Objective To investigate the related risk factors of bone cement leakage after percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) of osteoporotic vertebral compression fracture.Methods A retrospective study was made on 108 patients (114 vertebrae) undergone PVP and PKP between January 2008 and June 2014.There were 32 patients with cement leakage and 76 patients without cement leakage.Between-group differences were analyzed in terms of gender,age,number of one-time treated vertebrae,anatomic dissection,surgical procedures (PKP or PVP),integrity of the posterior vertebral wall,puncture approaches (unilateral or bilateral),technical level of surgeons and bone cement volume.Results Bone cement leakage occurred in 36 vertebrae (with the proportion of 31.6％).Cement leakage was associated with number of one-time treated vertebrae,surgical procedures,fractured condition,and bone cement volume (P ＜ 0.05),but not with gender,age,anatomical site of injury,puncture approaches,and technical level of surgeons (P ＞ 0.05).Conclusions Bone cement leakage after PKP or PVP correlated with number of vertebrae with one-time therapy,surgical procedures,fractured condition,and volume of bone cement.A good master of technical procedures and indications and suitable injection of high viscosity bone cement can help reduce the incidence of cement leakage.

Objective To investigate the characteristic of lipoprotein(a)[Lp(a)]in different phases of chronic kidney disease (CKD ),to provide the basis for clinical prevention and treatment of CKD.Methods 200 patients with CKD in the Republic Hospital of Shifang were collected as study group,including 5 phases (every phase had 40 cases),and 100 healthy people were selected as control group.Measured the serum Lp(a)of both study and control group,analyzed the correlations between Lp(a)and different phase of CKD.All data were analyzed by SPSS version 17.0.The significant level was established at 0.05.Results CKD1 [(146.0 ±95.5)mg/L]and all CKD group [(231.5 ±133.2)mg/L]had higher level of serum Lp(a)than the control group [(115.5 ±70.2)mg/L] (Z=-2.800,P<0.05 and Z=-7.922,P<0.05).CKD3 had higher Lp(a)level than CKD2(Z=-2.069,P<0.05 ),while there were no significant differences between each of the other two groups.CKD4 -5 [(325 .0 ± 194.7)mg/L]also had higher Lp(a)level than CKD1 -3 [(182.0 ±110.5)mg/L](Z=-4.439,P<0.05). Conclusion Patients with CKD always have high level of serum Lp(a),which have been slowly increased since CKD1 ,meanwhile the level of Lp(a)may have a certain correlation with the stage of CKD development,since Lp(a) is an important promoting factor in the progress of CKD.

Objective:To investigate the role of down-regulating serine racemase (SRR) in alleviating the β-amyloid peptide (Aβ) induced neurotoxicity and synaptic damage and possible mechanism in PC12 cells.Methods:(1) PC12 cells cultured in vitro were divided into 0, 20, 40 and 80 μmol/L Aβ 25-35 treatment groups; they were treated with 0, 20, 40 and 80 μmol/L Aβ 25-35 for 24 h, respectively; cell counting kit (CCK)-8 was used to detect the survival rate of cells in each group, and Western blotting was used to detect the SRR protein expression. PC12 cells were treated with 40 μmol/L Aβ 25-35 for 0, 12, 24 and 48 h, respectively; cell survival and SRR protein expression were detected by CCK-8 and Western blotting, respectively. (2) PC12 cells were divided into control group, nonsense sequence group, SRR small interfering RNA (siRNA) group 1, SRR siRNA group 2, and SRR siRNA group 3; cells in the later three groups were transfected with SRR nonsense sequence or different SRR siRNA sequences, respectively; 48 h after that, Western blotting was used to detect the SRR protein expression of cells in each group, and SRR siRNA with best effect was selected for subsequent experiments. (3) PC12 cells were divided into control group, AD group, AD+nonsense sequence group, and AD+SRR siRNA group; cells in the latter two groups were transfected with nonsense sequence or SRR siRNA for 48 h, respectively; cells in the latter three groups were added 40 μmol/L Aβ 25-35, and cells in the control group were added same amount of solvent; 24 h after treatment, the SRR protein expression was detected by Western blotting, cell survival was detected by CCK-8, cell apoptosis was detected by Hoechst 33258 fluorescent staining, Caspase 3 activity was detected by enzyme linked immunosorbent assay, and the expressions of activated Caspase 3, N-methyl- D aspartate (NMDA) receptor-associated proteins and postsynaptic dense protein 95 (PSD95) were detected by Western blotting. Results:(1) The survival rate of cells in 0, 20, 40 and 80 μmol/L Aβ 25-35 treatment groups was successively decreased and the SRR protein expression was successively increased, with significant differences ( P<0.05); PC12 cells treated with 40 μmol/L Aβ 25-35 for 0, 12, 24 and 48 h had successively decreased survival rate and successively increased SRR protein expression, with significant differences ( P<0.05). (2) The SRR protein expressions in the SRR siRNA group 1, SRR siRNA group 2 and SRR siRNA3 group 3 were significantly decreased as compared with those in the control group and nonsense sequence group ( P<0.05), and the decrease in the SRR siRNA group 2 was the most obvious. (3) As compared with the control group, the cells in the AD group had significantly increased SRR protein expression and apoptosis rate, statistically decreased cell survival rate, significantly increased Caspase 3 activity and activated Caspase 3 protein expression, significantly increased protein expressions of NMDA receptor 2A (NMDAR2A) and NMDA receptor 2B(NMDAR2B), and statistically decreased PSD95 protein expression ( P<0.05); as compared with cells in the AD group, cells in the AD+SRR siRNA group had significantly decreased SRR protein expression and apoptosis rate, statistically increased cell survival rate, significantly decreased Caspase 3 activity and activated Caspase 3 protein expression, significantly decreased NMDAR2A protein expression, and statistically increased PSD95 protein expression ( P<0.05). Conclusion:Down-regulation of SRR expression can reduce the NMDAR2A protein expression, alleviate the over-activation of NMDA receptor, reduce the cell apoptosis, improve cell survival rate, protect nerve cells, increase PSD95 protein expression, and alleviate synaptic damage in PC12 cells.

Objective To observe the value of spectral CT parameters for evaluating T staging of advanced gastric cancer(AGC).Methods Totally 155 AGC patients were collected and divided into T2 stage(n=40)and T3/4a stage(n=115)according to postoperative pathology.CT values,water concentration(WC)and iodine concentration(IC)of AGC lesions on 40-140 keV arteriovenous phase single energy level images were measured,and the standardized IC(nIC)and spectral curve slopes k1 and k2 were calculated.Clinical variables and spectral quantitative parameters were compared between groups,and receiver operating characteristic curve was plotted,the area under the curve(AUC)was calculated to evaluate the value of each parameter and model for identifying T2 and T3/4a stage AGC.Results Tumor thickness,proportion of low differentiation degree,CT100kev,CT140kev,and WC values in T3/4a group were all significantly higher than those in T2 group(all P＜0.05).CT140keV of AGC lesions on venous phase images presented the highest discrimination efficacy among single parameters,with AUC of 0.782.AUC of clinical-arterial phase-venous phase model was 0.848,higher than that of clinical model and arterial phase model alone(both P＜0.05)but not significantly different compared with AUC of venous phase model(P＞0.05).Conclusion Spectral CT quantitative parameters,especially venous phase parameters could be used to effectively identify T stage of AGC.Multi-parameter combined models had higher diagnostic value.

Objective Mitochondrial reactive oxygen species(mtROS)could cause damage to pancreatic β-cells,rendering them susceptible to oxidative damage.Hence,investigating the potential of the mitochondria-targeted antioxidant(Mito-TEMPO)to protect pancreatic β-cells from ferroptosis by mitigating lipid peroxidation becomes crucial. Methods MIN6 cells were cultured in vitro with 100 μmol/L sodium palmitate(SP)to simulate diabetes.FerroOrange was utilized for the detection of Fe2+fluorescence staining,BODIPY581/591C11 for lipid reactive oxygen species,and MitoSox-Red for mtROS.Alterations in mitophagy levels were assessed through the co-localization of lysosomal and mitochondrial fluorescence.Western blotting was employed to quantify protein levels of Acsl4,GPX4,FSP1,FE,PINK1,Parkin,TOMM20,P62,and LC3.Subsequently,interventions were implemented using Mito-TEMPO and Carbonyl cyanide 3-chlorophenylhydrazone(CCCP)to observe changes in ferroptosis and mitophagy within MIN6 cells. Results We found that SP induced a dose-dependent increase in Fe2+and lipid ROS in MIN6 cells while decreasing the expression levels of GPX4 and FSP1 proteins.Through bioinformatics analysis,it has been uncovered that mitophagy assumes a crucial role within the ferroptosis pathway associated with diabetes.Additionally,SP decreased the expression of mitophagy-related proteins PINK1 and Parkin,leading to mtROS overproduction.Conversely,Mito-TEMPO effectively eliminated mtROS while activating the mitophagy pathways involving PINK1 and Parkin,thereby reducing the occurrence of ferroptosis in MIN6 cells.CCCP also demonstrated efficacy in reducing ferroptosis in MIN6 cells. Conclusion In summary,Mito-TEMPO proved effective in attenuating mtROS production and initiating mitophagy pathways mediated by PINK1 and Parkin in MIN6 cells.Consequently,this decreased iron overload and lipid peroxidation,ultimately safeguarding the cells from ferroptosis.

Objective To observe the value of spectral CT multi-parameter imaging for preoperative predicting lymph node metastasis(LNM)of gastric cancer.Methods Totally 136 patients with gastric adenocarcinoma were retrospectively enrolled.The patients were further divided into LNM group(n=74)and non-LNM group(n=62)according to postoperative pathological findings of lymph nodes status.Clinical data,conventional CT findings and spectral CT parameters were compared between groups.Factors being significant different between groups were included in multivariate logistic regression analysis to screen independent predictors of gastric cancer LNM.Clinical+conventional CT model(model 1),spectrum CT model(model 2)and combined model(model 3)were constructed based on the above independent predictors,respectively.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of each model for preoperative predicting LNM of gastric cancer.Results CT-N stage,CT-T stage,70,100 and 140 keV CT valuestumor at arterial phase(AP),arterial enhancement fraction(AEF)and normalized iodine concentration at venous phase(NICVP)were all independent predictors of gastric cancer LNM(all P＜0.05).AUC of model 3 was 0.846,higher than that of model 1 and model 2(AUC=0.767,0.774,Z=-0.368,-2.373,both P＜0.05)for preoperative predicting LNM of gastric cancer,while the latter two were not significantly different(Z=-0.152,P=0.879).Conclusion Spectral CT multi-parameter imaging could effectively predict LNM of gastric cancer preoperatively.

【Objective】 To investigate the effect of autologous blood transfusion(ABT) drainage system and simple drainage(using drainage bags) on the prognosis of patients after lumbar surgery. 【Methods】 The patients admitted to the Department of Orthopedics of our hospital from August 2018 to September 2020 who underwent posterior open lumbar internal fixation and fusion were divided into two groups according to different drainage methods adopted after surgery: 50 patients were randomly selected from the patients who received postoperative ABT system for drainage as ABT group, and 50 patients were randomly selected from the patients who received postoperative drainage by drainage bag as simple drainage bgroup(the control group). The postoperative drainage volume, actual postoperative drainage, total dominant blood loss, total autologous blood transfusion volume, as well as the postoperative anemia indexes, infection indexes and albumin levels in d1, d3 and d7 of the 2 groups were retrospectively analyzed. 【Results】 The gender, age, operation duration and operation segment of the 2 groups were comparable (P>0.05), and preoperative Hb, Hct, ALB, WBC, NE%, intraoperative blood loss, intraoperative autologous blood transfusion volume and actual postoperative drainage volume were similar (P>0.05). There were no significant differences in Hb, Hct, ALB, WBC, NE% and CRP in postoperative d1, d3 and d7, as well as in preoperative and postoperative Hb, Hct and ALB, and in postoperative and preoperative WBC, NE% and CRP (P>0.05). The postoperative drainage volume (mL) and total dominant blood loss (mL) in ABT group and the control group were 554.40±176.82 vs 337.80±102.43, and 1 048.40±282.87 vs 791.80±277.02, respectively (P<0.05). 【Conclusion】 The use of ABT drainage system after lumbar surgery increased the drainage volume compared with simple drainage, but the improvement of anemia, albumin and infection was not obvious. ABT system should not be used routinely for drainage after lumbar surgery.