on the preoperative bone mineral density.Visual analogue score (VAS),Roland-Morris disability survey scale (RDQ),vertebral compression rate,kyphotic Cobb angle and refracture rate were recorded before and after operation.Efficacy in correlation with the severity of osteoporosis was evaluated.Results Mean duration of follow-up was 24.3 months (range,18-36 months).Three days after operation,VAS descended from (7.7 ± 2.1) points to (4.3 ± 1.1) points in osteopenia group and from (7.7 ± 2.0) points to (4.2 ± 1.5) points in osteoporosis group (P ＜ 0.05);RDQ descended from (21.2 ± 1.5) points to (10.4 ± 2.5) points in osteopenia group and from (20.8 ± 1.9) points to (11.2 ± 1.7) points in osteoporosis group (P ＜ 0.05);rate of vertebral body compression descended from (42.2 ± 10.5) ％ to (3.2 ± 0.5) ％ in osteopenia group and from (46.2 ± 12.7) ％ to (2.9 ± 0.8) ％ in osteoporosis group (P ＜ 0.05);kyphotic Cobb angle descended from (21.2 ± 9.5) ° to (7.2 ±2.4) °in osteopenia group and from (23.1 ± 8.9) ° to (7.1 ± 2.6) ° in osteoporosis group (P ＜ 0.05).Three years after operation,all the parameters remained better than these before operation,with the value higher in osteoporosis group than in osteopenia group (P ＜ 0.05).Rate of refracture was higher in osteoporosis group after operation,compared to that in osteopenia group (P ＜ 0.05).Conclusions The clinical short-term result is satisfactory,but refracture rate is increased with the osteoporosis aggravation.Targeting osteoporosis therapy is important to obtain a better mid-term results.

Researchers subjective emphasis on application for the project,contempt to complete the project.To safeguard the research projects carried out smoothly and successfully completed,improve hospital credibility,the hospital in many ways to strengthen the scientific research project management,such as creating a strong scientific and academic atmosphere,the establishment of preresearch funds,hospital research,enhance service awareness,the establishment of the project evaluation system to strengthen the management of project mid-term and node title,funds management,effectively promoted the development of the hospital research.

With the rise of microecology and medical model getting into the stage of the development of the ecological medicine, the intersection and consistency in the cognition traditional of Chinese and Western medical system are highlighted. Yin-yang theory is the core theory in TCM. In order to extend the guidance effects of theory of the balance of yin and yang in the clinic, and help TCM theory and curative effect be further recognized by the world, this article analyzed the consistency of different systems by comparing TCM balance theory and microecology, with a purpose to explore the closed link between TCM balance theory and microecology and microscopic nature of TCM balance theory.

Objective To evaluate the efficacy and safety of Sheng-qi-zhuang-yang formula combined with specific immunotherapy (SIT) with standardized house dust mite vaccine on allergic asthmatic children. Methods Participants were 100 children with mild to moderate allergic asthma , who were receiving SIT at Guangdong Provincial Hospital of Chinese Medicine from Jan 2011 to Dec 2013 , who were divided into treatment group and control group. Patients in the treatment group received Sheng-qi-zhuang-yang Decoction combined with SIT while patients in the control group received SIT alone. Asthma symptom scores, respiratory function and related adverse events were compared before and after treatment, between groups. Results The desensitization treatment functions was ahead of time than expected in both groups. There is no significant difference between groups in terms of respiratory function and adverse effects. Conclusion Sheng-qi-zhuang-yang decoction combined with SIT for allergic asthmatic children seems to advance clinical effect without increasing adverse events. Further large scale clinical trial is required to confirm this.

The TCM theory over body constitution has been greatly developed in the past several decades.However,the body constitution for children still lacks a standard classification.Available studies often ignored the impacts of the factors,such as region,climate and diet,on the body constitution of children.Given this situation,the present review focused on the research progress on the discipline of TCM body constitution and its classification and differentiation in Chinese children,and put forward the development on this issue based on current state policy and our own research experience.It was suggested that scholars develop a well-recognized classification method for the TCM body constitution for children in a particular region before investigating interventions according to TCM body constitution.

Objective To explore the clinical significance of expression of DcR3/TR6 gene in the tissue of cardiac cancer and its correlation with survivin gene expression, Methods Two-step immnaohistochemistry technology was adopted to detect the expression of TR6 and survivin gene in 66 cases of cardiac cancer, none of the patients received prior chemotherapy. Results The positive expression rate of TR6 and survivin genes in cardiac cancer was 54.5% and 62.1% , respectively. The expression of TR6 was correlated with histology type,clinical stage and lymph node metastasis of cardiac cancer ( P<0.05 ). The positive expression rate of TR6 in cases that cardiac cancer with survivin expressed was significant higher than those without surviving expressed (χ2=15.145, P<0.01 ). Conclusions The expres-sion of TR6 and survivin can be regarded as valuable indicators for the diagnosis and prognosis of cardiac cancer.

Objective To explore the changes of type H vessel during the low bone mineral density caused by iron accumulation and discuss its clinical meaning.Methods Ten 8-week old male C57BL/6J mice were used for experiments,and randomly divided into two groups:control group and iron group,and 5 mice in each group.In the iron group,0.1 g/kg of iron dextran was injected intraperitoneally once a week for 8 weeks.The control group was injected with the same amount of saline.The femoral and tibial specimens were examined by microscopic CT scan and bone tissue type H vessel immunohistochemical staining.Liver tissue from the two groups were collected for the content of iron by atomic absorption spectroscopy.All experimental data were analyzed with t-test.Results The content of hepatic iron in mice was significantly higher than that in the control group,which indicating that the model was successfully established.The tibia specimens were collected for immunostaining.The vascular area of type H at metaphyseal regions is 11.24％± 1.76％ in iron group and 30.69％±2.78％ in control group,respectively.There is significant difference between the two groups (P＜0.005).The femur specimens were collected for Micro-CT scan,the value of bone mineral density (BMD),bone volume/tissue volume (BV/TV),trabecular thickness (Tb.Th),trabecular number (Tb.N) and trabecular separation (Tb.Sp) was (0.19±0.013) g/cm3,11.92％±1.199％,(35.66±2.684) μm,(2.36±0.429)/mm and (284.41±23.197) μm in iron group and (0.37±0.023) g/cm3,35.76％± 1.336％,(62.05±2.238) μm,(5.68± 1.039)/mm and (163.23± 13.203) μm in control group,respectively.The differences between the two groups were statistically significant (P＜0.05).Conclusion Iron accumulation can lead to low BMD and suppress type H vessel formation in bone,which might provide a new experimental value for mechanism research on osteoporosis caused by iron accumulation.

Most osteoporotic hip fracture occurs in the elderly, with the aging of society, the incidence of such fracture is increasing. The majority of patients are now treated with surgery due to high mortality rate by non-surgical treatment. In the choice of time interval about "fracture-operation", several studies found that elderly with osteoporotic hip fracture had various co-morbidities and their physiological reserve function of the body were obviously reduced, which should be corrected before surgery. However, others believed that the co-morbidities are not aggravated within 2-3 days, using the "window period" to perform surgery could help patients to stand as early as possible after operation, which was beneficial not only to the control of co-morbidities, but also to the prevention of complications such as pneumonia, bedsore and muscular atrophy caused by lying on bed after fracture. Therefore, there are some different opinions on the operation time after fracture in the guidelines and consensus of various countries, including 36 hours, 48 hours, 120 hours and early operation. Among these time points, the idea of "surgery within 48 hours after fracture" has been incorporated into the National Medical Insurance Payment Conditions by the Israeli Ministry of Health, and has been included in the guidelines by the American Association of Orthopaedics, and has been reported in most clinical studies. This article reviewed the studies on different operation time after hip osteoporotic fracture, especially for the reasons, advantages and clinical management process of hip fracture surgery within 48 hours. In addition, these views were analyzed in order to provide reference and inspiration for clinical treatment and hospital management of hip osteoporotic fracture.

Objective:To investigate the predictive value of Graeb score for the outcome of high-grade aneurysmal subarachnoid hemorrhage (aSAH) patients with intraventricular hemorrhage (IVH).Methods:Consecutive high-grade aSAH patients with IVH admitted to the No. 1 People's Hospital of Jiujiang from January 2012 to March 2020 were enrolled retrospectively. High-grade aSAH was defined as grade Ⅳ to Ⅴ according to the World Federation of Neurological Surgeons (WFNS) scale. The outcome of patients was evaluated by the modified Rankin Scale (mRS) at 3 months after discharge. A score of ≤2 was defined as a good outcome and a score of >2 were defined as a poor outcome. Multivariate logistic regression model was used to evaluate the correlation between Graeb score and clinical outcome, and the receiver operating characteristic (ROC) curve was used to determine the predictive value of Graeb score for clinical outcome. Results:A total of 86 high-grade aSAH patients with IVH were enrolled. Aneurysm treatment: craniotomy clipping in 42 patients (48.8%), intravascular embolization in 21 (24.4%), and conservative treatment in 23 (26.7%). Twenty-nine patients (33.7%) had a good outcome and 57 (66.3%) had a poor outcome. Multivariate logistic regression analysis showed that the Graeb score >6 (odds ratio [ OR] 26.360, 95% confidence interval [ CI] 4.106-169.235; P<0.001), the modified Fisher grade 3-4 ( OR 11.674, 95% CI 1.540-88.512; P=0.017) and complicated with chronic hydrocephalus ( OR 21.236, 95% CI 2.883-156.431; P=0.003) were the independent risk factors for the poor outcome. ROC curve analysis showed that the area under the curve of the Graeb score predicting for poor outcome was 0.843 (95% CI 0.760-0.926; P<0.001), the best cut-off value was 6.5, and the corresponding sensitivity and specificity were 71.9% and 86.2%, respectively. Conclusion:The Graeb score is an independent influencing factor affecting the clinical outcome of high-grade aSAH patients with IVH. Graeb score >6.5 had higher predictive value for the poor outcome in such patients.

Objective:Iron accumulation is related to the occurrence of postmenopausal osteoporosis. Meanwhile, autophagy abnormality of bone marrow hematopoietic cells is observed in hip osteoporotic fracture. This study is performed to investigate correlation between iron accumulation induced bone loss and hematopoietic autophagy dysfunction to explore the new risk factor of osteoporosis.Methods:Male iron accumulation mice model was established by intraperitoneally injecting ferric ammonium citrate. Serum ferritin and osteogenic indicator P1NP were tested by ELISA. Bone mineral density was measured by micro-CT. Femur and tibia bone marrows were collected for hematopoietic stem and progenitor cells proportion and cell apoptosis analysis. Autolysosome formation was measured by image flow cytometry. We used conditional mouse model Atg7 flox/flox; Vav-Cre(Atg7 -/-) in which Atg7 had been genetically deleted in the hematopoietic system. Bone marrow hematopoietic stem and progenitor cells were collected for RNA sequence. micro-CT scan was conducted for Atg7 -/- femur. Results:Ferritin level of iron accumulation mice was significantly higher than control group( P<0.05). Iron accumulation inhibited P1NP and induced decreased bone mineral density( P<0.05). Iron accumulation bone marrow displayed enhanced hematopoietic stem and progenitor cells proportion( P<0.05), with more cell apoptosis( P<0.05). Hematopoietic autophagy was deteriorated in iron accumulation bone marrow. Transcriptomic profiling showed up-regulation of iron activity in Atg7 -/- mice, with increased iron homeostasis and iron membrane transporter genes, including Lcn2, Tfr2, Slc40a1(Fpn1), Steap3, and Cpox. micro-CT revealed severe bone loss and decreased bone mineral density in Atg7 -/- mice( P<0.05). Conclusion:Iron accumulation induced bone loss is related to inhibition of hematopoietic cells. Hematopoietic autophagy dysfunction is associated with bone loss.