Objectives:This study aims to evaluate the safety and efficacy of minimally invasive small inci-sion decompression surgery for patients with thoracolumbar metastatic cancer.Methods:A retrospective analy-sis was conducted on 71 cases of spinal metastases who underwent posterior decompression surgery in our de-partment from June 2017 to March 2024.There were 55 males and 16 females with an average age of 63.9±1.2 years.Among them,24 patients underwent posterior minimally invasive small incision decompression surgery,and 47 patients underwent routine posterior decompression surgery.Independent sample t-test and chi square test were used to evaluate the differences between the two groups of patients in baseline data such as age,gender,primaiy tumor pathological type and blood supply,surgical site,and preoperative embolism,as well as the differences in total blood loss,surgical time,surgical complications,postoperative allogeneic blood transfusion volume,postoperative drainage volume and drainage tube retention time,and postoperative hospital-ization time.Results:There was no significant difference in baseline data between the two groups of patients(P＜0.001).The postoperative blood loss in the minimally invasive small incision group was significantly lower than that in the conventional surgery group(P=0.003).The postoperative blood transfusion(P=0.011),total drainage volume(P=0.000),drainage tube retention time(P=0.000),and postoperative hospital stay(P=0.000)were significantly reduced in the minimally invasive small incision group compared to the conventional surgery group.The decrease in ALB on the first day after surgery in the minimally invasive group was significantly improved compared to the conventional surgery group(P=0.040).There was no significant difference in the in-cidence of dural injury,postoperative pain,and functional improvement between the two groups of patients.Conclusions:Minimally invasive small incision decompression surgery can effectively reduce surgical blood loss and allogeneic blood transfusion in patients,shorten postoperative hospital stay,and improve surgical complications and postoperative function similar to conventional surgery.

Objectives:To evaluate the safety and efficacy of intravenous injection of tranexamic acid(TXA)in reducing the perioperative blood loss in patients with lung cancer spinal metastases undergoing posterior decompression surgery.Methods:A retrospective analysis was conducted on 68 patients with lung cancer spinal metastases who underwent decompression surgery between May 2011 and August 2022,with an average age of 63.1±1.3 years.Among them,there were 42 males and 26 females.According to whether received in-travenous injection of 1g TXA after the start of anesthesia to operation within 30mins,the patients were di-vided into observation group(26 cases)and control group(46 cases).The following data were collected includ-ing general information[age,gender,American Society of Aneshesiologists physical status classification system(ASA)grade,and the use of oral anticoagulant or antiplatelet drugs],tumor related information(pathological types and systemic treatments),laboratory related information(preoperative HGB,Hct,PLT,PT.APTT,and postoperative 1d Hct),and surgical related information(decompression site,exposed segment,surgical type,sur-gical time,blood transfusion volume on the day of surgery,postoperative drainage volume and drainage tube retention time,and postoperative hospitalization status),as well as the data related to lower limb venous thrombosis during postoperative hospitalization.The total blood loss was calculated using Gross's formula.t-test,Mann Whitney U test,and chi square test were used to evaluate the differences between the two groups.Results:There were no statistically significant differences between the two groups of patients in general information and tumor-related information such as age,gender,ASA grading,pathological type,and the use of oral anticoagulant or antiplatelet drugs(P＞0.05).The preoperative HGB levels in the observation group were significantly lower than those in the control group(P=0.035),while there were no statistically significant differences in other preoperative laboratory data such as Hct,PLT,PT,and APTT(P＞0.05).There were no statistically significant differences between the two groups of patients in terms of surgical decompression site,surgical type,exposed segment,and surgical time(P＞0.05).The blood loss in the observation group was significantly lower than that in the control group[961.3.4(741.5,1810.4)mL vs 1593.5(1170.2,1936.1)mL,P=0.013].The blood transfusion volume of the observation group was significantly lower than that of the control group[400(0,800)mL vs 800(400,800)mL,P=0.024].There were no significant differences between the two groups in terms of drainage volume,drainage tube retention time,postoperative hospitalization time,and newly developed lower limb venous thrombosis after surgery(P＞0.05).Conclusions:Intravenous injection of 1g TXA after the start of anesthesia to operation within 30mins can reduce the blood loss and transfusion volume in patients with lung cancer spinal metastases undergoing posterior decompression surgery.

Objectives:To evaluate the safety and efficacy of intravenous injection of tranexamic acid(TXA)in reducing the perioperative blood loss in patients with lung cancer spinal metastases undergoing posterior decompression surgery.Methods:A retrospective analysis was conducted on 68 patients with lung cancer spinal metastases who underwent decompression surgery between May 2011 and August 2022,with an average age of 63.1±1.3 years.Among them,there were 42 males and 26 females.According to whether received in-travenous injection of 1g TXA after the start of anesthesia to operation within 30mins,the patients were di-vided into observation group(26 cases)and control group(46 cases).The following data were collected includ-ing general information[age,gender,American Society of Aneshesiologists physical status classification system(ASA)grade,and the use of oral anticoagulant or antiplatelet drugs],tumor related information(pathological types and systemic treatments),laboratory related information(preoperative HGB,Hct,PLT,PT.APTT,and postoperative 1d Hct),and surgical related information(decompression site,exposed segment,surgical type,sur-gical time,blood transfusion volume on the day of surgery,postoperative drainage volume and drainage tube retention time,and postoperative hospitalization status),as well as the data related to lower limb venous thrombosis during postoperative hospitalization.The total blood loss was calculated using Gross's formula.t-test,Mann Whitney U test,and chi square test were used to evaluate the differences between the two groups.Results:There were no statistically significant differences between the two groups of patients in general information and tumor-related information such as age,gender,ASA grading,pathological type,and the use of oral anticoagulant or antiplatelet drugs(P＞0.05).The preoperative HGB levels in the observation group were significantly lower than those in the control group(P=0.035),while there were no statistically significant differences in other preoperative laboratory data such as Hct,PLT,PT,and APTT(P＞0.05).There were no statistically significant differences between the two groups of patients in terms of surgical decompression site,surgical type,exposed segment,and surgical time(P＞0.05).The blood loss in the observation group was significantly lower than that in the control group[961.3.4(741.5,1810.4)mL vs 1593.5(1170.2,1936.1)mL,P=0.013].The blood transfusion volume of the observation group was significantly lower than that of the control group[400(0,800)mL vs 800(400,800)mL,P=0.024].There were no significant differences between the two groups in terms of drainage volume,drainage tube retention time,postoperative hospitalization time,and newly developed lower limb venous thrombosis after surgery(P＞0.05).Conclusions:Intravenous injection of 1g TXA after the start of anesthesia to operation within 30mins can reduce the blood loss and transfusion volume in patients with lung cancer spinal metastases undergoing posterior decompression surgery.

Objectives:This study aims to evaluate the safety and efficacy of minimally invasive small inci-sion decompression surgery for patients with thoracolumbar metastatic cancer.Methods:A retrospective analy-sis was conducted on 71 cases of spinal metastases who underwent posterior decompression surgery in our de-partment from June 2017 to March 2024.There were 55 males and 16 females with an average age of 63.9±1.2 years.Among them,24 patients underwent posterior minimally invasive small incision decompression surgery,and 47 patients underwent routine posterior decompression surgery.Independent sample t-test and chi square test were used to evaluate the differences between the two groups of patients in baseline data such as age,gender,primaiy tumor pathological type and blood supply,surgical site,and preoperative embolism,as well as the differences in total blood loss,surgical time,surgical complications,postoperative allogeneic blood transfusion volume,postoperative drainage volume and drainage tube retention time,and postoperative hospital-ization time.Results:There was no significant difference in baseline data between the two groups of patients(P＜0.001).The postoperative blood loss in the minimally invasive small incision group was significantly lower than that in the conventional surgery group(P=0.003).The postoperative blood transfusion(P=0.011),total drainage volume(P=0.000),drainage tube retention time(P=0.000),and postoperative hospital stay(P=0.000)were significantly reduced in the minimally invasive small incision group compared to the conventional surgery group.The decrease in ALB on the first day after surgery in the minimally invasive group was significantly improved compared to the conventional surgery group(P=0.040).There was no significant difference in the in-cidence of dural injury,postoperative pain,and functional improvement between the two groups of patients.Conclusions:Minimally invasive small incision decompression surgery can effectively reduce surgical blood loss and allogeneic blood transfusion in patients,shorten postoperative hospital stay,and improve surgical complications and postoperative function similar to conventional surgery.

Objective To understand the current situation of human brain donation in Hebei Province by analyzing the basic information of Human Brain Bank samples of Hebei Medical University in order to provide basic data support for subsequent scientific research.Methods The samples collected from the Human Brain Bank of Hebei Medical University were analyzed(from December 2019 to February 2024),including gender,age,cause of death,as well as quality control data such as postmortem delay time,pH value of cerebrospinal fluid and and RNA integrity number and result of neuropathological diagnosis.Results Until February 2024,30 human brain samples were collected and stored in the Human Brain Bank of Hebei Medical University,with a male to female ratio of 9∶1.Donors over 70 years old accounted for 53％.Cardiovascular and cerebrovascular diseases(36.67％)and nervous system diseases(23.33％)accounted for a high proportion of the death causes.The location of brain tissue donors in Shijiazhuang accounted for 90％donations,and the others were from outside the city.The postmortem delay time was relatively short,90％within 12 hours and 10％more than 12 hours.69.23％of the brain samples had RNA integrity values greater than 6.Cerebrospinal fluid pH values ranged from 5.8 to 7.5,with an average value of 6.60±0.45.Brain weights ranged from 906-1496 g,with an average value of(1210.78±197.84)g.Three apolipoprotein E(APOE)alleles were detected including five genotypes(ε2/ε3,ε2/ε4,ε3/ε3,ε3/ε4,ε4/ε4).Eleven staining methods related to neuropathological diagnosis had been established and used.A total of 12 cases were diagnosed as neurodegenerative diseases(including Alzheimer's disease,Parkinson's disease,multiple system atrophy,corticobasal degeneration and progressive supranuclear palsy,etc.),accounting for 40％donated brains.The comorbidity rate of samples over 80 years old was 100％.Conclusion The summary and analyses of the data of brain donors in the Human Brain Bank of Hebei Medical University can reflect the current situation of the construction and operation of the brain bank in Hebei Province,and it can also be more targeted to understand and identify potential donors.Our information can provide reference for the construction of brain bank and provides more reliable materials and data support for scientific research.

AIM To establish a UPLC-MS/MS method for the simultaneous content determination of hyperoside,kaempferol-3-O-rutinoside,esculin,chlorogenic acid,berberine,quercetin,rehmannioside D,palmatine,leonurin A,paeoniflorin,timosaponin BⅡand rutin in Guanhuangmu Granules.METHODS The analysis was performed on a 40℃ thermostatic Acquity UPLC HSS T3 column(100 mm×2.1 mm,1.8 μm),with the mobile phase comprising of 0.05%formic acid(containing 2 mmol/L ammonium acetate)-acetonitrile flowing at 0.3 mL/min in a gradient elution manner,and electron spray ionization source was adopted in positive and negative ion scanning.RESULTS Twelve constituents showed good linear relationships within their own ranges(r＞0.999 0),whose average recoveries were 93.46%-102.01%with the RSDs of 2.13%-3.65%.CONCLUSION This rapid,accurate,stable and sensitive method can be used for the quality control of Guanhuangmu Granules.

OBJECTIVE: To investigate the effectiveness of percutaneous pedicle screw fixation combined expandable tubular retractor in the treatment of patients with spinal metastases. METHODS: In the study, 12 patients of spinal metastases treated with percutaneous pedicle screw fixation combined expandable tubular retractor in our hospital were retrospectively reviewed between June 2017 and October 2019. Among the 12 patients, 9 were males and 3 were females; the median age was 62.5 years [(65.1±2.9) years]. The decompression segment of 7 patients was located at the lower thoracic spine (including 1 patient with incomplete paraplegia) and the decompression segment of 5 patients was located at the lumbar spine; Tomita score was 6.0±0.6. Perioperative data of the patients were reviewed. Visual analog scale (VAS score), Karnofsky score, and Eastern Cooperative Oncology Group (ECOG) score were compared before and after surgery. The patient's survival, adjuvant treatment, and internal fixation failure were observed in the follow-up period. RESULTS: All the 12 patients had a successful operation with percuta-neous pedicle screw fixation combined expandable tubular retractor. The average operative time, blood loss, and blood transfused of the patients were (247.0±14.6) min, (804.2±222.3) mL and (500.0±100.0) mL, respectively. The average amount of drainage was (240.8±79.3) mL. Drainage tubes were pulled out early postoperative [(3.2±0.3) d], allowing early mobilization. The patients discharged (7.8±0.8) d postoperative. All the patients were followed up for 6-30 months, and the average overall survival time was (13.6±2.4) months. During the follow-up period, 2 patients experienced screw displacement, the internal fixation was stable after conservative treatment and no revision surgery was performed. The VAS of the patients was 7.1±0.2 before surgery, which decreased to 2.3±0.1 and 2.8±0.4 at 3 and 6 months after surgery (P < 0.05). The Karnofsky score of the patients was 59.2±1.9 before surgery, which increased to 75.0±1.9 and 74.2±3.1 at 3 and 6 months after surgery (P < 0.05). The ECOG of the patients was 2.3±0.2 before surgery, which decreased to 1.7±0.1 and 1.7±0.2 at 3 and 6 months after surgery (P < 0.05). CONCLUSION For selected patients with spinal metastases, minimally invasive surgical treatment of spinal metastases (percutaneous pedicle screw internal fixation combined with expandable tubular retractor) can effectively relieve the clinical symptoms and improve the quality of life, with satisfactory clinical outcome.
Male ; Female ; Humans ; Middle Aged ; Pedicle Screws ; Treatment Outcome ; Spinal Neoplasms/surgery* ; Quality of Life ; Retrospective Studies ; Fracture Fixation, Internal ; Lumbar Vertebrae/surgery* ; Thoracic Vertebrae/surgery* ; Spinal Fusion ; Spinal Fractures/surgery*

Objective:To investigate the research competence and training needs of young general practitioners (GPs) in Guangdong province.Methods:A questionnaire survey on research competence and training needs was conducted in December 2020 among GPs from one selected economically developed area and one selected less developed area in Guangdong Province.Results:A total of 172 young GPs were included in the study. The survey showed that 75.6% (130/172) and 76.2% (131/172) respondents thought that participation in scientific research and research literacy were important, but only 11.9% (21/172) had participated in research project, among whom 81.0% (17/21) undertook data collection. The basic score of evidence-based medicine was 24.00(21.00, 28.00), and 55.2% respondents (95/172) were able search literature when they encountered problems and 43.7% (77/172) used domestic databases. The self-assessment score of scientific research ability was 14.00(12.00, 17.00), the score of research training needs was 41.00(31.00, 49.50), and the scores of "scientific research topic selection, scientific research design, statistical analysis, organization and implementation, and paper writing" were generally high. There was significant difference in the total scores of the two scales of evidence-based medicine basis and scientific research ability self-assessment among respondents with different educational background ( P<0.05). The basic score of evidence-based medicine of orientation-trained GPs was higher than that of non-orientation-tranined GPs; the average score of research training needs in female respondents was higher than that in males ( P<0.05). Conclusions:The study suggests that young general practitioners have inadequate experience in research participation and organization, and low self-ratings of research competence, but generally high personal efficacy in research. It is recommended that appropriate training content and well-organized intervention should be developed for young GPs.

Objective: To investigate the application values of immunophenotypic analysis and molecular genetics in the diagnosis of acute promyelocytic leukemia (APL) . Methods: The retrospective analyses of flow cytometric (FCM) immunophenotypic anyalysis, chromosome karyotype and chromosome fluorescence in situ hybridization (FISH) of 798 outpatient or hospitalization APL patients referred to our hospital between May 2012 and December 2017 were performed to further study the application values of FCM and molecular genetics in the diagnosis of APL. Results: The sensitivity and specificity of FCM were 91.9% and 98.7% respectively. The typical characteristic immunophenotype for APL was as of follows: a high SSC, absence of expression of cluster differntiation (CD) CD34 and HLA-DR, and expression or stronger expression of CD33, consistent expression of CD13, CD9, CD123, expression of CD56, CD7, CD2 (sometimes) . The rest 10% of the cases harbored atypical APL phenotypes, generally accompanied by CD34 and/or HLA-DR expression, decreased SSC and often accompanied by CD2 expression, it was difficult to definitively diagnose APL by this FCM phenotype, and their diagnoses depended on the results of genetics or molecular biology tests. Compared with normal individuals, complex karyotypes APL with t (15;17) translocation, other variant translocations and variant t (11;17) , t (5;17) had no significant differences in terms of their FCM phenotypes. Conclusions FCM could rapidly and effectively diagnose APL. Despite the fact that complex karyotypes with various additional chromosomal abnormalities were detected in approximately one third of APL cases in addition to the pathognomonic t (15;17) (q22;q21) , they had no observable impact on the overall immunophenotype. Molecular and genetic criteria were the golden criteria for the diagnosis of APL. About 10% of immunophenotyping cases relied on molecular genetics for diagnosis.

Background: Mental stress-induced myocardial ischemia (MSIMI) is closely associated with adverse cardiac events in patients with coronary artery disease (CAD) and we aimed to determine whether biomarkers and blood pressure could be potential predictors of MSIMI. Methods: This study enrolled 82 patients with documented CAD between June 1, 2017 and November 9, 2017. Patient blood samples were obtained at resting period and at the end of mental arithmetic. Then, patients were assigned to MSIMI positive group and MSIMI negative group. The main statistical methods included linear regression, receiver operating characteristic (ROC) curves, and logistic regression. Results: Patients with CAD with MSIMI had significantly greater median resting N-terminal pro-brain natriuretic peptide (NT-proBNP, 141.02 [45.85–202.76] pg/mL vs. 57.95 [27.06–117.64] pg/mL; Z = -2.23, P = 0.03) and mean systolic blood pressure (SBP) (145.56 ± 16.87 mmHg vs. 134.92 ± 18.16 mmHg, Z = -2.13, P = 0.04) when compared with those without MSIMI. After 5-min mental stress task, those who developed MSIMI presented higher elevation of median post-stressor high sensitivity cardiac troponin I (hs-cTnI, 0.020 [0.009–0.100] ng/mL vs. 0.009 [0.009–0.010] ng/mL; Z = -2.45, P = 0.01), post-stressor NT-proBNP (138.96 [39.93–201.56] pg/mL vs. 61.55 [25.66–86.50] pg/mL; Z = -2.15, P = 0.03) compared with those without MSIMI. Using the ROC curves, and after the adjustment for basic characteristics, the multiple logistic regression analysis showed that patients presenting a post-stressor hs-cTnI ≥ 0.015 ng/mL had seven-fold increase in the risk of developing MSIMI (odds ratio [OR]: 7.09; 95% confidence interval [CI]: 1.65–30.48; P = 0.009), a rest NT-proBNP ≥ 80.51 pg/mL had nearly eight-fold increase (OR: 7.85; 95% CI: 1.51–40.82; P = 0.014), a post-stressor NT-proBNP ≥ 98.80 pg/mL had 35-fold increase (OR: 34.96; 95% CI: 3.72– 328.50; P = 0.002), a rest SBP ≥ 129.50 mmHg had 11-fold increase (OR: 11.42; 95% CI: 1.21–108.17; P = 0.034). Conclusions The present study shows that CAD patients with higher hs-cTnI level, and/or greater NT-proBNP and/or SBP are at higher risk of suffering from MSIMI when compared with those without MSIMI, indicating that hs-cTnI, NT-proBNP, SBP might be potential predictors of MSIMI.