BACKGROUND:At present,research has only shown that the cervical lordosis ratio can be an important factor in predicting the loss of lordosis curvature after laminoplasty,and no one has studied whether the cervical lordosis ratio,a dynamic level indicator,can be one of the decision-making factors for the selection of posterior cervical surgical procedures. OBJECTIVE:To investigate whether the cervical lordosis ratio,an index of cervical hyperextension and hyperflexion,can be used as a selective index for laminoplasty and laminectomy fusion. METHODS:A retrospective review of 141 patients who had undergone posterior cervical surgery more than one year of follow-up due to multi-level cervical spondylotic myelopathy from December 2015 to March 2020 was performed.Among them,63 patients received laminectomy and fusion(laminectomy and fusion group)and 78 patients received laminoplasty(laminoplasty group).The demographic statistics(gender,age,body mass index,follow-up time),imaging indexes such as C2-7 Cobb angle,C2-7 range of motion,flexion Cobb angle,extension Cobb angle,flexion range of motion and extension range of motion,clinical effect indexes such as Japanese Orthopaedic Association score and visual analog scale score were compared between the two groups.The evaluation index of cervical lordosis alignment change was C2-7 Cobb angle difference before and after operation(ΔCL).Cervical lordosis ratio was equal to 100%×flexion range of motion/C2-7 range of motion.Receiver operating characteristic curve analysis was used to determine the role of cervical lordosis ratio in predicting postoperative severe cervical lordosis loss(ΔCL≤-10°).According to the critical value of cervical lordosis ratio(68.5%),all patients were divided into low cervical lordosis ratio group and high cervical lordosis ratio group.In these two ratio groups,the cervical lordosis alignment index and clinical effect index between the two operation groups were discussed again. RESULTS AND CONCLUSION:(1)Cervical lordosis alignment decreased after laminectomy and fusion and laminoplasty(P=0.039,P=0.002),and cervical lordosis alignment change in laminoplasty group(ΔCL)was greater than that of laminectomy and fusion group,and the difference between the two groups was statistically significant.(2)Based on receiver operating characteristic curve analysis,cervical lordosis ratio in predicting severe cervical lordosis alignment change(ΔCL≤-10°)had good identification ability(area under the curve=0.792).(3)In low cervical lordosis ratio group,there was no significant difference in cervical lordosis alignment change(ΔCL)between laminectomy and fusion group and laminoplasty group(P=0.141).(4)In high cervical lordosis ratio group,the ΔCL of laminoplasty group was greater than that in laminectomy and fusion group(P=0.001),which had a higher probability of postoperative severe cervical lordosis alignment change(ΔCL≤-10°)(43%,29%).(5)It is indicated that cervical lordosis ratio can be used as a decision-making index for the choice of posterior surgery for multi-level cervical spondylotic myelopathy.Laminoplasty can be considered in the low cervical lordosis ratio group,while laminectomy and fusion can be considered in the high cervical lordosis ratio group.

Objective To explore the application effect of the anchored and paired classroom combined case teaching mode in the teaching of pediatric Surgery.Methods The five-year undergraduate students of pediatrics in Guangzhou Medical U-niversity from September 2022 to June 2024 were selected as the research objects.Traditional teaching mode was used as the con-trol group,and the anchored and paired classroom combined case teaching mode was used as the research group.According to the"Teaching Evaluation Form",the learning process,learning effect,classroom atmosphere and teaching strategies were evaluated,and the test results of the two groups of medical students were compared,so as to evaluate the degree of students'mastery of bas-ic knowledge and clinical thinking ability.Results The study group scored higher than the control group,and the difference was statistically significant(P＜0.05).Conclusion The anchored and paired classroom combined case teaching mode can improve the teaching quality of Pediatric Surgery,improve the classroom atmosphere,and enhance the learning interest and autonomy of medical students.

Objective To explore the application effect of the anchored and paired classroom combined case teaching mode in the teaching of pediatric Surgery.Methods The five-year undergraduate students of pediatrics in Guangzhou Medical U-niversity from September 2022 to June 2024 were selected as the research objects.Traditional teaching mode was used as the con-trol group,and the anchored and paired classroom combined case teaching mode was used as the research group.According to the"Teaching Evaluation Form",the learning process,learning effect,classroom atmosphere and teaching strategies were evaluated,and the test results of the two groups of medical students were compared,so as to evaluate the degree of students'mastery of bas-ic knowledge and clinical thinking ability.Results The study group scored higher than the control group,and the difference was statistically significant(P＜0.05).Conclusion The anchored and paired classroom combined case teaching mode can improve the teaching quality of Pediatric Surgery,improve the classroom atmosphere,and enhance the learning interest and autonomy of medical students.

Background and purpose:Hepatocellular carcinoma (HCC) is a common malignant tumor of the digestive system in our country, with high fatality, development of HCC and the machine system research and treatment is a primary issue in current study of HCC. To explore the expression ofβ-catenin at different stages in the process of hepatocellular carcinoma carcinogenisis for SD rats induced by chemicals. Methods: The experimental group included 48 male SD rats mice with primary liver cancer induced by diethylnirtosamine/carbon tetrachloride/Ethanol, while 48 normal male SD rats mice were used as the control group. The rats were killed every 3 weeks to collect the specimens and observe the pathological changes by HE staining. The changes ofβ-catenin protein expressions were detected by immunohistochemistry and Western blot respectively. Results:SD rats liver cancer was conifrmed by HE staining after 21 weeks DEN/CCl4/Ethanol induction. Immunohistochemistry showed thatβ-catenin expression level was obviously higher in the experimental group(0.27±0.01) than that of the control group(0.21±0.02) after 3 weeks induction(P<0.05). As time progresses, the expression levels ofβ-catenin kept on rising, and at the 18th(0.30±0.02) and 21th weeks(0.32±0.02), it was significantly higher than that of the earlier liver tissues of the experimental group(P<0.05), Western blot consistent with immunohistochemical results. Conclusion:β-catenin protein expression is different in the normal liver tissue, cirrhosis, liver cancer,β-catenin and the occurrence of liver carcinoma development had close relationship.β-catenin protein in the cell with further accumulation, may active a series of target gene, leading to the formation of liver cancer..