Osteoporotic vertebral compression fractures(OVCFs)are common orthopedic conditions that can lead to spinal pain and deformity,which greatly affects the quality of life of patients.Currently,there are various treatment methods for OVCFs,but there is still a lack of standards for optimal treatment modalities.Therefore,this article introduces the current treatment methods and character-istics of epidemiology for OVCFs,in order to improve the awareness of this disease among clinicians and provide a reference for select-ing more appropriate treatment regimens.Conservative treatment measures,such as bracing and analgesia,are the basic treatment mea-sures for OVCFs,and anti-osteoporosis drugs play a crucial role in management.Minimally invasive procedures,including percutane-ous vertebroplasty and percutaneous balloon kyphoplasty,remain the primary surgical interventions,and traditional open surgeries are also an important part of treatment,such as anterior spinal fusion,combined anterior and posterior spinal fusion,posterior spinal fusion with three-column osteotomy,and posterior spinal fusion with vertebroplasty.Furthermore,surgeons should focus on the accumulation of related surgical techniques and skills during surgery to effectively address the challenges and complications associated with surgical interventions.Finally,scientific and appropriate treatment methods should be selected for patients,in order to improve long-term treat-ment outcomes and increase the degree of satisfaction among pa-tients.

Objective To investigate the clinical effect of free electromyography(fEMG)monitoring as-sisted unilateral biportal endoscopy(UBE)in the treatment of lumbar disc herniation.Methods Forty pa-tients with lumbar disc herniation were included.The UBE lumbar nucleus pulposus resection under general anesthesia was performed.The operation whole process was completed under the fEMG monitor.The recorded potential was displayed on the monitor screen and the myoelectrical activity was played through speaker.The treatment effect was evaluated by the Visual Analogue Scale(VAS)score and Oswestry Disability Index(ODI).Results All 40 patients completed the surgery successfully,and the postoperative symptoms were im-proved significantly.The VAS scores before operation and in postoperative 3 months were 7(6,8)points and 0(0,1)points respectively,and the difference between the two time points was statistically significant(P＜0.05).The ODI before operation and in postoperative 3 months were(58.30±11.58)and(13.28±5.20)re-spectively,and the difference between the two time points also was statistically significant(P＜0.05).The VAS score and ODI in postoperative 1 year were 1(0,1)points and(13.13±0.40)respectively,showing sta-tistically significant difference compared with before surgery(P＜0.05),but there was no statistically signifi-cant difference compared with postoperative 3 months(P＞0.05).There were 8 cases developing the abnor-mal EMG changes such as spike,burst or tonic fEMG during surgery,with an incidence rate of 20％.After surgery in 8 cases,7 cases had burning radiculalgia and paresthesia of lower extremity,and 1 case had no obvi-ous neuralgia,with a false positive rate of 12.5％.The patients without abnormal fEMG reaction during sur-gery had no significant postoperative neuralgia,and the false negative rate was zero.Conclusion fEMG moni-toring assisted UBE under general anesthesia is a safe and easy method for the treatment of lumbar disc herni-ation.

Objective:To explore the efficacy of Qingjin Huatan Decoction combined with conventional Western medicine for the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with phlegm-heat obstructing lung syndrome.Methods:A randomized controlled trial was conducted. Totally 90 hospitalized patients with AECOPD phlegm-heat obstructing lung syndrome in the respiratory department of Shunyi Hospital, Beijing Traditional Chinese Medicine Hospital from January 2023 to June 2024 were selected as the observation subjects. According to the simplified randomization method (single-double number method), the patients were divided into two groups, with 45 cases in each group. The conventional Western medicine group was given conventional Western medicine treatment, and the combined Chinese materia medica group was given Qingjin Huatan Decoction on the basis of the conventional Western medicine group. The treatment for both groups lasted for 7 d. TCM symptoms were scored before and after treatment; FEV 1 and FVC were detected by pulmonary function analyzer, PaO 2, PaCO 2, PaO 2/FiO 2 were detected by blood gas biochemical analyzer, CRP and PCT were detected by ELISA, and white blood cell count (WBC) was detected by automatic blood cell analyzer. Adverse reactions were recorded, and the clinical efficacy was evaluated. Results:The total effective rate was 93.33% (42/45) in the combined Chinese materia medica group and 77.78% (35/45) in the conventional Western medicine group, with statistical significance ( χ2=4.41, P=0.036). After treatment, the scores of cough, wheezing, chest tightness and shortness of breath and fever and the total score in the combined Chinese materia medica group were lower than those in the conventional Western medicine group ( t=4.83, 2.26, 5.36, 10.43, 5.27,respectively, P<0.01 or P<0.05); the levels of FEV 1 and FVC in the combined Chinese materia medica group were higher than those in the conventional Western medicine group ( t=3.03, 2.64, respectively, P<0.01); the levels of PaO 2 and PaO 2/FiO 2 in the combined Chinese materia medica group were higher than those in the conventional Western medicine group ( t=4.83, 5.36, P<0.01), while the level of PaCO 2 in the combined Chinese materia medica group was lower than that in the conventional Western medicine group ( t=2.26, P<0.05); the levels of CRP, PCT and WBC in the combined Chinese materia medica group were lower than those in the conventional western medicine group ( t=10.53, 11.29 and 2.59, respectively, P<0.01 or P<0.05). During the treatment, the incidence of adverse reactions was 6.67% (3/45) in the combined Chinese materia medica and 8.89% (4/45) in the conventional Western medicine group, without statistical significance ( χ2=0.16, P=0.694). Conclusion:Qingjin Huatan Decoction can effectively improve the lung function and blood gas indicators of AECOPD with phlegm-heat obstructing lung syndrome, and relieve the inflammation, with safety and effectiveness.

Objective:To investigate the application of transoral robotic thyroidectomy (TORT) in overweight patients.Methods:Clinical data of 109 thyroid tumor patients who underwent TORT at 960th Hospital of People’s Liberation Army from May. 2020 to Aug. 2023 were retrospectively collected and analyzed. After excluding 10 patients who underwent prophylactic lateral neck dissection, a total of 99 patients were included in this study. According to the World Health Organization (WHO) guidelines, which define people with BMI:25-29.9 kg/m 2 as overweight, we divided the 99 patients into normal weight group (n=69) and overweight group (n=30) . To make the baseline data consistent between the two groups and ensure comparability, 20 matched pairs were generated using a 1∶1 propensity score matching (PSM) method, considering four clinicopathologic factors: age, gender, diameter of tumor and operation scope. In the normal-weight group, there were 18 females and 2 males, aged (32.82±9.51) years (range: 17-53 years) , and there exhibited 18 females and 2 males in the overweight group, aged (35.14±10.63) years (range: 18-55 years) . Results:All patients successfully underwent the operation without conversions to open surgery. After matching, both groups had 2 cases of thyroid adenoma and 18 cases of papillary thyroid carcinoma ( P=1) , with no statistically significant difference in the surgical scope between the two groups ( P=0.376) . There was no statistically significant difference in the mean tumor diameter between the normal-weight group and the overweight group (5.38±1.79 mm vs. 5.61±3.32 mm, P=0.575) . All malignant tumor cases in both groups were classified as T1 stage, and there was no statistically significant difference in N stage ( P=0.186) . All patients with malignant tumors underwent central lymph node dissection, there was no significant difference in the number of central lymph nodes dissected ( P=0.623) and metastatic lymph nodes ( P=0.109) between the two groups. There were no statistically significant differences in operative duration (217.53±62.83 min vs. 220.67±73.73 min, P=0.808) , median postoperative hospital stay [6 (6,7.75) days vs. 6 (6,7) days, P=0.682], or 24-hour drainage volume (78.52±30.49 mL vs. 68.23±29.11 mL, P=0.180) between the normal-weight group and the overweight group. There was no permanent hypoparathyroidism, postoperative hemorrhage, lymphatic fistula, mental nerve injury, postoperative infection in both groups. In both groups, there occurred one case of transient hypoparathyroidism. As for other complications, 1 case of temporary recurrent laryngeal nerve injury and oral tearing occurred in the overweight group, while the normal-weight group had 1 case of skin scald. Conclusions:Among patients who underwent TORT, the overweight group exhibited comparable surgical outcomes and postoperative complications to those in the normal-weight group. TORT is a safe and feasible surgical option for overweight patients, which provides more surgical options for this patient population.

AIM:To investigate the effects of glutathione-S-transferase(GST)gene polymorphism on the concentration of 6-thioguanine nucleotides(6-TGN),an active metabolite of azathioprine(AZA),in patients with inflammatory bowel disease(IBD),in order to provide reference for the optimization of AZA treatment in patients.METHODS:The clini-cal data of patients with IBD treated by AZA were collected prospectively,the genotypes of GST-A1,GST-M1,GST-P1 and GST-T1 were detected by tar-geted sequencing of multiplex PCR combined with high-throughput sequencing technology before ad-ministration,and the steady-state trough concen-trations of 6-TGN in patients' red blood cells were determined by HPLC.Statistical analysis was carried out by SPSS 26.0 software.RESULTS:A total of 90 patients were included in this study.The alleles fre-quencies of GST-A1,GST-M1,GST-P1 and GST-T1 were consistent with Hardy-Weinberg equilibrium law.Logistic regression analysis showed that carry-ing GST-A1 mutant gene was an independent risk factor for the increase of trough concentration of 6-TGN(low concentration OR=17.50,P=0.030;high concentration OR=3.60,P=0.033),while the gene polymorphism of GST-M1,GST-P1,GST-T1 had no significant correlation with the concentration of 6-TGN(P＞0.05).CONCLUSION:The gene polymor-phism of GST-A1 may affect the concentration of 6-TGN,an active metabolite of AZA,and detection of GST-A1 genotype before AZA treatment will contrib-ute to clinical individualized medication.

Objective:To investigate the application of transoral robotic thyroidectomy (TORT) in overweight patients.Methods:Clinical data of 109 thyroid tumor patients who underwent TORT at 960th Hospital of People’s Liberation Army from May. 2020 to Aug. 2023 were retrospectively collected and analyzed. After excluding 10 patients who underwent prophylactic lateral neck dissection, a total of 99 patients were included in this study. According to the World Health Organization (WHO) guidelines, which define people with BMI:25-29.9 kg/m 2 as overweight, we divided the 99 patients into normal weight group (n=69) and overweight group (n=30) . To make the baseline data consistent between the two groups and ensure comparability, 20 matched pairs were generated using a 1∶1 propensity score matching (PSM) method, considering four clinicopathologic factors: age, gender, diameter of tumor and operation scope. In the normal-weight group, there were 18 females and 2 males, aged (32.82±9.51) years (range: 17-53 years) , and there exhibited 18 females and 2 males in the overweight group, aged (35.14±10.63) years (range: 18-55 years) . Results:All patients successfully underwent the operation without conversions to open surgery. After matching, both groups had 2 cases of thyroid adenoma and 18 cases of papillary thyroid carcinoma ( P=1) , with no statistically significant difference in the surgical scope between the two groups ( P=0.376) . There was no statistically significant difference in the mean tumor diameter between the normal-weight group and the overweight group (5.38±1.79 mm vs. 5.61±3.32 mm, P=0.575) . All malignant tumor cases in both groups were classified as T1 stage, and there was no statistically significant difference in N stage ( P=0.186) . All patients with malignant tumors underwent central lymph node dissection, there was no significant difference in the number of central lymph nodes dissected ( P=0.623) and metastatic lymph nodes ( P=0.109) between the two groups. There were no statistically significant differences in operative duration (217.53±62.83 min vs. 220.67±73.73 min, P=0.808) , median postoperative hospital stay [6 (6,7.75) days vs. 6 (6,7) days, P=0.682], or 24-hour drainage volume (78.52±30.49 mL vs. 68.23±29.11 mL, P=0.180) between the normal-weight group and the overweight group. There was no permanent hypoparathyroidism, postoperative hemorrhage, lymphatic fistula, mental nerve injury, postoperative infection in both groups. In both groups, there occurred one case of transient hypoparathyroidism. As for other complications, 1 case of temporary recurrent laryngeal nerve injury and oral tearing occurred in the overweight group, while the normal-weight group had 1 case of skin scald. Conclusions:Among patients who underwent TORT, the overweight group exhibited comparable surgical outcomes and postoperative complications to those in the normal-weight group. TORT is a safe and feasible surgical option for overweight patients, which provides more surgical options for this patient population.

AIM:To investigate the effects of glutathione-S-transferase(GST)gene polymorphism on the concentration of 6-thioguanine nucleotides(6-TGN),an active metabolite of azathioprine(AZA),in patients with inflammatory bowel disease(IBD),in order to provide reference for the optimization of AZA treatment in patients.METHODS:The clini-cal data of patients with IBD treated by AZA were collected prospectively,the genotypes of GST-A1,GST-M1,GST-P1 and GST-T1 were detected by tar-geted sequencing of multiplex PCR combined with high-throughput sequencing technology before ad-ministration,and the steady-state trough concen-trations of 6-TGN in patients' red blood cells were determined by HPLC.Statistical analysis was carried out by SPSS 26.0 software.RESULTS:A total of 90 patients were included in this study.The alleles fre-quencies of GST-A1,GST-M1,GST-P1 and GST-T1 were consistent with Hardy-Weinberg equilibrium law.Logistic regression analysis showed that carry-ing GST-A1 mutant gene was an independent risk factor for the increase of trough concentration of 6-TGN(low concentration OR=17.50,P=0.030;high concentration OR=3.60,P=0.033),while the gene polymorphism of GST-M1,GST-P1,GST-T1 had no significant correlation with the concentration of 6-TGN(P＞0.05).CONCLUSION:The gene polymor-phism of GST-A1 may affect the concentration of 6-TGN,an active metabolite of AZA,and detection of GST-A1 genotype before AZA treatment will contrib-ute to clinical individualized medication.

CAPOS syndrome is an autosomal dominant neurological disorder caused by mutations in the ATP1A3 gene. Initial symptoms, often fever-induced, include recurrent acute ataxic encephalopathy in childhood, featuring cerebellar ataxia, optic atrophy, areflflexia, sensorineural hearing loss, and in some cases, pes cavus. This report details a case of CAPOS syndrome resulting from a maternal ATP1A3 gene mutation. Both the child and her mother exhibited symptoms post-febrile induction,including severe sensorineural hearing loss in both ears, ataxia, areflexia, and decreased vision. Additionally, the patient's mother presented with pes cavus. Genetic testing revealed a c. 2452G>A（Glu818Lys） heterozygous mutation in theATP1A3 gene in the patient . This article aims to enhance clinicians' understanding of CAPOS syndrome, emphasizing the case's clinical characteristics, diagnostic process, treatment, and its correlation with genotypeic findings.
Humans ; Child ; Female ; Cerebellar Ataxia/diagnosis* ; Talipes Cavus ; Hearing Loss, Sensorineural/diagnosis* ; Optic Atrophy/diagnosis* ; Mutation ; Phenotype ; Sodium-Potassium-Exchanging ATPase/genetics* ; Foot Deformities, Congenital ; Reflex, Abnormal

Objective:To research the efficacy and safety of robotic thyroidectomy and bilateral modified radical neck dissection through bilateral axillo-breast approach (BABA) .Methods:We retrospectively analyzed the clinical data of 37 patients with thyroid cancer who received bilateral modified radical neck dissection through the BABA at the Department of Thyroid and Breast Surgery of the 960th Hospital of the People’s Liberation Army from Jan. 2014 to Jan. 2023. There were 24 females and 13 males, and the average age of the patients was (33,22±10.53) years old. The tumor diameter, number of lymph node dissection and metastasis in the central and lateral regions, average operation time, average hospital stay, complications, and aesthetic score were recorded. SPSS 25.0 software was used for statistical analysis, and the measurement data was calculated using mean ± standard deviation ( ± s), and the counting data was expressed in percentages and numbers. Results:A total of 37 thyroid cancer patients underwent robotic bilateral regional lymph node dissection. The 37 patients received total thyroidectomy, bilateral central compartment and cervical lateral regional lymph node dissection. All the pathological types were papillary carcinoma, with a maximal tumor diameter of (1.47±0.85) cm. The average number of central lymph nodes dissected was 19.46±8.84, and there were (10.24±5.95) metastases; The average number of lymph nodes removed from the bilateral cervical region was 38.92±14.21, and there were (7.92±5.84) metastases. The average operation time was (288.05±77.09) min, the average length of stay in the hospital was (10.76±3.92) days, and the average length of stay in the hospital following surgery was (8.03±2.08) days. These patients had no permanent hypoparathyroidism, permanent recurrent laryngeal nerve palsy, infection, accessory nerve injury and phrenic nerve injury after operation. Transient hypoparathyroidism occurred in 15 patients, transient recurrent laryngeal nerve palsy occurred in 1 patient, and chyle leak occurred in 2 patients. One month after surgery, the aesthetic score was 9.51±0.69.Two patients were found lymph node metastases during the (27.81±15.10) months of follow-up, and received robotic cervical lymph node dissection with BABA.Conclusion:For carefully chosen thyroid cancer patients with bilateral lateral cervical region lymph node metastases, robotic bilateral cervical lymph node regional dissection via BABA is safe and feasible, and good cosmetic results can be obtained.

【Objective】 To analyze the association between the composition of gut microbiota and blood pressure in children aged 6 - 9 years, in order to provide new ideas for childhood hypertension prevention and treatment. 【Methods】 A total of 411 children aged 6 - 9 years were recruited in Guangzhou from December 2015 to March 2017. The gut microbiota was characterized by 16S ribosomal RNA amplicon sequencing. The multivariate methods with unbiased variable selection in R (MUVR) were performed to identify the significant OTUs. Spearman correlation as well as multiple linear regression were used to explore the relationship between gut microbiota and blood pressure in children. 【Results】 Significant difference in β diversity index was observed between children with normal blood pressure and those with abnormal blood pressure (R²weighted=0.015,Pweighted=0.01; R²unweighted=0.027, Punweighted=0.001). After adjustment for covariates and controlling the false discovery rate (FDR), multiple linear regression analysis showed that blood pressure level in children decreased with the increasing abundance of OTU_3 (genus Blautia), OTU_131 (genus [Clostridium]_innocuum_group), OTU_1776 (genus Blautia), OTU_2159 (genus Prevotella) and OTU_91 (species Bifidobacterium_breve) (β:-0.18 --0.14; PFDR<0.05. In contrast, blood pressure in children increased with the increasing abundance of OTU_108(genus Sutterella), OTU_1(species Faecalibacterium_prausnitzii)、OTU_8(genus Roseburia), OTU_48 (genus Lachnoclostridium), OTU_81 (genus Coprococcus), OTU_401 (family Lachnospiraceae), OTU_1284 (family Lachnospiraceae) and OTU_2793 (family Lachnospiraceae)(β: 0.14 - 0.21; PFDR<0.05. The influence of gut microbiota on systolic pressure and diastolic pressure may be mediated by the increase of body mass index (BMI). 【Conclusions】 Pediatric blood pressure level is associated with the composition of gut microbiota, while BMI partially plays a mediating role in the relationship. It is recommended to modulate the abundance of microbiota as genus Blautia, Sutterella and so on to prevent hypertension in children.