BACKGROUND:According to different locations of lumbar disc herniation,it can be classified into many types.Among them,patients with intradural sac type lumbar disc herniation have severe clinical symptoms,which greatly affect their quality of life.Therefore,this article studies the risk factors for its onset,and improving the preoperative diagnostic rate is of great significance for the treatment and prevention of this disease.OBJECTIVE:To explore the risk factors for intradural lumbar disc herniation.METHODS:A retrospective analysis was conducted on 15 patients with intradural lumbar disc herniation(herniation group)admitted to three hospitals in Xuzhou city from May 2014 to November 2022.Propensity score matching was used to match patients with lumbar disc herniation who did not protrude into the dura mater in a ratio of 1:4.A total of 59 patients were selected and included in the non-herniation group.Clinical data were observed in the two groups.Univariate and binary logistic regression analysis,multiple linear regression,and PROBIT regression analysis were utilized to identify the relevant risk factors for intradural lumbar disc herniation.RESULTS AND CONCLUSION:(1)The results of univariate analysis showed that the average disease course,proportion of segments,modified Pfiirmann grading,sacral tilt angle,proportion of previous lumbar spine surgery history,and proportion of heavy manual workers,proportion of lumbar spinal stenosis,redundancy of the cauda equina,and ossification of the posterior longitudinal ligament all showed statistical differences in the herniation and non-herniation groups(P＜0.05).(2)Multivariate regression analysis showed that duration of disease,protruding segment,history of lumbar surgery,modified Pfiirmann grading,cauda equina redundancy,and lumbar spinal stenosis were independent risk factors for intradural lumbar disc herniation.(3)Based on the influencing factors,an receiver operating characteristic curve was constructed,with an area under curve of 0.956(95％CI:0.913-0.998),indicating good discrimination.(4)There was a significant correlation between the duration of the disease,the protruded segment,the history of lumbar spine surgery,the modified Pfirmann classification,cauda equina redundancy,lumbar spinal canal stenosis,and the incidence rate of intradural lumbar disc herniation.

BACKGROUND:According to different locations of lumbar disc herniation,it can be classified into many types.Among them,patients with intradural sac type lumbar disc herniation have severe clinical symptoms,which greatly affect their quality of life.Therefore,this article studies the risk factors for its onset,and improving the preoperative diagnostic rate is of great significance for the treatment and prevention of this disease.OBJECTIVE:To explore the risk factors for intradural lumbar disc herniation.METHODS:A retrospective analysis was conducted on 15 patients with intradural lumbar disc herniation(herniation group)admitted to three hospitals in Xuzhou city from May 2014 to November 2022.Propensity score matching was used to match patients with lumbar disc herniation who did not protrude into the dura mater in a ratio of 1:4.A total of 59 patients were selected and included in the non-herniation group.Clinical data were observed in the two groups.Univariate and binary logistic regression analysis,multiple linear regression,and PROBIT regression analysis were utilized to identify the relevant risk factors for intradural lumbar disc herniation.RESULTS AND CONCLUSION:(1)The results of univariate analysis showed that the average disease course,proportion of segments,modified Pfiirmann grading,sacral tilt angle,proportion of previous lumbar spine surgery history,and proportion of heavy manual workers,proportion of lumbar spinal stenosis,redundancy of the cauda equina,and ossification of the posterior longitudinal ligament all showed statistical differences in the herniation and non-herniation groups(P＜0.05).(2)Multivariate regression analysis showed that duration of disease,protruding segment,history of lumbar surgery,modified Pfiirmann grading,cauda equina redundancy,and lumbar spinal stenosis were independent risk factors for intradural lumbar disc herniation.(3)Based on the influencing factors,an receiver operating characteristic curve was constructed,with an area under curve of 0.956(95％CI:0.913-0.998),indicating good discrimination.(4)There was a significant correlation between the duration of the disease,the protruded segment,the history of lumbar spine surgery,the modified Pfirmann classification,cauda equina redundancy,lumbar spinal canal stenosis,and the incidence rate of intradural lumbar disc herniation.

Parkinson′s disease is a degenerative disease, in which cognitive impairment is main non-motor symptom. It can develop to dementia and seriously affect the quality of life and life expectancy of patients. Therefore, a correct understanding of the etiology and mechanism of cognitive impairment in Parkinson′s disease is helpful for the disease diagnosis and treatment. In recent years, the correlation between vascular factors and the development of Parkinson′s disease has become a research hot topic. This article reviewed the research progress of the correlation between vascular related factors and cognitive impairment in Parkinson′s disease.

Aquaporin4(AQP4),a member of the aquaporin family,is mainly expressed inastrocytes end-feet in the central nervous system. A large number of experimental studies have show n that AQP4 expression plays an important role in the occurrence, development, and regression of brain edema after different types of stroke. In addition, the AQP4 expression can affect the development process of cerebrovascular disease through the mechanisms such as affecting the integrity of the blood-brain barrier and promoting astrocyte migration, nerve regeneration, and neuroinflammatory response. Investigation of regulation mechanisms of AQP4 in transmembrane transport of substance in brain and intracel ular and extracel ular environmental balance and its expression in model of cerebrovascular disease have an important significance for understanding the occurrence, development, protection, and treatment of clinical cerebrovascular disease.

Spontaneous intracerebral hemorrhage is the most deadly type of stroke.Its 30-day mortality rate is nearly 40％.More than 30％ of patients with spontaneous intracerebral hemorrhage will have hematoma growth,which lead to poor outcomes.In addition to the classic predictors,some inaging signs also have important implications for identifying hematoma growth,such as swirl sign,blend sign,and black hole sign on nonenhanced CT scans,extravasation sign on contrast-enhanced CT scans,spot sign on CT angiography,leak sign revealed by the modified imaging method,as well as the spot sign on CT peffusion imaging.

Objective To investigate the clinical value of Color Doppler Ultrasound in diagnosis of lymph node diseases. Methods We observed the ultrasound features of the 93 cases of swelled lymph nodes with Color Doppler ultrasound. The ultrasound features included pseudokidney sign, assessment on blood flow distribution, the Doppler resistive Index (RI), maximal flow rate (Vmax),the longitudinal axis compared to the diameter of a node (L/D ratio) . Results Out of 93 cases of clinically confirmed swelled lymph nodes,the concordance rate of Color Doppler Ultrasound was 86%and 88%in diagnosis of malignant lymph node disease and benign lymph node disease, respectively. 4 cases of lymph tuberculosis were misdiagnosed as lymphoma due to the similar ultrasound characteristics found in malignant lymph group,the rate of misdiagnosis was 8%. In the cases of proliferative lymph node diseases with Pseudokidney sign, 93% of the blood flow distribution was classified as grade 0-I. 90% of lymphadenitis were found with Pseudokidney sign,and 95%of those cases with blood flow distribution was classified as grade II-III. Malignant lymph diseases had no Pseudokidney sign, and 86%of blood flow distribution grade was as III. There was statistically significant difference in the L/D ratio and RI between benign lymph group and malignant lymph group (P<0.01) . There was statistically significant difference in Vmax between lymphoproliferative group and other groups (P<0.01) . Conclusions Pathological characteristics on different lymph node disease determin the ultrasound characteristics. Combined clinical data based on Pseudokidney sign, Blood Flow Distribution, RI value,Vmax value and L/D ratio can enhance the accuracy of various lymph node disease diagnosis.

Objective To investigate the effects of anesthesia and operation on glomerular and renal tubular function Methods Forty patients without renal disease were assigned to 4 groups: general anesthesia + minor operation; general anesthesia +major operation; epidural block + minor operation and epidural block + major operation The concentration of ?_2-microglobulin(?_2-MG)、albumin(Alb)and immunoglobulin G(IgG)in urine were measured before operation ,1h following operation and 24h after operationResults In the groups of major operation, the concentrations of ?_2-MG, Alb and IgG in urine increased significantly during and after operation(P005)Conclusions The influences on renal glomerular and tubular function during perioperation are related to the degree of operative stimulation, but do not to the anesthesia