Objectives:To investigate the impact of bone hyperplasia in the thoracolumbar spine caused by diffuse idiopathic skeletal hyperostosis(DISH)on the changes of spinopelvic sagittal parameters between stand-ing and sitting positions.Methods:A total of 61 DISH patients[DISH group,42 males and 19 females,50-76(65.1±6.3)years]who underwent surgical treatment for lumbar spinal stenosis in our hospital between Jan-uary 2019 and December 2023 were retrospectively analyzed.100 age-and sex-matched non-DISH patients undergone the same surgical procedure during the same period were included as control[N-DISH group,63 males and 37 females,54-77(67.5±7.2)years].According to the distribution of osteophytes,the patients in the DISH group with ectopic ossification limited to the thoracic spine were categorized into the T-DISH group,while those with involvement of both thoracic and lumbar spines were divided in the L-DISH group.Preoper-atively,full-spine anteroposterior and lateral X-rays were taken in both standing and sitting positions.All patients were measured for spinopelvic sagittal parameters in standing and sitting positions,including sagittal vertical axis(SVA),pelvic tilt(PT),sacral slope(SS),pelvic incidence(PI),thoracic kyphosis(TK),lumbar lordosis(LL),and proximal femoral angle(PFA).The differences in standing and sitting positions and changes between DISH and N-DISH groups,T-DISH and L-DISH groups were compared.Results:In the standing position,the SVA(P=0.008)and TK(P=0.028)in the DISH group were significantly higher than those in the N-DISH group,while no significant differences were observed in PI,PT,SS,LL,and PFA(P＞0.05).In the sitting position,the TK(P=0.003)and LL(P=0.007)in the DISH group were significantly higher than those in the N-DISH group,whereas no significant differences were noted inSVA,PT,PI,SS,and PFA(P＞0.05).When transitioning from standing to sitting,the changes in SVA(P=0.021),PT(P=0.008),SS(P=0.001),TK(P=0.002),and LL(P＜0.001)in DISH group of patients were significantly smaller than those in N-DISH group of patients.Among DISH patients,the L-DISH group had significantly lower PI(P=0.016),SS(P=0.011),and LL(P=0.006)in the standing position compared to the T-DISH group,while no significant differences were observed in SVA,PT,TK,and PFA(P＞0.05).In the sitting position,the PI(P=0.008)and SS(P=0.007)of the L-DISH group were significantly lower than those of the T-DISH group,while no significant differences were observed in SVA,PT,TK,LL,and PFA(P＞0.05).The changes in LL when transitioning from standing to sitting were significantly lower in the L-DISH group compared to the T-DISH group(P=0.033),while the changes of other sagittal parameters showed no significant difference(P＞0.05).Conclusions:Bone hyperplasia in DISH patients significantly limits spinal mobility,and the restriction is more pronounced in patients with osteophytes extending to the lumbar spine compared to those with isolated thoracic involvement.

Objective To investigate the effects of chronic intermittent hypoxia(CIH)on hippocampal neuronal injury in rats,and to clarify the role of endoplasmic reticulum(ER)stress-related apoptotic pathways.Methods Male Sprague-Dawley rats were randomly assigned to a control group(n=8)or a CIH group(n=8).The CIH group was exposed to intermittent hypoxia for 8 h/day over 8 weeks.Hippocampal neuronal morphology was examined by hematoxylin-eosin staining and transmission electron microscopy.Neuronal apoptosis was assessed using the TUNEL assay.Intracellular Ca2? levels were measured by flow cytometry.The mRNA and protein expression of ER stress-related factors(GRP78,CHOP)and the apoptotic effector Caspase-3 were quantified by qPCR and Western blot.Results Compared with controls,rats in the CIH group exhibited marked hippocampal neuronal damage,including disrupted cytoarchitecture,cytoplasmic dissolution,and swollen rough ER.Ultrastructural analysis revealed nuclear deformation and organelle disruption.TUNEL assay demonstrated a significant increase in apoptotic cells(P<0.05).Flow cytometry showed elevated intracellular Ca2? levels(P<0.05).GRP78,CHOP,and Caspase-3 were significantly upregulated at both mRNA and protein levels in the CIH group(all P<0.05).Conclusion CIH induces pronounced hippocampal neuronal injury and apoptosis in rats,associated with Ca2? dysregulation and activation of ER stress-mediated apoptotic pathways.These findings provide experimental evidence for elucidating the mechanisms of OSAHS-related neuronal injury and identifying potential therapeutic targets.

Objectives:To investigate the impact of bone hyperplasia in the thoracolumbar spine caused by diffuse idiopathic skeletal hyperostosis(DISH)on the changes of spinopelvic sagittal parameters between stand-ing and sitting positions.Methods:A total of 61 DISH patients[DISH group,42 males and 19 females,50-76(65.1±6.3)years]who underwent surgical treatment for lumbar spinal stenosis in our hospital between Jan-uary 2019 and December 2023 were retrospectively analyzed.100 age-and sex-matched non-DISH patients undergone the same surgical procedure during the same period were included as control[N-DISH group,63 males and 37 females,54-77(67.5±7.2)years].According to the distribution of osteophytes,the patients in the DISH group with ectopic ossification limited to the thoracic spine were categorized into the T-DISH group,while those with involvement of both thoracic and lumbar spines were divided in the L-DISH group.Preoper-atively,full-spine anteroposterior and lateral X-rays were taken in both standing and sitting positions.All patients were measured for spinopelvic sagittal parameters in standing and sitting positions,including sagittal vertical axis(SVA),pelvic tilt(PT),sacral slope(SS),pelvic incidence(PI),thoracic kyphosis(TK),lumbar lordosis(LL),and proximal femoral angle(PFA).The differences in standing and sitting positions and changes between DISH and N-DISH groups,T-DISH and L-DISH groups were compared.Results:In the standing position,the SVA(P=0.008)and TK(P=0.028)in the DISH group were significantly higher than those in the N-DISH group,while no significant differences were observed in PI,PT,SS,LL,and PFA(P＞0.05).In the sitting position,the TK(P=0.003)and LL(P=0.007)in the DISH group were significantly higher than those in the N-DISH group,whereas no significant differences were noted inSVA,PT,PI,SS,and PFA(P＞0.05).When transitioning from standing to sitting,the changes in SVA(P=0.021),PT(P=0.008),SS(P=0.001),TK(P=0.002),and LL(P＜0.001)in DISH group of patients were significantly smaller than those in N-DISH group of patients.Among DISH patients,the L-DISH group had significantly lower PI(P=0.016),SS(P=0.011),and LL(P=0.006)in the standing position compared to the T-DISH group,while no significant differences were observed in SVA,PT,TK,and PFA(P＞0.05).In the sitting position,the PI(P=0.008)and SS(P=0.007)of the L-DISH group were significantly lower than those of the T-DISH group,while no significant differences were observed in SVA,PT,TK,LL,and PFA(P＞0.05).The changes in LL when transitioning from standing to sitting were significantly lower in the L-DISH group compared to the T-DISH group(P=0.033),while the changes of other sagittal parameters showed no significant difference(P＞0.05).Conclusions:Bone hyperplasia in DISH patients significantly limits spinal mobility,and the restriction is more pronounced in patients with osteophytes extending to the lumbar spine compared to those with isolated thoracic involvement.

Objective To investigate the effects of chronic intermittent hypoxia(CIH)on hippocampal neuronal injury in rats,and to clarify the role of endoplasmic reticulum(ER)stress-related apoptotic pathways.Methods Male Sprague-Dawley rats were randomly assigned to a control group(n=8)or a CIH group(n=8).The CIH group was exposed to intermittent hypoxia for 8 h/day over 8 weeks.Hippocampal neuronal morphology was examined by hematoxylin-eosin staining and transmission electron microscopy.Neuronal apoptosis was assessed using the TUNEL assay.Intracellular Ca2? levels were measured by flow cytometry.The mRNA and protein expression of ER stress-related factors(GRP78,CHOP)and the apoptotic effector Caspase-3 were quantified by qPCR and Western blot.Results Compared with controls,rats in the CIH group exhibited marked hippocampal neuronal damage,including disrupted cytoarchitecture,cytoplasmic dissolution,and swollen rough ER.Ultrastructural analysis revealed nuclear deformation and organelle disruption.TUNEL assay demonstrated a significant increase in apoptotic cells(P<0.05).Flow cytometry showed elevated intracellular Ca2? levels(P<0.05).GRP78,CHOP,and Caspase-3 were significantly upregulated at both mRNA and protein levels in the CIH group(all P<0.05).Conclusion CIH induces pronounced hippocampal neuronal injury and apoptosis in rats,associated with Ca2? dysregulation and activation of ER stress-mediated apoptotic pathways.These findings provide experimental evidence for elucidating the mechanisms of OSAHS-related neuronal injury and identifying potential therapeutic targets.

Objective:To analyze the iodine nutritional status of children aged 8 - 10 in Tongren City, Guizhou Province, and provide a basis for scientific iodine supplementation for children.Methods:From 2020 to 2022, a systematic sampling method was adopted in 10 districts and counties of Tongren City. Each year, each district and county was divided into 5 districts based on east, west, south, north, and center. One township (street) was selected from each district, and 40 non boarding students aged 8 to 10 were selected from each township (street) to measure the iodine content of household salt and urine samples. The content of salt iodine in children of different yesas as well as the distribution of urine iodine in children of different districts and counties and different genders were analyzed and compared. Additionally, B-ultrasound was used to measure the thyroid volume of some children and the situation of thyroid enlargement was analyzed.Results:From 2020 to 2022, a total of 6 000 salt samples were collected and monitored from children's households, and 5 989 samples of iodized salt were detected, the coverage rate of iodized salt was 99.8%; and 5 750 samples of qualified iodized salt were found, the qualified rate of iodized salt was 96.0%, the consumption rate of qualified iodized salt was 95.8%; and the median salt iodine was 27.3 mg/kg, the difference in the median salt iodine among children between different years was statistically significant ( H = 10.04, P < 0.001). A total of 6 000 urine samples from children were tested, the median urinary iodine was 225.2 μg/L, the median urinary iodine among children in different districts and counties were statistically significantly different ( H = 85.73, P < 0.001); 3 077 male and 2 923 female urine samples were tested, and the median urinary iodine between different genders was statistically significant different ( Z = - 67.10, P < 0.001). The median urinary iodine of male samples were higher than those of female samples(227.8 vs 222.9 μg/L). The thyroid gland of 2 000 children was examined, and the rate of goiter was 1.0% (21/2 000). Conclusions:From 2020 to 2022, the consumption rate of qualified iodized salt, urinary iodine content and goiter rate of children in Tongren City have all met the national standard for eliminating iodine deficiency disorders. The overall iodine nutrition level exceeds the appropriate amount (urinary iodine of 200 - 299 μg/L).

Objective:To investigate the iodine nutrition status of pregnant women in Tongren City, and to provide a basis for scientific iodine supplementation of key population.Methods:From 2020 to 2022, a cross-sectional survey was conducted, and one township (street) was selected from each of the five districts of east, west, south, north, and central in 10 counties (districts) of Tongren City each year. Twenty pregnant women were selected from each township (street) for the determination of iodine level in household salt samples and one random urine sample. The levels of salt iodine and urinary iodine in pregnant women from different years and regions, as well as the distribution of urinary iodine during different pregnancy periods, were compared and analyzed.Results:A total of 3 000 household edible salt samples were collected from pregnant women, with a median salt iodine level of 27.3 mg/kg. The coverage rate of iodized salt was 99.7% (2 991/3 000), the qualified rate of iodized salt was 96.1% (2 875/2 991), and the consumption rate of qualified iodized salt was 95.8% (2 875/3 000). There was a statistically significant difference in the iodine level of household salt consumed by pregnant women in different years ( H = 6.85, P < 0.001). A total of 3 000 urine samples from pregnant women were tested, and the median urinary iodine was 177.4 μg/L. By years, the median urinary iodine levels in different years were 197.8, 169.2, and 168.3 μg/L, with statistically significant differences ( H = 35.46, P < 0.001). By region, there were statistically significant differences in the median urinary iodine levels of pregnant women in different counties (districts, H = 104.00, P < 0.001); among them, Yuping County had the lowest median urinary iodine level, at 149.8 μg/L. By pregnancy periods, there were no statistically significant difference in the median urinary iodine levels of pregnant women in different pregnancy periods ( H = 177.44, P = 0.290). Conclusions:The overall iodine nutrition level of pregnant women in Tongren City is appropriate, and the iodine nutrition of pregnant women in individual areas is insufficient. We should continue to strengthen the monitoring of iodine nutrition level, pay attention to the iodine nutrition status of pregnant women in key areas, and guide pregnant women to supplement iodine scientifically.

Objective:To investigate the clinical results of decompression preserving proximal upper laminae combined with lumbar instrumental fusion in the treatment of lumbar degenerative diseases and the prevention of adjacent segment degeneration (ASD).Methods:A retrospective analysis was conducted on 124 patients (the reserved group) with lumbar degeneration who underwent compression preserving proximal upper laminae combined with fusion surgery involving upper half of the lamina, upper half of the spinous process, adjacent facets, and interspinous ligament at Nanjing Drum Tower Hospital between March 2018 and February 2020. These patients were followed up for more than 2 years. Additionally, 130 patients who underwent traditional total laminectomy decompression combined with fusion surgery from January 2016 to February 2018 were selected as the control group (total laminectomy group). In the reserved group, there were 60 males and 64 females, aged 58.3±10.3 years, including 50 cases of giant lumbar disc herniation, 11 cases of lumbar disc herniation with ossification, 10 cases of simple lumbar spinal stenosis, and 53 cases of degenerative lumbar spondylolisthesis. Total laminectomy group comprised 62 males and 68 females, aged 59.6±9.2 years, with 51 cases of giant lumbar disc herniation, 13 cases of lumbar disc herniation with ossification, 11 cases of simple lumbar spinal stenosis, and 55 cases of degenerative lumbar spondylolisthesis. The number of operative segments, operative time, intraoperative blood loss, postoperative hospital stay, complications, extent of laminectomy, dural sac area, and sagittal spinopelvic parameters were compared between the two groups. Fusion status, adjacent segment stability, and the incidence of ASD were assessed at the last follow-up. Oswestry disability index (ODI) and visual analogue scale (VAS) for back and leg were used to evaluate clinical effectiveness.Results:The follow-up time was 30.5±5.4 months in the reserved group and 31.0±5.8 months in total laminectomy group, and the difference was not statistically significant ( t=0.63, P=0.528). In patients undergoing single segment surgery, the operation time (173.6±47.3 min), blood loss (351.7±102.0 ml) and postoperative hospital stay (7.8±3.1 d) in the reserved group were lower than those in total laminectomy group (196.2±34.2 min, 401.9±97.2 ml, 9.9±3.6 d, respectively), and the differences were statistically significant ( t=2.93, P=0.004; t=2.69, P=0.008; t=3.26, P<0.001). The dural sac area in both groups was significantly improved after surgery, but the extent of laminectomy in the reserved group (22.8±4.5 mm) was smaller than that in total laminectomy group (29.5±4.8 mm), and the difference was statistically significant ( t=7.62, P<0.001). The above indicators of the patients with two segment or three segments in the reserved group were better than those in total resection group, with a statistically significant difference ( P<0.05). PI, PT, SS, and LL showed significant improvement in both groups compared to preoperative values ( P<0.05), with no statistically significant differences between the groups ( P>0.05). At the last follow-up, both groups achieved Bridwell I or II fusion level. The proportion of adjacent vertebral instability in the reserved group (11.3%, 14/124) was lower than that in total laminectomy group (22.3%, 29/130), and the difference was statistically significant (χ 2=5.48, P=0.019). The total incidence of ASD in the reserved group (20.9%, 26/124) was lower than that in total laminectomy group (36.2%, 47/130), and the difference was statistically significant (χ 2=7.15, P=0.008). R-ASD (16.9%, 21/124), S-ASD (4.0%, 5/124) and O-ASD (0, 0/124) in the reserved group were lower than those in total laminectomy group [(25.4% (33/130), 9.3% (12/130) and 1.5% (2/130), respectively)], and the difference was statistically significant (χ 2=8.20, P=0.027). ODI and VAS of back and leg were significantly reduced in both groups compared to preoperative values, and the differences were statistically significant ( P<0.05). There were no significant differences in ODI and VAS scores of back and leg in the reserved group compared with total laminectomy group at 3 months, 1 year, and the last follow-up ( P>0.05). Conclusion:Decompression with preservation of the upper half of the lamina can reduce intraoperative blood loss, shorten operation time and postoperative hospital stay, achieve comparable decompression effects to traditional decompression surgery, and effectively reduce the occurrence of adjacent segment instability and ASD.

Objective:To investigate reversal of vertebral wedging and to evaluate the contribution of adding satellite rods to correction maintenance in patients with adolescent Scheuermann kyphosis (SK) after posterior-only instrumented correction.Methods:A retrospective cohort study with SK was performed. From January 2009 to December 2018, a total of 26 SK patients (21 males and 5 females) who received posterior instrumented correction surgery at the age of 13–16 years were included. The mean age was 14.5±0.9 years. Risser sign was level 1 in 5 patients, level 2 in 10 patients and level 3 in 11 patients. Patients receiving placement with a standard 2-RC construct were composed in the 2-RC group, and those with enhanced instrumentation with satellite rods adding to 2-RC via duet screws were assigned to the S-RC group. The anterior vertebral body height (AVBH), posterior vertebral body height (PVBH), global kyphosis (GK), disc wedging angle (DWA), vertebral wedging angle (VWA) and Scoliosis Research Society questionnaires-22 (SRS-22) were collected preoperatively, immediately postoperatively, and at the latest follow-up. Further, these outcomes were compared between the two groups.Results:The average follow-up durations for the S-RC and 2-RC groups were 3.1±1.0 and 2.9±1.1 years ( t=0.04, P=0.837), respectively. Remarkable postoperative correction of GK was observed in S-RC group and 2-RC group without significant difference (51.1%±5.1% vs. 46.7%±5.8%, t=1.74, P=0.099). The correction loss of S-RC group was significantly less than that at 2-RC group during follow-up (0.6°±0.3° vs. 1.8°±0.8°, t=-6.52, P<0.001). The ratio between AVBH and PVBH of deformed vertebrae notably increased in S-RC group and 2-RC group from post-operation to the latest follow-up ( P<0.05). Compared with the 2-RC group, the S-RC group had significantly greater increase in AVBH/PVBH ratio during follow-up (32.6%±8.5% vs. 22.5%±13.4%, t=2.31, P=0.030). The two groups had similar preoperative and postoperative SRS-22 questionnaire scores for all domains ( P>0.05). Conclusion:The AVBH of deformed vertebrae could be increased after posterior correction in SK patients. Compared with the traditional two-rod construct, satellite rods construction could be more effective which could achieve greater vertebral remodeling and less correction loss.

Objective:To investigate the association of the cross-sectional area of lumbar paraspinal muscle with the spino-pelvic profile based on Roussouly classification.Methods:From January 2019 to December 2019, 102 patients with lumbar disc herniation were collected, the index level included L 2, 3 in 3 cases(2.9%), L 3, 4 in 14 cases(13.7%), L 4,5 in 58 cases (56.9%), and L 5S 1 in 27 cases (23.5%). According to Roussouly classification, there were 29 cases of type I (28.4%), aged 57.0±11.7 years old (range 43 to 72 years old), 31 of type II (30.4%), aged 56.9±10.3 years old (range 40 to 70 years old), 28 of type III (27.5%), aged 53.5±12.9 years old (range 42 to 70 years old), and 14 of type IV (13.7%), aged 59.7±9.5 years old (range 51 to 70 years old). The clinical status of the patients were evaluated with the MOS 36-item short-form health survey (SF-36), Oswestry disability index (ODI) and visual analog scale (VAS). Select all patients with L 1, 2, L 2, 3, L 3, 4, L 4, 5 and L 5S 1 disc level axial MRI images, to measure the cross-sectional area (CSA) of paraspinal muscles (back extensor muscle and psoas muscle) and the CSA of intervertebral disc at each disc level, and calculate the relative cross-sectional area (RCSA: the ratio of the CSA of muscles to that of the disc at the same level). One-way ANOVA was used to test the RCSA of the paraspinal muscles of the four groups, and then LSD- t test was used for pair wise comparisons to compare the RCSA of the paraspinal muscles in each group. Results:There was no significant difference in age ( F=1.067, P=0.367), female/male sex ratio ( χ2=2.412, P=0.491) and body mass index ( F=0.326, P=0.481). Roussouly type I group showed lower SF-36 score in both SF-36 PCS (31.5±6.5, F=3.207, P=0.047) and SF-36 MCS (33.9±5.7, F=3.409, P=0.031) compared with the other three types. In contrast, there were no significant differences in VAS Back Pain ( F=0.140, P>0.05), VAS leg pain ( F=0.622, P>0.05). and ODI scores ( F=1.075, P>0.05) among the types. At each level from L 1, 2 to L 5S 1, the RCSA of psoas muscle in Roussouly type IV (19.18±6.98, 35.36±10.37, 41.25±14.35, 61.58±12.03, 59.29±11.73) was significantly lower than that in patients with any other Roussouly type ( P<0.05), while no significant difference in the psoas RCSA among type I, type II and type III curves ( P>0.05). With regards to back extensor muscle, the RCSAs of back extensor muscle in Roussouly types I (135.32±19.86, 138.53±22.92, 125.06±21.44, 122.40±19.69, 110.87±18.08) and II (131.30±18.68, 136.39±24.87, 122.61±22.52, 121.10±20.47, 107.46±18.29) were significantly lower than those in Roussouly type III and IV at each level ( P<0.05), yet no significant difference between type I and II or between type III and IV. The ratio between the RCSA of back extensor muscle and psoas muscle in four types increased gradually from L 1, 2 to L 5S 1, with that being higher in type II (0.20±0.07, 0.33±0.09, 0.40±0.13, 0.58±0.11, 0.65±0.08) and lower in type IV (0.13±0.05, 0.24±0.07, 0.31±0.10, 0.47±0.10, 0.52±0.11). Conclusion:RCSA of paraspinal muscles varied among Roussouly types, suggesting a significant association between paraspinal muscles and the sagittal spino-pelvic alignment. Sagittal spino-pelvic alignment may be involved in the degeneration of paraspinal muscles.

Objective:This study is to investigate the predictive value of serum levels of TIMP-2 and insulin-like growth factor-binding protein 7(IGFBP7) in patients with DCD(donation after cardiac death) kidney transplantation.Methods:A prospective research design was used to select DCD kidney transplant patients admitted to the Li Huili Hospital of Ningbo University from January 2018 to October 2020.Inclusion criteria: ①Complete data; ②There were no serious complications affecting the function of the transplanted kidney in the early postoperative period.Exclusion criteria: ①Incomplete data; ②Patients were unable or unwilling to cooperate with the study; ③Severe complications affecting the function of the transplanted kidney occurred early after the operation.The ELASE method was used to quantitatively detect the serum TIMP-2 and IGFBP7 levels at 6, 12, 24, 48, 72 hours and 7 days after renal transplantation, and monitor the serum creatinine values during the same period and 21 days after the operation. According to the occurrence of DGF, the measured values of TIMP-2 and IGFBP7 at different time points and their product's ability to predict the occurrence of DGF after kidney transplantation were analyzed. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the diagnostic efficacy of TIMP-2 and IGFBP7 for DGF.Results:A total of 33 patients were enrolled, 7 patients (21.2%) in the DGF group and 26 patients (78.8%) in the non-DGF group. Between the two groups, the donor glomerular filtration rate were [98.5(15.8-132.5)ml/(min·1.73m 2) and 79.1(60.6-102.5)ml/(min·1.73m 2)], recipient gender (male/female: 3/4 cases and 10/16 cases), recipient age [48(34-56) Years old and 45(23-61) years old], the recipient's preoperative creatinine [1114.0(731.4-1293.0)μmol/L and 858.4(657.6-1051.9)μmol/L], the recipient's preoperative urea nitrogen [15.0(13.2-19.6)mmol/L and 17.3(13.6-20.9)mmol/L], receptor preoperative albumin [43.5(38.5-45.3)mmol/L and 41.2(37.5-46.1) mmol/L], recipient dialysis method [hemodialysis/peritoneal dialysis: 3/4 cases and 9/17 cases], warm ischemia time [6(5-7) and 5(4-6) min, there was no statistically significant difference] ( P>0.05). The values of serum IGFBP7 and TIMP-2×IGFBP7 in the DGF group were higher than those in the non-DGF group at all time points ( F=15.753, P=0.040; F=13.000, P=0.024), while serum TIMP-2 was not significant between the two groups difference ( F=1.157, P=0.075). For the diagnostic value of DGF, the AUC of serum IGFBP7 at 48 h after surgery was 0.863 (95% CI 0.696-1.000, P=0.004). When 5.97 ng/ml was used as the cut-off value, the sensitivity was 85.7% and the specificity was 80.8 %. The AUC of TIMP-2×IGFBP7 at 48 hours after surgery was 0.819 (95% CI 0.641-0.996, P=0.011). When 62.06(ng/ml) 2 was used as the cutoff value, the sensitivity was 71.4% and the specificity was 80.8%.There was no statistical difference in the area under the curve between the two ( P>0.05). There were differences in the dynamic trend of serum IGFBP7 and creatinine in the DGF group. Serum IGFBP7 at 7 days after surgery was positively correlated with creatinine at 21 days after surgery. Conclusion:Serum IGFBP7 and TIMP-2×IGFBP7 could predict the occurrence of DGF after DCD donor kidney surgery. The predictive value changes with time. Among them, 48h and 7d after surgery are the most valuable. However, serum TIMP-2 has not been found to have predictive value in this study.