Objective To investigate the effects on IL-6 and PGE2 expression in wear-particles-induced osteoblast cells by blocking calcium phosphatase (Cn)/ activated T nuclear factor (NFAT) pathway. Methods Fetal Sprague-Dawley rats were used in this study. Osteoblast were prepared from the calvariae of rats . Osteoblast cells were incubated in four group according to different supplementation:(1) neither Ti particles nor 11R-VIVIT (Control group), (2) only Ti particles (Ti group), (3) both Ti particles and 11R-VIVIT (Ti/VIVIT group), and (4) only 11R-VIVIT (VIVIT group). Cells were incubated for 96 hours and the expression of NFATc1 protein was detected by western blot. The expression of IL-6 and PGE2 in liquid supernatant of osteoblast were detected at 6, 24 and 96 hours by ELISA. Results The expression of NFATc1 in the Ti group was higher than that in the Control group (P < 0.01), but in Ti/VIVIT group that was significantly lower than in the titanium particle group (P < 0.01). The IL-6 and PGE2 expression in the supernatant of the Ti group were significantly increased than those in the control group (P < 0.05). The IL-6 and PGE2 in the Ti/VIVIT group were significantly lower than that in the Ti group (P < 0.05). Conclusions 11R-VIVIT peptide specific blockade of Cn/NFAT signaling pathway significantly inhibited IL-6 and PGE2 of osteoblast cells induced by titanium particles.

Objective: : To analyze the anatomical location of the ureter in relation to lateral lumbar interbody fusion and evaluate the potential risk of ureteral injury. Methods: : One hundred eight patients who performed contrast-enhanced computed tomographic scans were enrolled in this study. The location of the ureter from L2-L3 to L4-L5 was evaluated. The distances between the ureter and psoas muscle, intervertebral disc, and retroperitoneal vessels were also recorded bilaterally. Results: : Over 30% of the ureters were close to the working corridor of extreme lumbar interbody fusion at L2-L3. Most of the ureters were close to working corridor of oblique lumbar interbody fusion, especially at L4-L5. The distance from the ureter to the great vessels on the left side was significantly narrowing from L2-L3 to L4-L5 (28.8±9.5 mm, 22.0±8.0 mm, 15.5±8.4 mm), and it was significantly larger than that on the right side (12.3±6.1 mm, 7.4±5.7 mm, 5.4±4.4 mm). Conclusion : Our findings indicate that the location of the ureter varies widely among individuals. To avoid unexpected damage to the ureter, it is imperative to directly visualize it and verify the ureter is not in the surgical pathway during lateral lumbar interbody fusion.

Objective:To evaluate the clinical efficacy and safety of oral mifepristone (10 mg/day) versus placebo in the preoperative treatment of uterine fibroids.Methods:This study was a multi-center, randomized, double-blind, placebo, parallel controlled trial. A total of 132 patients with uterine fibroids were randomly divided into study group and control group, with 66 cases in each group. The patients in the study group orally took 1 tablet/day of mifepristone (dose of 10 mg/tablet), the patients in the control group orally took 1 tablet/day of placebo, and both groups were treated for 3 months. The primary efficacy evaluation indicators were the change rate of maximum fibroid volume; the secondary efficacy evaluation indicators included amenorrhea rate, improvement of subjective symptoms and anemia; the safety evaluation indicators included the analysis of adverse events and changes in laboratory biochemical indicators.Results:At the end of treatment, the maximum leiomyoma volume was reduced by 25.97% (95% CI: -34.79%--15.95%) in the study group and reduced by 1.51% (95% CI: -13.03%-11.54%) in the control group. The change rate of the maximum leiomyoma volume before and after treatment in the study group was significantly greater than that in the control group, and the difference in the change rate of the maximum leiomyoma volume between the two groups was -24.84% (95% CI: -36.56%--10.94%), which was much higher than the 10% superiority threshold goal set by this study within the 95% CI interval. At the end of treatment, the complete amenorrhea rate [84% (52/62)], dysmenorrhea elimination rate [98% (61/62)], and menstrual blood loss disappearance rate [87% (54/62)] in the study group were significantly higher than those in the control group (all P<0.05). At the end of treatment, the mean hemoglobin [(131±13) g/L], red blood cell count [(4.5±0.4)×10 12/L] and hematocrit (0.39±0.03) in the study group were significantly increased compared with the baseline, and the differences had statistical significance (all P<0.05); after treatment, the differences in the above three indicators between the two groups had statistical significance (all P<0.01). The serum estradiol level in the study group was significantly lower than that in the control group at the end of treatment, and the difference was statistically significant ( P<0.01). There were no significant differences in follicle-stimulating hormone and cortisol levels before and after treatment between the two groups ( P>0.05). The overall incidences of any adverse event were not significantly different between the two groups (all P>0.05). Abdominal pain was the most common adverse event in the study group [9% (6/65)], but the incidence was not significantly increased compared with the control group [3% (2/64); P>0.05]. Conclusion:Compared with placebo, oral mifepristone 10 mg/day is significantly superior to placebo in reducing the size of uterine fibroids and improving anemia, without significant adverse reactions, and could be used as a drug treatment for patients with of uterine fibroids before surgery.

Objective: The related literatures on supra acetabular spinal pedicle screws and a subcutaneous connecting rod (INFIX) in recent years was reviewed, and the overall prognosis was analyzed by meta analysis. Methods: literatures were obtained by searching the PubMed, Google Scholar, and Wanfang Full-text Database according to the criteria of inclusion and exclusion. The two members independently screened the qualified literature, evaluated the quality of the literature and extracted the data information. The data information includes demographic and surgical information, main results and secondary results. A large number of data in the selected articles were analyzed and summarized by meta. Results: A total of 20 studies were included, including 567 patients. The clinical results were evaluated by Majeed standard in 6 articles, of which 5 articles described the number of excellent and general prognosis, including 185 patients. The excellent and good prognosis rate was 91% (95%CI: 80%-103%) by meta analysis. The general prognosis rate was 9% (95%CI: 3%-14%). Among the prognostic complications, the incidence of lateral femoral cutaneous nerve damage and heterotopic ossification was higher, and the incidence of other complications was less than 5%. There were 13 articles about the complications of ectopic ossification, of which 1 did not mention the specific number of asymptomatic heterotopic ossification, and the remaining 12 included 424 cases, including 132 cases of ectopic ossification. The incidence of ectopic ossification was 26% (95%CI: 11%-40%). Among the 567 cases, obvious symptoms of lateral femoral cutaneous nerve injury were reported. The patients with lateral femoral cutaneous nerve injury accounted for 25% (95%CI: 17%-32%), and the temporary nerve damage was found in 124 cases. The incidence of temporary agitation after subgroup analysis was 21% (95%CI: 14%-28%). Five articles mentioned the manifestations of postoperative femoral nerve damage, including 10 patients, the incidence of femoral nerve damage was 3% (95%CI: -1%-6%). A total of 18 articles on surgical site-related infections were reported, including 534 patients, of which 15 were infected, with an infection rate of 3% (95%CI: 2%-4%). 19 articles clearly reported the failure of internal fixation after INIFX operation, including 32 patients who needed reoperation for different reasons. The failure of internal fixation was 3% (95%CI: 2%-4%). A total of 585 cases of fracture non-prognosis data were reported, of which 473 cases were cured and 3 cases had bone nonunion. The non-union rate of fracture was 3% (95%CI: 1%-5%). Conclusion After InFix pelvic surgery, the patient's clinical follow-up prognosis score and imaging findings showed that the postoperative recovery was good, and the new technique also avoided the inconvenience and postoperative complications caused by many traditional pelvic external fixation techniques. However, it was also found that the lateral femoral cutaneous nerve damage and the incidence of heterotopic ossification were also higher.