Objective:To evaluate the characteristic manifestations of lumbar fusion following oblique lateral interbody fusion (OLIF), determine the specific incidence of these patterns, and the identify factors associated with fusion characteristics.Methods:This retrospective study analyzed 209 patients who underwent OLIF surgery at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, between July 2017 and September 2023. The cohort had a mean age of 64.2±9.8 years and included 125 males and 84 females. A total of 338 lumbar segments were assessed, comprising 159 segments treated with stand-alone OLIF (OLIF-SA) and 179 segments treated with OLIF combined with posterior pedicle screw fixation (OLIF-PSF). Inclusion criteria were: patients aged 18-80 years who underwent OLIF with complete radiographic records. Surgical parameters, including fixation method, number of fused segments, surgical approach, and cage dimensions (height and width), were obtained from operative records. Radiographic evaluation included preoperative osteophytes, Hounsfield unit (HU) values of endplates, and cage positioning. Fusion rate, fusion pattern (lateral vs. central), cage subsidence, and related influencing factors were assessed. Clinical outcomes were measured via the Oswestry disability index (ODI) and visual analog scale (VAS) preoperatively, immediately postoperatively, and at 1-year follow-up. Results:The overall fusion rate was 98.2% (332/338), with a non-union rate of 1.8% (6/338). The incidence of lateral fusion was 40.2% (136/338). In the OLIF-SA group, lateral and central fusion rates were 50.3% (80/159) and 49.7% (79/159), respectively, with no cases of non-union. In the OLIF-PSF group, lateral fusion occurred in 31.3% (56/179), central fusion in 65.4% (117/179), and non-union in 3.3% (6/179), with statistically significant differences between groups ( P<0.05). Preoperative osteophytes and higher endplate HU values were significantly associated with lateral fusion ( P<0.05). However, cage dimensions and cage position (anterior-posterior and lateral placement) were not significantly associated with fusion pattern ( P>0.05). Overall, 61.5% (208/338) of segments showed no cage subsidence; 24.5% (83/338) had settling, and 14.0% (47/338) had grade 1 or higher subsidence. Among lateral fusion cases, the rates of no subsidence, anchoring, grade 1, grade 2, and grade 3 subsidence were 67.6%, 21.3%, 7.4%, 3.9%, and 0.7%, respectively. In the central fusion group, these rates were 59.2%, 27.6%, 9.2%, 2.5%, and 1.3%, respectively. In the non-union group, grade 2 and 3 subsidence occurred in 50% (3/6) each, significantly higher than in the other fusion groups ( P<0.05). Post hoc analysis confirmed that grade 2 and 3 subsidence rates were significantly elevated in the non-union group compared to the lateral and central fusion groups, while other subsidence categories showed no significant differences across groups. Clinically, patients showed significant improvements in ODI and VAS scores following surgery ( P<0.05). Conclusions:Lateral fusion occurred in 40.2% of OLIF cases. The OLIF-SA technique, preoperative osteophytes, and elevated preoperative HU values were significantly associated with lateral fusion. In contrast, surgical approach, number of fused segments, cage height, width, and cage positioning did not significantly influence the occurrence of lateral fusion.

Objective:To evaluate the characteristic manifestations of lumbar fusion following oblique lateral interbody fusion (OLIF), determine the specific incidence of these patterns, and the identify factors associated with fusion characteristics.Methods:This retrospective study analyzed 209 patients who underwent OLIF surgery at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, between July 2017 and September 2023. The cohort had a mean age of 64.2±9.8 years and included 125 males and 84 females. A total of 338 lumbar segments were assessed, comprising 159 segments treated with stand-alone OLIF (OLIF-SA) and 179 segments treated with OLIF combined with posterior pedicle screw fixation (OLIF-PSF). Inclusion criteria were: patients aged 18-80 years who underwent OLIF with complete radiographic records. Surgical parameters, including fixation method, number of fused segments, surgical approach, and cage dimensions (height and width), were obtained from operative records. Radiographic evaluation included preoperative osteophytes, Hounsfield unit (HU) values of endplates, and cage positioning. Fusion rate, fusion pattern (lateral vs. central), cage subsidence, and related influencing factors were assessed. Clinical outcomes were measured via the Oswestry disability index (ODI) and visual analog scale (VAS) preoperatively, immediately postoperatively, and at 1-year follow-up. Results:The overall fusion rate was 98.2% (332/338), with a non-union rate of 1.8% (6/338). The incidence of lateral fusion was 40.2% (136/338). In the OLIF-SA group, lateral and central fusion rates were 50.3% (80/159) and 49.7% (79/159), respectively, with no cases of non-union. In the OLIF-PSF group, lateral fusion occurred in 31.3% (56/179), central fusion in 65.4% (117/179), and non-union in 3.3% (6/179), with statistically significant differences between groups ( P<0.05). Preoperative osteophytes and higher endplate HU values were significantly associated with lateral fusion ( P<0.05). However, cage dimensions and cage position (anterior-posterior and lateral placement) were not significantly associated with fusion pattern ( P>0.05). Overall, 61.5% (208/338) of segments showed no cage subsidence; 24.5% (83/338) had settling, and 14.0% (47/338) had grade 1 or higher subsidence. Among lateral fusion cases, the rates of no subsidence, anchoring, grade 1, grade 2, and grade 3 subsidence were 67.6%, 21.3%, 7.4%, 3.9%, and 0.7%, respectively. In the central fusion group, these rates were 59.2%, 27.6%, 9.2%, 2.5%, and 1.3%, respectively. In the non-union group, grade 2 and 3 subsidence occurred in 50% (3/6) each, significantly higher than in the other fusion groups ( P<0.05). Post hoc analysis confirmed that grade 2 and 3 subsidence rates were significantly elevated in the non-union group compared to the lateral and central fusion groups, while other subsidence categories showed no significant differences across groups. Clinically, patients showed significant improvements in ODI and VAS scores following surgery ( P<0.05). Conclusions:Lateral fusion occurred in 40.2% of OLIF cases. The OLIF-SA technique, preoperative osteophytes, and elevated preoperative HU values were significantly associated with lateral fusion. In contrast, surgical approach, number of fused segments, cage height, width, and cage positioning did not significantly influence the occurrence of lateral fusion.

Objective:To understand the current status of HIV self-testing reagent use in pre-exposure prophylaxis (PrEP) and related factors in men who have sex with men (MSM).Methods:From December 2018 to December 2019, "Gold data" online platform (www.jinshuju.com) was used to conduct multicenter PrEP studies in Shenyang, Beijing, Chongqing and Shenzhen of China.Results:A total of 1 222 MSM PrEP users were included in the multicenter study. The average age of the participants was (31.5±8.7) years, and the number of sexual partners in the past three months was 3 ( P 25, P 75:2,6). The proportions of those who did not use condoms in anal sex with fixed, casual and commercial partners were 62.7% (456/727), 56.3% (440/781) and 41.0% (16/39), respectively. Up to 74.5% (910/1 222) of participants had used HIV self-testing reagents, and the number of HIV self-testing during last year was 3 ( P 25, P 75:2,5). The multivariate logistic regression analysis indicated that compared with age group >40 years, those with education level of junior high school or below, those with psychological identity as female, event driven PrEP users, those never using new type drugs in past 3 months, the participants aged 18- years (a OR=2.06, 95% CI: 1.35-3.14), 26- years (a OR=2.72, 95% CI: 1.77-4.17), 31- years (a OR=1.76, 95% CI: 1.19-2.59), undergraduates (a OR=2.18, 95% CI: 1.35-3.49), graduate students and above (a OR=3.06, 95% CI: 1.69-5.54), those with psychological identity as male (a OR=3.22, 95% CI: 1.55-6.70), daily PrEP users (a OR=1.35, 95% CI: 1.03-1.78), and new type drug users in the past three months (a OR=1.72, 95% CI: 1.30-2.28) had higher proportions of HIV self-testing behaviors. Conclusions:The proportion of HIV self-testing in MSM PrEP users was high, while it was relatively low in older age group, event driven PrEP users and MSM never using new type drugs. To assess and improve the effectiveness and compliance of PrEPs, it is necessary to provide better HIV self-testing service for MSM with low HIV self-testing rate.

Objective:To investigate the effects of a single deep helium-oxygen (heliox) diving on divers’ pulmonary function.Methods:In April 2019, 15, 5, and 6 male divers of the Second Detachment of Risk Prevention and Rescue were selected to perform the 80 m, 100 m, and 120 m heliox diving, respectively. Their pulmonary functions were measured before, immediately after, and 24 h after diving.Results:The forced expired volume in one second (FEV1.0) / forced vital capacity (FVC), and maximum expiratory flow at 25% of vital capacity (MEF 25%) of divers immediately after 80 m heliox diving were lower than those before diving, and there were statistically significant differences ( P<0.05). The FEV1.0, FEV1.0/FVC, peak expiratory flow (PEF), and maximum expiratory flow at 75% of vital capacity (MEF 75%) of divers immediately after 100 m and 120 m heliox diving presented a decreasing trend, but there was no statistically significant difference( P>0.05). The results of the above measurements 24 h after the diving rebounded close to the levels before diving. Conclusion:A single deep heliox diving can cause temporary expiratory and small airway dysfunction, which will disappear 24 h after the diving.

Objective:To investigate the effects of a single deep helium-oxygen (heliox) diving on divers’ pulmonary function.Methods:In April 2019, 15, 5, and 6 male divers of the Second Detachment of Risk Prevention and Rescue were selected to perform the 80 m, 100 m, and 120 m heliox diving, respectively. Their pulmonary functions were measured before, immediately after, and 24 h after diving.Results:The forced expired volume in one second (FEV1.0) / forced vital capacity (FVC), and maximum expiratory flow at 25% of vital capacity (MEF 25%) of divers immediately after 80 m heliox diving were lower than those before diving, and there were statistically significant differences ( P<0.05). The FEV1.0, FEV1.0/FVC, peak expiratory flow (PEF), and maximum expiratory flow at 75% of vital capacity (MEF 75%) of divers immediately after 100 m and 120 m heliox diving presented a decreasing trend, but there was no statistically significant difference( P>0.05). The results of the above measurements 24 h after the diving rebounded close to the levels before diving. Conclusion:A single deep heliox diving can cause temporary expiratory and small airway dysfunction, which will disappear 24 h after the diving.

Objective: To investigate and analyze serological and hepatic morphological changes in aged rats with non-alcoholic fatty liver disease(NAFLD)by establishing NAFLD model with SD rats at different months of age. Methods: Male SD rats were randomly divided into four groups according to age: the aged model group(18-months-old), the aged control group(18-months-old), the young model group(2-months-old)and the young control group(2-months-old), with 12 rats in each group.Rats in the model groups and the control groups were fed a 45% high-fat diet and a normal diet, respectively, for eight weeks.Serum biochemical indexes and the insulin index were measured.Hepatic histological changes were evaluated under a light microscope following HE staining and Oil red staining. Results: The body and liver weights of the rats increased with age, and the average rate of weight growth and liver wet weight of the model groups were higher than those of their corresponding control groups(P<0.01). Levels of serum alanine aminotransferase(ALT), triglycerides(TG), cholesterol(CHOL), glucose(GLU), fasting insulin(FINS)and homeostatic model assessment of insulin resistance(HOMA-IR)in the aged model group were higher than those in the corresponding control group and of the young model group(P<0.05). Under the light microscope, hepatic cells stained with HE and Oil red showed diffuse swelling and were full of lipid vacuoles in the model groups.In the aged model group, hepatic cells were characterized by macrovesicular steatosis with focal necrosis. Conclusions Clear hyperlipemia, hyperglycemia and hyperinsulinemia can be seen in a NAFLD model induced by short-term high-fat feeding.Insulin resistance and decreased insulin sensitivity are more significant in aged rats with NAFLD.

OBJECTIVE： To provide scientific basis for the utilization and development of Miao medicine Oxalis corniculata by promoting the quality standard of it. METHODS： Total of 12 batches of O. corniculata were collected from Guizhou， Anhui and Henan， etc. Microscopic characteristics of 12 batches of O. corniculata powder were observed. According to the corresponding methods in 2015 edition of Chinese Pharmacopoeia （part Ⅳ）， TLC was used for qualitative identification [developing solvent was trichloromethane-methanol-formic acid （8 ∶ 1 ∶ 0.1， V/V/V）]， and the contents of moisture， total ash， acid insoluble ash and alcohol soluble extractive from 12 batches of O. corniculata were determined. The content of isovitexin was determined by HPLC. The determination was performed on Venusil XBP C18 （L） with mobile phase consisted of acetonitrile-0.1％ phosphoric acid solution  （15 ∶ 85， V/V） at the flow rate of 1 mL/min. The column temperature was 35 ℃， and the detection wavelength was set at 338 nm. The sample size was 10 μL. RESULTS： Microscopic observation showed that the powder was grayish brown to yellowish brown， with many non-glandular hairs and obvious fibrous pore. Results of TLC identification showed that the spots of the same color appeared in the corresponding positions of the test and the control chromatogram. The contents of moisture， total ash， acid insoluble ash and alcohol soluble extract from samples were 6.66％-12.13％， 9.16％-13.79％， 1.58％-4.63％ and 5.22％-15.79％， respectively. Results of HPLC method showed that the concentration of isovitexin showed a good linear relationship in the range of 5.20-78.3 μg/mL （r＝0.999 0）； RSDs of reproducibility （n＝9）， intermediate precision （n＝6） and stability （24 h， n＝6） tests were all lower than 2.0％； and the recovery rates were 97.54％-99.52％ （RSD＝0.74％， n＝6）； the contents of isovitexin in 12 batches of O. corniculata were 0.036％-0.144％ （n＝3）. CONCLUSIONS： Qualitative and quantitative identification methods of O. corniculate were established， which can be used as a reference for improving the quality standard of O. corniculata.

Objective To investigate the diagnostic value and the impact on treatment decision of 18F-FDG PET/CT in differentiated thyroid carcinoma (DTC) patients with elevated serum thyroglobulin (Tg) levels and negative radioiodine 131I post-therapy whole body scan (131I-RxWBS).Methods Totally 72 patients with DTC who had elevated serum Tg levels and negative 131I-RxWBS were enrolled,and 18F-FDG PET/CT was performed.The imaging results of 18F-FDG PET/CT were compared with the clinical results of surgical pathology or 6 to 36 months follow up.The diagnostic efficacy of 18F-FDG PET/CT in detection of recurrence and/or metastasis of DTC with elevated Tg levels and negative 131I-RxWBS was evaluated.Results The accuracy,sensitivity,specificity,positive prediction value and negative prediction value of 18F-FDG PET/CT in diagnosis of DTC with elevated Tg levels and negative 131I-RxWBS was 83.33％ (60/72),89.47％ (34/38),76.47％ (26/34),80.95％ (34/42) and 86.67％ (26/30),respectively.18F-FDG PET/CT changed the treatment strategies of 35 patients (35/72,48.61 ％) among 72 patients,while recurrence or metastasis of DTC was not found during clinical follow-up in 23 of these 35 patients (23/35,65.71％) who underwent reoperation,but was detected in the other 12 patients (12/35,34.29％).Conclusion 18F-FDG PET/CT is a valuable method for detection of recurrence and/or metastasis of DTC with elevated Tg levels and negative 131I-RxWBS,also for guiding the follow-up treatment strategy.

ObjectiveTo investigate clinical features and outcomes in acute ischemic stroke patients with remote symptomatic intracranial hemorrhage (sICHr) after intravenous thrombolysis.MethodsThe acute ischemic stroke patients with sICHr after intravenous thrombolysis therapy were enrolled retrospectively.The clinical data were collected and the related literature was analyzed and summarized.ResultsA total of 6 acute ischemic stroke patients with sICHr were enrolled, including 4 males.Three patients had a history of using antiplatelet agents, 2 with atrial fibrillation, 4 with hypertension, 3 with previous stroke history, 4 with smoking history, and 4 had sICHr at 2 h after intravenous thrombolysis.Of the 14 hemorrhagic foci (except in the infarct areas), 10 were in the cerebral cortex.Three patients died within 1 week, and 1 was in a persistent vegetative state.Conclusions SICHr after intravenous thrombolysis in patients with acute ischemic stroke is mainly located in the cerebral cortex.The outcomes in acute ischemic stroke patients with SICHr after intravenous thrombolysis are poor, and the mortality is high.

Objective To study the effect of CBT resection on blood pressure in essential hypertensive subjects.Methods Clinical data of 24 essential hypertensive patients (BP ＞ 140/90 mmHg or was using anti-hypertensive drugs) with CBT resection from May 2005 to March 2016 was analyzed,retrospectively.The heart rate,blood pressure were recorded continuously during the peri-operative and follow-up period.All of the patients were followed-up for at least 1 year.Results The systolic blood pressure(SBP) and pulse pressure (PP) decreased 1-3 months after the operation,and the difference was significant (P ＜ 0.001),while the diastolic blood pressure (DBP) and heart rate (HR) did not change significantly (P ＞ 0.05).Postoperative patients used less amount of antihypertensive drugs,but the difference was statistically not significant (P ＞ 0.05).Conclusions Unilateral CBT resection is associated with short-term to intermediate-term lowering of BP in hypertensive patients (P ＞ 0.05).