BACKGROUND:The cortical bone reinforcement area of bone cement in the vertebral body during percutaneous vertebroplasty for osteoporotic vertebralcompression fractures has an important influence on spinal biomechanics and clinical efficacy,but previous studies were mostly limited to the two-dimensional level. OBJECTIVE:To investigate the effect of the difference in cortical bone reinforcement of bone cement in the three-dimensional plane of the vertebral bodyon the biomechanical distribution of the vertebral body,adjacent intervertebral disc and endplate in osteoporotic vertebral compression fractures by finite element analysis during percutaneous vertebroplasty,so as to evaluate its effect.METHODS:The finite element model of percutaneous vertebroplasty for osteoporotic vertebral compression fractures of T12 vertebrae was established. The presence or absence of cortical reinforcement of bone cement was analyzed in groups from the transverse,sagittal and coronal planes. The effects of cortical reinforcement on the biomechanics of T12 vertebral cancellous bone,cortical bone,T11/T12 intervertebral disc,T12/L1 intervertebral disc,T11 lower endplate,and L1 upper endplate under different body position changes were studied.RESULTS AND CONCLUSION:(1) Under the effect of vertical compression force,percutaneous vertebroplasty cortical reinforcement with or without bone cement had no significant changes in structural stress except for the injured vertebral cortical bone. (2) The Von Mises stress value of the injured cortical bone was significantly different in human forward flexion,left/right bend,and left/right axial rotation. The maximum Von Mises stress value in the best group of cortical reinforcement was significantly smaller than that in the non-cortical reinforcement group. The Von Mises stress value showed a downward trend with extensive cortical reinforcement in the same plane. (3) It is indicated that when percutaneous vertebroplasty is performed,bone cement should be distributed as broadly and symmetrically horizontally along the cortical edge of the vertebral body as far as possible in cross section. Bone cement in sagittal plane should be widely distributed longitudinally near the upper and lower endplates and the anterior and posterior walls. Bone cement in coronal plane should be widely distributed on both sides of the midline while symmetrically touching the upper and lower endplates and lateral walls. It can effectively avoid the risk of refracture of the injured vertebra and does not increase the risk of adjacent vertebral fracture and residual discogenic pain.

Cerebral ischemia-reperfusion injury can lead to secondary brain damage through com-plex pathological processes such as ion imbalance,inflammation,mitochondrial dysfunction,oxidative stress,and increased vascular permeability,serious-ly affecting the prognosis and quality of life of isch-emic stroke patients.How to effectively reduce and prevent neurological damage caused by CIRI has become a key and hot topic in CIS research.In re-cent years,many studies have confirmed that the active ingredients of traditional Chinese medicine can alleviate oxidative stress,inhibit autophagy,regulate cell apoptosis,control neuroinflammation,reduce cell apoptosis index,alleviate neuronal his-topathological damage,promote neuronal survival,enhance synaptic plasticity,and play a therapeutic role in CIRI through the PI3K/Akt signaling pathway.In summary,this article provides a review of the PI3K/Akt signaling pathway and its role in CIRI,as well as the research on the regulation of PI3K/Akt signaling by active ingredients in traditional Chi-nese medicine for the treatment of CIRI.The aim is to provide a theoretical basis for the clinical use of active ingredients in traditional Chinese medicine to alleviate CIRI damage.

Cerebral ischemia-reperfusion injury can lead to secondary brain damage through com-plex pathological processes such as ion imbalance,inflammation,mitochondrial dysfunction,oxidative stress,and increased vascular permeability,serious-ly affecting the prognosis and quality of life of isch-emic stroke patients.How to effectively reduce and prevent neurological damage caused by CIRI has become a key and hot topic in CIS research.In re-cent years,many studies have confirmed that the active ingredients of traditional Chinese medicine can alleviate oxidative stress,inhibit autophagy,regulate cell apoptosis,control neuroinflammation,reduce cell apoptosis index,alleviate neuronal his-topathological damage,promote neuronal survival,enhance synaptic plasticity,and play a therapeutic role in CIRI through the PI3K/Akt signaling pathway.In summary,this article provides a review of the PI3K/Akt signaling pathway and its role in CIRI,as well as the research on the regulation of PI3K/Akt signaling by active ingredients in traditional Chi-nese medicine for the treatment of CIRI.The aim is to provide a theoretical basis for the clinical use of active ingredients in traditional Chinese medicine to alleviate CIRI damage.

BACKGROUND:The cortical bone reinforcement area of bone cement in the vertebral body during percutaneous vertebroplasty for osteoporotic vertebralcompression fractures has an important influence on spinal biomechanics and clinical efficacy,but previous studies were mostly limited to the two-dimensional level. OBJECTIVE:To investigate the effect of the difference in cortical bone reinforcement of bone cement in the three-dimensional plane of the vertebral bodyon the biomechanical distribution of the vertebral body,adjacent intervertebral disc and endplate in osteoporotic vertebral compression fractures by finite element analysis during percutaneous vertebroplasty,so as to evaluate its effect.METHODS:The finite element model of percutaneous vertebroplasty for osteoporotic vertebral compression fractures of T12 vertebrae was established. The presence or absence of cortical reinforcement of bone cement was analyzed in groups from the transverse,sagittal and coronal planes. The effects of cortical reinforcement on the biomechanics of T12 vertebral cancellous bone,cortical bone,T11/T12 intervertebral disc,T12/L1 intervertebral disc,T11 lower endplate,and L1 upper endplate under different body position changes were studied.RESULTS AND CONCLUSION:(1) Under the effect of vertical compression force,percutaneous vertebroplasty cortical reinforcement with or without bone cement had no significant changes in structural stress except for the injured vertebral cortical bone. (2) The Von Mises stress value of the injured cortical bone was significantly different in human forward flexion,left/right bend,and left/right axial rotation. The maximum Von Mises stress value in the best group of cortical reinforcement was significantly smaller than that in the non-cortical reinforcement group. The Von Mises stress value showed a downward trend with extensive cortical reinforcement in the same plane. (3) It is indicated that when percutaneous vertebroplasty is performed,bone cement should be distributed as broadly and symmetrically horizontally along the cortical edge of the vertebral body as far as possible in cross section. Bone cement in sagittal plane should be widely distributed longitudinally near the upper and lower endplates and the anterior and posterior walls. Bone cement in coronal plane should be widely distributed on both sides of the midline while symmetrically touching the upper and lower endplates and lateral walls. It can effectively avoid the risk of refracture of the injured vertebra and does not increase the risk of adjacent vertebral fracture and residual discogenic pain.

Objective:To study the timeliness incentive nursing intervention applied to rectal cancer postoperative rehabilitation of colostomy.Methods:A total of 120 cases of permanent rectal cancer patients who were treated with colostomy in Dalian University affiliated Xinhua Hospital during February 2016 to February 2019 were evenly divided into observation group and control group by random number table method. The control group were caught out by conventional postoperative rehabilitation nursing. The control group were caught out by the timeliness incentive nursing intervention. Two groups of patients were compared before and after continuous care for 3 months in many ways which included the pain degree, the time to get out of bed, the time of first eating, length of hospital stay, negative emotions, compliance, self-management ability and postoperative complications.Results:The pain degree, the first activity time away from the bed, the first time to eat and the hospital stay were 1.9±0.5, (14.36±2.43) h, (21.39±3.08) h, (8.78±0.82) d in the observation group, and 3.5±1.1, (20.02±2.97) h, (27.14±3.96) h, (11.01±1.43) d in the control group. The difference was statistically significant ( t values were 5.369- 9.539, P<0.05). The negative emotions such as anxiety and depression in the observation group scored 41.4±2.3 and 39.9±2.0 after nursing. However, the control group scored 47.6±3.8 and 45.9±2.2 after nursing, respectively. The difference was statistically significant ( t values were 3.509, 3.519, P<0.05). The self-management abilities of patients in the observation group, including emotional cognition management, general life management, disease cognitive management and colostomy nursing management were 23.43±2.12, 24.04±0.96, 23.02±3.22, and 21.43±1.75, significantly higher than those in the control group (18.96±2.82,18.89±1.69, 17.95±2.61, 16.87±2.12). The difference was statistically significant ( t values were 17.712-18.879, P<0.05). The compliance of the observation group in nursing, rehabilitation and reexamination was 0.79±0.19, 0.98±0.23 and 0.87±0.35, significantly higher than those of the control group (1.02±0.26, 1.58±0.36, 1.46±0.43). The difference was statistically significant ( t values were 5.532, 5.221, 5.645, P < 0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group. The incidence of observation group was 8.33% (5/60), and the incidence of control group was 23.33% (14/60). The difference was statistically significant ( χ 2 values were 5.065, P<0.05). Conclusions:Timeliness incentive can obviously shorten the postoperative recovery time of colostomy patients in getting out of bed and capacity to eat, length of hospital stay. It can relieve the postoperative pain and the negative emotions, and also improve compliance and relieve self-management ability, and reduce the occurrence of postoperative complications.

Objective:To investigate subjective ranking of factors influencing life and work among submariners in long oceangoing voyage, and to make some exploratory analysis and classification of those factors.Methods:A total of 546 submariners who had taken part in long oceangoing voyage were investigated by the specially designed Questionnaire on the Influence of Various Factors in the Long Oceangoing Voyage of Submariners. The data were analyzed by SPSS 23.0 software. Results:During the long oceangoing voyage, the order of the factors influencing submariners′ life and work from high degree to low degree were as follows: submarine harmful gas, submarine noise, biorhythm disorder, worries about personal health, lack of information, monotonous life, temperature and humidity of post and rest cabin, difficulty in personal hygiene maintenance, worries about parents′ health, food problem, narrow space, pressures from operation on post and learning, seasickness, family economic pressure, limited personal development, effects of color and lighting, relationships with leaders and fellow crew members. These factors constituted two categories of factors: physical and chemical environment factors and psychosocial factors. The physical and chemical environmental factors included loud noise and high pollution, seasickness and visual discomfort, high temperature and humidity, self-hygiene problems and biorhythm disorder; and the psychosocial factors were health concerns, life pressure, monotonous life, interpersonal relationship pressure, and work pressure.Conclusion:The main factors that greatly affect submariners′ work and life in long oceangoing voyage are harmful gas, noise, biorhythm disorder, worries about personal health, lack of information, and monotonous life. Generally speaking, the influence of the physical and chemical environment factors is greater than that of the psychosocial factors, although the latter one cannot be neglected as a major factor. It is necessary to improve the working and living environment of submariners through some targeted work, e. g. optimizing submarine design and providing psychological function care, so as to reduce the influence of various factors on the life and work of submariners.

Objective:To investigate subjective ranking of factors influencing life and work among submariners in long oceangoing voyage, and to make some exploratory analysis and classification of those factors.Methods:A total of 546 submariners who had taken part in long oceangoing voyage were investigated by the specially designed Questionnaire on the Influence of Various Factors in the Long Oceangoing Voyage of Submariners. The data were analyzed by SPSS 23.0 software. Results:During the long oceangoing voyage, the order of the factors influencing submariners′ life and work from high degree to low degree were as follows: submarine harmful gas, submarine noise, biorhythm disorder, worries about personal health, lack of information, monotonous life, temperature and humidity of post and rest cabin, difficulty in personal hygiene maintenance, worries about parents′ health, food problem, narrow space, pressures from operation on post and learning, seasickness, family economic pressure, limited personal development, effects of color and lighting, relationships with leaders and fellow crew members. These factors constituted two categories of factors: physical and chemical environment factors and psychosocial factors. The physical and chemical environmental factors included loud noise and high pollution, seasickness and visual discomfort, high temperature and humidity, self-hygiene problems and biorhythm disorder; and the psychosocial factors were health concerns, life pressure, monotonous life, interpersonal relationship pressure, and work pressure.Conclusion:The main factors that greatly affect submariners′ work and life in long oceangoing voyage are harmful gas, noise, biorhythm disorder, worries about personal health, lack of information, and monotonous life. Generally speaking, the influence of the physical and chemical environment factors is greater than that of the psychosocial factors, although the latter one cannot be neglected as a major factor. It is necessary to improve the working and living environment of submariners through some targeted work, e. g. optimizing submarine design and providing psychological function care, so as to reduce the influence of various factors on the life and work of submariners.

Objective To study the clinical and genetic features of familial paroxysmal kinesigenic dyskinesia (PKD). Methods The clinical information of 14 family members in one pedigree, including 2 patients (one treated in hos?pital, the other not treated) were analyzed and the response to treatment and prediction were followed up. DNA was ex?tracted from peripheral blood samples, and then screened for PRRT2 mutations. Results There were two male patients in the pure PKD pedigree, Prevalence rate was 14.3%,One of the PKD patients showed good response to carbamazepine as well as lamotrigine whereas other patients recovered without treatment. We detected a nonsense mutation c.797G>A (p.266R>Q) in PRRT2 gene in three family members. One affected member harboring PRRT2 mutation resulted from the incomplete penetrance of the disease,PKD and polycystic kidney disease coexist in the pedigree which showed autoso?mal dominant inheritance with incomplete penetrance and anticipation. Conclusions The curative effect of antiepileptic drugs to purely familial PKD is related to mutations and clinical features;Treatments should be decided based upon clini?cal features and mutations.