Objectives:To explore the incidence and risk factors of adjacent vertebral fractures(AVF)in pa-tients with osteoporotic vertebral compression fractures(OVCF)after percutaneous vertebroplasty(PVP)treatment.Methods:A retrospective analysis was conducted on 482 OVCF patients who underwent PVP at our hospital from June 2017 to January 2022.There were 146 males and 336 females,with an average age of 68.4±3.1 years(63-86 years).The average follow-up time was 42.9±10.2 months(24-70 months).Based on whether AVF occurred during the follow-up period,the patients were divided into an AVF group and a non-AVF group.The time of AVF occurrence was recorded,and the incidence rate of AVF was calculated using the Ka-plan-Meier method to obtain a survival curve.Intergroup comparisons were made in terms of clinical factors including gender,age,body mass index(BMI),adjacent vertebral CT value,and bone metabolism related index-es[total procollagen type Ⅰ N-terminal propeptide(tP Ⅰ NP),[3-cross-linked C-telopeptide of type Ⅰ collagen(β-CTX),and 25-hydroxyvitamin D(25-OHD)];Imaging factors such as whether the fracture was located in the thoracolumbar segment,whether it was accompanied by an upper endplate fracture,whether it was accom-panied by an intravertebral vacuum cleft(IVC),preoperative vertebral body height,wedge angle,and kyphosis angle;And surgical factors including bone cement injection volume,postoperative restoration of vertebral height,restoration of wedge angle,restoration of kyphosis angle and whether bone cement leakage occurred.Indicators that were significant in the univariate analysis were included in the multivariate logistic regression analysis.Results:AVF occurred in 47 cases(9.75％)in 17.9±14.7 months(1-55 months)after PVP.The Kaplan-Meier survival curve showed that the incidence of AVF in the group with upper endplate fractures was significantly higher than that in the group without upper endplate fractures(P＜0.001).There were no statistically significant differences between the AVF group and the non-AVF group in terms of gender,BMI,tP Ⅰ NP,[3-CTX,25-OHD,preoperative vertebral body height,wedge angle,kyphosis angle,bone cement injection volume,postoperative restoration of vertebral height,restoration of wedge angle and restoration of kyphosis angle(P＞0.05).Statistically significant differences were found in age,adjacent vertebral CT value,whether the fracture was located in the thoracolumbar segment,whether it was accompanied by an upper endplate fracture,whether it was accompanied by an IVC,and whether bone cement leakage occurred(P＜0.05).Further multivariate logistic regression analysis showed that advanced age(OR=1.187,95％CI=1.084-1.300,P＜0.001),low CT value of adjacent vertebra(OR=0.928,95％CI=0.892-0.964,P＜0.001),presence of upper endplate fracture(OR=3.514,95％CI=1.444-8.551,P=0.006),presence of IVC(OR=2.804,95％CI=1.238-6.349,P=0.013),and bone cement leakage(OR=2.415,95％CI=1.134-5.146,P=0.022)were the risk factors for AVF after PVP.Conclusions:Advanced age,low CT value of adjacent vertebra,upper endplate fracture,IVC,and bone cement leakage are the independent risk factors for postoperative AVF in OVCF patients undergoing PVP.

Objectives:To explore the incidence and risk factors of adjacent vertebral fractures(AVF)in pa-tients with osteoporotic vertebral compression fractures(OVCF)after percutaneous vertebroplasty(PVP)treatment.Methods:A retrospective analysis was conducted on 482 OVCF patients who underwent PVP at our hospital from June 2017 to January 2022.There were 146 males and 336 females,with an average age of 68.4±3.1 years(63-86 years).The average follow-up time was 42.9±10.2 months(24-70 months).Based on whether AVF occurred during the follow-up period,the patients were divided into an AVF group and a non-AVF group.The time of AVF occurrence was recorded,and the incidence rate of AVF was calculated using the Ka-plan-Meier method to obtain a survival curve.Intergroup comparisons were made in terms of clinical factors including gender,age,body mass index(BMI),adjacent vertebral CT value,and bone metabolism related index-es[total procollagen type Ⅰ N-terminal propeptide(tP Ⅰ NP),[3-cross-linked C-telopeptide of type Ⅰ collagen(β-CTX),and 25-hydroxyvitamin D(25-OHD)];Imaging factors such as whether the fracture was located in the thoracolumbar segment,whether it was accompanied by an upper endplate fracture,whether it was accom-panied by an intravertebral vacuum cleft(IVC),preoperative vertebral body height,wedge angle,and kyphosis angle;And surgical factors including bone cement injection volume,postoperative restoration of vertebral height,restoration of wedge angle,restoration of kyphosis angle and whether bone cement leakage occurred.Indicators that were significant in the univariate analysis were included in the multivariate logistic regression analysis.Results:AVF occurred in 47 cases(9.75％)in 17.9±14.7 months(1-55 months)after PVP.The Kaplan-Meier survival curve showed that the incidence of AVF in the group with upper endplate fractures was significantly higher than that in the group without upper endplate fractures(P＜0.001).There were no statistically significant differences between the AVF group and the non-AVF group in terms of gender,BMI,tP Ⅰ NP,[3-CTX,25-OHD,preoperative vertebral body height,wedge angle,kyphosis angle,bone cement injection volume,postoperative restoration of vertebral height,restoration of wedge angle and restoration of kyphosis angle(P＞0.05).Statistically significant differences were found in age,adjacent vertebral CT value,whether the fracture was located in the thoracolumbar segment,whether it was accompanied by an upper endplate fracture,whether it was accompanied by an IVC,and whether bone cement leakage occurred(P＜0.05).Further multivariate logistic regression analysis showed that advanced age(OR=1.187,95％CI=1.084-1.300,P＜0.001),low CT value of adjacent vertebra(OR=0.928,95％CI=0.892-0.964,P＜0.001),presence of upper endplate fracture(OR=3.514,95％CI=1.444-8.551,P=0.006),presence of IVC(OR=2.804,95％CI=1.238-6.349,P=0.013),and bone cement leakage(OR=2.415,95％CI=1.134-5.146,P=0.022)were the risk factors for AVF after PVP.Conclusions:Advanced age,low CT value of adjacent vertebra,upper endplate fracture,IVC,and bone cement leakage are the independent risk factors for postoperative AVF in OVCF patients undergoing PVP.

Objective:To explore the status of early social function in young and middle-aged patients after percutaneous coronary intervention (PCI) and analyze its influencing factors, so as to provide a basis for formulating relevant intervention measures.Methods:From July to December 2021, the convenient sampling method was used to select 110 young and middle-aged patients with coronary heart disease after PCI in the First Affiliated Hospital of Harbin Medical University as the research objects. The general information questionnaire, Social Disability Screening Schedule (SDSS) , Social Support Rate Scale (SSRS) and General Self-Efficacy Scale (GSES) were used to investigate the patients. Univariate analysis and multiple linear regression analysis were used to explore the influencing factors of early social function in young and middle-aged patients with coronary heart disease after PCI. A total of 110 questionnaires were distributed and 106 valid questionnaires were recovered, with an effective recovery rate of 96.36% (106/110) .Results:The scores of SDSS, SSRS and GSES of 106 young and middle-aged patients after PCI were (3.89±1.63) , (38.80±7.02) and (21.08±6.39) , respectively. The results of univariate analysis showed that there were statistically significant differences in SDSS scores among patients with different gender, family per capita monthly income, education level and number of stents ( P<0.01) . The results of multiple linear regression analysis showed that gender, family per capita monthly income, education level, number of stents, general self-efficacy and social support were the influencing factors of early social function in young and middle-aged patients with coronary heart disease after PCI ( P<0.05) . Conclusions:The status of early social function in young and middle-aged patients with coronary heart disease after PCI is not ideal. Medical staff should give more intervention and guidance to patients after PCI who are female, have a lower education level, have a lower per capita monthly family income and have a large number of stents, consider the influence of self-efficacy and social support on the social function of patients and formulate corresponding intervention measures according to the influencing factors, so as to improve the level of social function of patients.

Objective To evaluate the role of GABAA receptors in sevoflurane-induced inhibition of the discharge activities of inspiratory neurons in the medullary respiratory center of neonatal rats.Methods The medulla oblongnta slices of neonatal rats (aged 0-4 days) including the medial region of the nucleus retrofacialis with the hypoglossal nerve rootlets retained were prepared.The slices were perfused with artificial cerebrospinal fluid (ACSF),and the activity of the inspiratory neurons in the medial region of the nucleus retrofacialis and the respiratory rhythmical discharge activity of the hypoglossal nerve rootlets were simultaneously recorded using microelectrodes and suction electrodes,respectively.The ACSF,5％ sevoflurane,GABAA receptor blocker bicuculline 10 μmol/L and combination of 5％ sevoflurane and 10 μmol/L bicuculline were added to the perfusion liquid after the discharge activity was stable.The respiratory cycle (RC),inspiratory time (TI),integral amplitude (IA) and changes in peak frequency (PFn) of the inspiratory neurons were recorded.Results Compared with that after giving ACSF,RC was significantly prolonged,TI was shortened,and IA and PFn were decreased after giving sevoflurane,and RC was significantly shortened,IA and PFn were increased (P＜0.05),and no significant change was found in TI after giving bicuculline (P＞ 0.05).Compared with that after giving sevoflurane,RC was significantly shortened,TI was prolonged,and IA and PFn were increased after giving sevoflurane and bicuculline (P＜ 0.05).Conclusion Sevoflurane inhibits the discharge activities of inspiratory neurons through GABAA receptors in the medullary respiratory center of neonatal rats.

Objective To observe the clinical effect of propofol combined with sufentanil in laparoscopic ovarian cyst resection.Methods 80 cases who underwent laparoscopic ovarian cyst resection were chosen,they were divided into the observation group and control group with 40 patients in each group according to the random number table method.The observation group was anaesthetized with propofol combined with sufentanil,while the control group was anaesthetized with propofol combined with fentanyl,the recovery status,operation time,intraoperative bleeding volume,recovery time of gastrointestinal function and postoperative complications in the two groups were compared. Results The recovered spontaneous breathing time,recovery time,extubation time of the observation group were (8.4 ±2.3)min,(10.51 ±3.3)min,(12.7 ±2.3)min,which of the control group were (10.11 ±2.2)min, (12.3 ±2.6)min,(15.3 ±3.5)min,there was statistically significant difference between the two groups (t =3.378, 2.710,3.926,all P <0.05);The operation time,operation amount of bleeding,gastrointestinal function recovery time of the observation group were (44.7 ±5.4)min,(19.5 ±3.5)mL,(18.3 ±2.4)h,which of the control group were (67.5 ±7.8)min,(42.7 ±2.8)mL,(42.4 ±3.2)h,there were significant differences between the two groups(t =15.200,32.736,38.105,all P <0.05).Postoperative analgesia,postoperative awareness,emergence delirium inci-dence rates of the observation group were 25%,0%,7.5%,which were significantly lower than 57.5%,12.5%, 37.5% of the control group,the differences were statistically significant(χ2 =8.717,5.333,10.323,all P <0.05). Conclusion The propofol combined with sufentanil in laparoscopic ovarian cyst resection has more significant effect, which can shorten the operation time,promote the postoperative recovery,reduce complications,worthy to be widely used in clinical practice.

Objective To explore effect of propofol or sevoflurane combined with dexmedetomidine on postoperative cognitive function , erythrocyte sedimentation rate and oxidative stress in patients with bone tumour .Methods 52 cases with bone tumor and requiring a surgery were selected and divided into sevoflurane group and propofol group randomly.The sevoflurane group were anesthetized with sevoflurane and dexmedetomidine.Propofol group were anesthetized with propofol and dexmedetomidine.The cognitive function score, recovery time, sedimentation value and oxidative stress level were compared after operation.ResuIts Compared with propofol group at the same time, the cognitive function score of patients in sevoflurane group at postoperative 6, 12, 24 h were higher (P<0.05) and restored to preoperative levels at postoperative 24 h (P<0.05) .The recovery time of spontaneous breathing, eyes open, remove endotracheal intubation and directional force in sevoflurane group were shorter than that in propofol group (P<0.05).Compared with propofol group at the same time, the erythrocyte sedimentation rate in sevoflurane group at postoperative 5, 10d were lower (P<0.05) and restored to preoperative levels at postoperative 10 d (P<0.05).Compared with propofol group postoperation, the superoxide dismutase (SOD) and methane dicarboxylic aldehyde (MDA) levels in sevoflurane group were lower, total antioxidant capacity (T-AOC) level was higher (P<0.05).ConcIusion Sevoflurane has a smaller effect on postoperative cognitive function than propofol in patients with bone tumor, combined with dexmedetomidine, which has an important significance to clinical surgery.

Objective To study the effect of dexmedetomidine complex with remifentanil in elderly patients with laparoscopic colon cancer resection.Methods 80 cases of elderly patients with laparoscopic colon cancer resec-tion were selected and divided into the study group and the control group with 40 patients in each group according to the random number table method.Two groups were induced conventionally,and intraoperative anesthesia maintained by remifentanil and sevoflurane.The study group were pumped dexmedetomidine 0.8μg/kg 10min before induction, then the doses reduced to 0.2 μg·kg -1 ·h -1 for continuous pumping until to the end of surgery,while the control group was pumped the same dose 0.9% sodium chloride injection,then the heart rate(HR)and mean arterial pres-sure(MAP)of the two groups were compared when entered into surgery room(T0 ),administered 5min(T1 ),after intubation(T2 ),surgical incision(T3 )and after extubation(T4 ),and the compose score,recovery time,and agitation score of two groups were compared.Results HR and MAP of the study group at T1 ,T2 ,T3 and T4 were (62.2 ± 1.1)times/min,(67.3 ±3.2)times/min,(69.2 ±2.3)times/min,(70.2 ±2.5)beats/min and(68.3 ±0.5)mmHg,(70.1 ±0.9)mmHg,(71.5 ±0.9)mmHg,(68.2 ±1.9)mmHg significantly lower than which of the control group (t =9.289,10.293,8.928,9.039,9.278,10.789,9.322,8.399,all P <0.05),and HR and MAP of the control group at T1 ,T2 ,T3 and T4 were significantly higher than T0,the differences were statistically significant(t =8.928, 9.892,8.387,8.927,9,783,9,073,9.039,7.938,all P <0.05);Compose score(4.2 ±1.3)points of the study group was significantly higher than (1.2 ±0.2)points of the control group,but the agitation score of the study group was(1.2 ±0.7)points,which was significantly lower than (2.9 ±1.5)points of the control group,the differences were statistically significant(t =9.38,8.379,all P <0.05).Conclusion Dexmedetomidine complex with remifen-tanil has a anesthetic good effect in elderly patients with laparoscopic colon cancer resection,and which can maintain the more stable hemodynamics.

Objective To investigate the effects of different doses of dexmedetomidine on perioperative inflammatory responses in patients undergoing one-lung ventilation (OLV).Methods Thirty-six ASA T or Ⅱ patients (aged 43-72 years and weighing 50-78 kg) scheduled for esophagectomy were randomly divided into three groups (n =12 each):control group (group C),low dose dexmedetomidine group (group D1) and high dose dexmedetomidine group (group D2).Dexmedetomidine 1 μg/kg was infused intravenously 10 minutes before anesthesia induction,then infused at a rate of 0.2 μg· kg-1 · h-1 (group D1) or 0.5 μg· kg-1· h-1 (group D2) until 30 minutes before the end of operation.Group C received the equal volume of normal saline.Blood samples were collected before anesthesia induction (T0),immediately before OLV (T1),30 minutes after OLV (T2),90 minutes after OLV (T3),30 minutes after lung inflation (T4) and 2 hours after operation (T5) for monitoring serumlevels of tumor necrosis factor-alpha (TNF-α) and interleukin-8 (IL-8).Results Compared with T0,serum levels of TNF-α and IL-8 significantly increased at T3 and T5 in all the three groups (P ＜ 0.05).Compared with group C,serum levels of TNF-α and IL-8 significantly decreased at T3 and T5 in group D2 (P ＜ 0.05).There was no significant difference in the indexes mentioned above between group C and group D1 (P ＞ 0.05).Conclusion Dexmedetomidine 1 μg/kg given before anesthesia induction and then infused at the rate of 0.5 μg· kg-1 ·h-1 during operation can reduce inflammatory responses in patients undergoing OLV.

Objective To investigate the effect of Solitaire stent combined with coils on endovascular embolization of intracranial wide-necked aneurysms.Methods Twenty-six cases with intracranial wide-necked aneurysms from June 2009 to December 2011 in the NO.264 Hospital of the Chinese People's Liberation Army were treated with Solitaire stent-assisted coils,and anticoagulation and antiplatelet therapy were done among peri operation period.The effect of endovascular embolization was evaluated after 3 months cerebral angiography.Results A total of 27 solitaire stent were used in the 26 patients,one of which used 2 stents.The stents were successfully put in place,and the placement effect were satisfaction.The immediate angiography showed that 24 cases were dense embolism,2 cases of subtotal embolization.Stent were placed at right position.Twenty-three patients were followed with DSA for 3 months,and no aneurysm evidence of recurrence was found.Conclusion Solitaire stent-assisted coil embolization of intracranial wide-necked aneurysms is simple to perform and embolism rate is high and the recurrence rate is low.

Objective To investigate the effect of doxapram on inhibition of medullary respiratory center excitability by sevoflurane in rats.Methods Neonatal Sprague-Dawley rats of both sexes,aged 1-4 days,were used in this study.Isolated medulla oblongata-spinal cord specimens were made according to the method described by Suzue and perfused with the artificial cerebrospinal fluid saturated with 95％O2-5％CO2.The specimens were randomly divided into 3 groups ( n =9 each):control group (group C),sevoflurane group (group S) and sevoflurane + doxapram group (group S + D).Respiratory rhythmical discharge activity of the hypoglossal nerve rootlets was recorded using suction electrode.After 10 min of equilibration,the specimens were perfused with the artificial cerebrospinal fluid,5％ sevoflurane and the mixture of 5％ sevoflurane and 5 μmol/L doxapram for 10 min in groups C,S,and S + D respectively.The respiratory cycle,inspiratory time and integral amplitude of inspiratory discharge were recorded.Results Compared with group C,the respiratory cycle was significantly prolonged,the inspiratory time was significantly shortened,and the integral amplitude of inspiratory discharge was significantly decreased in group S (P ＜ 0.05),and no significant change was found in the parameters mentioned above in group S + D (P ＞ 0.05).Compared with group S,the respiratory cycle was significantly shortened,the inspiratory time was significantly prolonged,the integral amplitude of inspiratory discharge was significantly increased in group S + D ( P ＜ 0.05).Conclusion Doxapram antagonizes sevoflurane-induced inhibition of excitability of medullary respiratory center in rats.