BACKGROUND:Existing studies have compared patients with degenerative lumbar spondylolisthesis with healthy populations,but comparative studies focusing on differences in this aspect of the parameter between these different lumbar spondylolisthesis are lacking.OBJECTIVE:To explore the differences in paraspinal muscle degeneration between isthmic spondylolisthesis and degenerative lumbar spondylolisthesis,and their correlation with low back pain symptoms.METHODS:A total of 107 patients with lumbar spondylolisthesis treated in Affiliated Hospital of Xuzhou Medical University between February 2019 and August 2023 were analyzed retrospectively.They were divided into the isthmic spondylolisthesis group(39 patients)and the degenerative lumbar spondylolisthesis group(68 patients)according to the type of spondylolisthesis.Paravertebral muscle tissue parameters were compared and analyzed as well as functional scores(visual analog scale for low back pain)in both groups.According to the visual analog scale score,the two groups of patients were divided into two subgroups:those with a visual analog scale score＜45 mm and those with a visual analog scale score＞45 mm,and the relationship between the difference in visual analog scale score and the parameters of paraspinal muscle tissue degeneration was analyzed.RESULTS AND CONCLUSION:(1)The percentage of fat infiltration in the multifidus muscle was higher in the degenerative lumbar spondylolisthesis group than in the isthmic spondylolisthesis group(P=0.003).(2)The percentage of fat infiltration in the multifidus muscle was significantly lower in patients with a visual analog scale score of＜45 mm than in patients with a visual analog scale score of＞45 mm in both groups(P=0.021,P＜0.001).(3)Patients in the isthmic spondylolisthesis group also showed a significantly lower percentage of fat infiltration in patients with visual analog scale score＜45 mm compared with those with visual analog scale score＞45 mm(P=0.002).(4)These results showed that there was a significant difference in paraspinal muscle tissue degeneration between isthmic spondylolisthesis patients and degenerative lumbar spondylolisthesis patients,and that degenerative lumbar spondylolisthesis patients demonstrated more severe paraspinal muscle degeneration compared to isthmic spondylolisthesis patients.In addition,the percentage of fatty infiltration of the multifidus muscle was relatively greater in those with higher pain scores in both groups of lumbar spondylolisthesis patients.

BACKGROUND:Existing studies have compared patients with degenerative lumbar spondylolisthesis with healthy populations,but comparative studies focusing on differences in this aspect of the parameter between these different lumbar spondylolisthesis are lacking.OBJECTIVE:To explore the differences in paraspinal muscle degeneration between isthmic spondylolisthesis and degenerative lumbar spondylolisthesis,and their correlation with low back pain symptoms.METHODS:A total of 107 patients with lumbar spondylolisthesis treated in Affiliated Hospital of Xuzhou Medical University between February 2019 and August 2023 were analyzed retrospectively.They were divided into the isthmic spondylolisthesis group(39 patients)and the degenerative lumbar spondylolisthesis group(68 patients)according to the type of spondylolisthesis.Paravertebral muscle tissue parameters were compared and analyzed as well as functional scores(visual analog scale for low back pain)in both groups.According to the visual analog scale score,the two groups of patients were divided into two subgroups:those with a visual analog scale score＜45 mm and those with a visual analog scale score＞45 mm,and the relationship between the difference in visual analog scale score and the parameters of paraspinal muscle tissue degeneration was analyzed.RESULTS AND CONCLUSION:(1)The percentage of fat infiltration in the multifidus muscle was higher in the degenerative lumbar spondylolisthesis group than in the isthmic spondylolisthesis group(P=0.003).(2)The percentage of fat infiltration in the multifidus muscle was significantly lower in patients with a visual analog scale score of＜45 mm than in patients with a visual analog scale score of＞45 mm in both groups(P=0.021,P＜0.001).(3)Patients in the isthmic spondylolisthesis group also showed a significantly lower percentage of fat infiltration in patients with visual analog scale score＜45 mm compared with those with visual analog scale score＞45 mm(P=0.002).(4)These results showed that there was a significant difference in paraspinal muscle tissue degeneration between isthmic spondylolisthesis patients and degenerative lumbar spondylolisthesis patients,and that degenerative lumbar spondylolisthesis patients demonstrated more severe paraspinal muscle degeneration compared to isthmic spondylolisthesis patients.In addition,the percentage of fatty infiltration of the multifidus muscle was relatively greater in those with higher pain scores in both groups of lumbar spondylolisthesis patients.

Objective:To investigate the clinical efficacy of three-dimensional (3D) laparos-copic radical resection of rectal cancer with left colic artery preservation and natural orfice specimen extraction surgery (NOSES).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 186 patients with rectal cancer who were admitted to Henan Provincial People's Hospital from December 2018 to December 2019 were colleted. There were 120 males and 66 females, aged from 30 to 81 years, with a median age of 59 years. Patients underwent 3D laparoscopic radical resection of rectal cancer. Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up using outpatient examination or telephone interview was conducted to detect survival of patients and tumor recurrence up to January 2021. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers and percentages. Result:(1) Surgical situations: 186 patients with rectal cancer under-went 3D laparoscopic radical resection and postoperative with left colic artery preservation and NOSES. The operation time was (123±24)minutes, volume of intraoperative blood loss was (30±20)mL, the numer of lymph nodes dissected was 15±7. The time to postoperative first flatus, time to semiliquid food intake, time to postoperative out-of-bed activities were (2.3±0.7)days, (4.1±1.4)days, (2.9±1.0)days, respectively. The incidence of postoperative complications was 8.06%(15/186). The duration of postoperative hospital stay of 186 patients was (6.6±1.9)days and the treatment cost was (3.8±1.1) ten thousand yuan. Results of postoperative pathological examination showed 54 cases of low differentiated adenocarcinoma, 97 cases of moderate differentiated adenocarcinoma, 19 cases of high differentiated adenocarcinoma and 16 cases of mucinous adenocarcinoma. (2) Follow-up: 186 patients with rectal cancer were followed up for 13 to 24 months, with a median follow-up time of 13 months. During the follow-up, 18 patients had tumor recurrence or metastasis including 6 patients of death, 168 cases recovered well.Conclusion:3D laparoscopic radical resection of rectal cancer with left colic artery preservation and NOSES is safe and feasible.

Objective To investigate the relationship between frailty and serum biomarkers in the elderly. Methods A total of 371 elderly individuals aged 60 years and above with complete medical data were recruited during health examinations. Frailty phenotype assessment and comprehensive geriatric assessment were conducted.Serum levels of interleukin-6 (IL-6 ) ,high sensitivity C-reactive protein(hs-CRP) ,tumor necrosis factor-α(TNF-α) ,homocysteine(Hcy) ,insulin-like growth factor-1(IGF-1) ,25-hydroxyvitamin D[25(OH)D] ,folic acid and vitamin B12(VitB12) were detected by enzyme-linked immunosorbent assays ( ELISA ) and chemiluminescence immunoassays. Associations between frailty and the above factors were analyzed. Results Serum levels of IL-6 ,TNF-α ,Hcy and IGF-1 were significantly elevated along with progressive increase in frailty severity(all P＜0.05).There were a downward trend in serum 25(OH)D levels and an upward trend in serum hs-CRP ,folic acid and VitB12 levels as frailty severity increased ,but the changes did not amount to any statistical significance(all P＞0.05).Logistic regression analysis showed that ,after adjusting for age ,gender ,body mass index (BMI)and some clinical aspects (hearing loss ,urinary incontinence ,pain ,malnutrition ,cognitive dysfunction ,decreased activities of daily living ,depression , insomnia ,and anemia) ,serum levels of IL-6(OR=1.012 ,95% CI=1.005-2.041 ,P=0.033) ,IGF-1 (OR= 1.017 ,95% CI = 1.011-1.118 ,P= 0.021)and Hcy (OR= 1.007 ,95% CI :1.002-1.073 ,P=0.047)were significantly associated with frailty status. Conclusions Serum levels of IL-6 ,Hcy and IGF-1 are related to frailty status and may be used as potential biomarkers for the assessment of frailty in older adults.

Objective To explore the relationship between the severity of frailty and muscle mass/function in older people,and to determine whether and/or how the results would be influenced by the assessment method for frailty.Methods A total of 106 older adults aged 63-95 years were recruited from individuals undergoing regular health examinations at the Outpatient Department of Beijing Hospital.The characteristics of participants were collected through a questionnaire and subsequently evaluated.Frailty was assessed by both the Fried phenotype and an index of accumulated deficits (FI).Sarcopenia was identified based on the criteria of the Asian Working Group for Sarcopenia (AWGS).Average skeletal muscle mass,appendicular skeletal muscle mass and the appendicular skeletal muscle index (ASMI) were measured by bioelectrical impedance analysis (BIA).Furthermore,grip strength,the 4 m walking test,the timed up and go test (TUGT),the five times sit to stand test (FTSST),and the balance test were performed to investigate the physical performance.Results There were 15 (14.2％) frail and 65 (61.3％) pre-frail cases in this group.Poor grip strength 59 (55.7％) and slow gait speed 33 (31.1％) were more prevalent in frail older people.Meanwhile,when the phenotypic definition of frailty was used,muscle mass and ASMI decreased as the severity of frailty increased (F=6.579,3.969,4.507,respectively;all P＜0.05).Frail older people had significantly slower gait speed and poorer grip strength than those who were not frail (F=23.897,4.583,respectively;both P＜0.05).Moreover,frail older people were more likely to be sarcopenia (53.5％) than those who were pre frail (30.8％) or not frail (3.8％).Participants with frailty performed worse on FTSST,TUGT and the balance test (all P＜0.05) and had markedly lower levels of FI (0.15±0.04,0.18±0.06,and 0.28±0.09,respectively;F=21.764,P＜0.05) than those in the pre-frail and non-frail groups.Appendicular skeletal muscle mass,skeletal muscle mass,grip strength and walking speed were negatively correlated with FI (r =-0.256,-0.321,-0.343,-0.374,respectively;all P＜0.05) while ASMI showed no statistical correlation with FI (P＞0.05).Conclusions Poor grip strength and slow gait speed are very common in frail older people.There is a close correlation between muscle mass/function and frailty.The degree of association of frailty severity with physical performance remains largely unchanged regardless of what assessment method is used.

Objective To compare the development of gastric insufflation related to different peak inspiratory pressures (PIPs) during facemask ventilation in the pediatric patients.Methods Ninety male pediatric patients,aged 2-4 yr,of American Society of Anesthesiologists physical status Ⅰ,scheduled for elective surgery under general anesthesia,were randomly divided into 5 groups (n =18 each) using a random number table:PIP 8 cmH2O group (group P8),PIP 10 cmH2O group (group P10),PIP 12 cm H2O group (groupP12),PIP 14cmH2O group (group P14) and PIP 16 cmH2O group (group P16).Anesthesia was induced with fentanil,propofol and rocuronium in sequence.After loss of eyelash reflex,positive pressure facemask ventilation was performed for a 120 s period in pressure-controlled mode.Gastric insufflation was detected by real-time ultrasonography of the antrum,and cross-sectional antral area was measured using ultrasonography before facemask ventilation and at 120 s of facemask ventilation.The pulse oximetry (SpO2),tidal volume (VT),end-tidal pressure of carbon dioxide (PETCO2) and end-tidal oxygen concentration (ETO2) were recorded at 30,60,90,and 120 s of facemask ventilation.The development of gastric insufflation and hypoventilation was recorded.Results Compared with group P8,the incidence of gastric insufflation was significantly increased in group P16 (P＜0.01),and no significant change was found in the incidence of gastric insufflation in the other groups (P＞0.05),the incidence of hypoventilation was significantly decreased,VT and ETO2 were increased,and PET CO2 was decreased in P12,P14 and P16 groups,and PETCO2 was significantly decreased at 120 s of facemask ventilation (P＜ 0.05 or 0.01),and no significant change was found in the other parameters in group P10 (P＞0.05).Compared with P12 and P14 groups,VT was significantly increased,PEHTCO2 was decreased at 120 s of facemask ventilation (P＜0.05),and no significant change was found in the incidence of hypoventilation and ETO2 in group P16 (P＞0.05).There was no significant difference between group P12 and group P14 in the incidence of hypoventilation,VT,PETCO2 and ETO2 (P＞0.05).The pediatric patients showed a certain CO2 accumulation [PETCO2 (40.6±4.0) mmHg] at 120 s of facemask ventilation in group P8,and the pediatric patients showed excessive ventilation [PETCO2 (23.6± 1.4) mmHg],and cross-sectional antral area was not measured using ultrasonography in three cases because of excessive gastric insufflation in group P16.Conclusion PIP at 12-14 mmHg in pressure-controlled ventilation mode can not only ensure adequate preoxygenation and but also avoid excessive gastric insufflation during facemask ventilation in the pediatric patients.

Objective To observe the cognitive function and its related factors in patients with essential epilepsy.Methods The cognitive function of 70 essential epilepsy patients (epilepsy group) and 40 healthy controls(control group) were evaluated by means of Wechsler Intelligence Scale for Adult-Chinese (WAIS-RC).The relation between the cognitive dysfunction and its related factors were analyzed.Results The scores of performance intelligence quotient,verbal intelligence quotient,full intelligence quotient in epilepsy group were significantly lower than those in control group [(98.06 ± 15.24) scores vs.(113.80 ± 12.14) scores,(98.09 ± 16.06) scores vs.(120.65 ± 11.28) scores,(98.06 ± 15.80) scores vs.(119.42 ± 11.85) scores] (P ＜ 0.01).The scores of 11 numbers of rating scales were significantly lower than those in control group (P ＜ 0.01).The factors related to the cognitive function were education level,age numbers,duration of the disease,frequency of seizures attack before medication,the duration of seizures and the quantity of antiepileptics.Conclusions Many of the essential epilepsy patients have cognitive function deficit.The cognitive condition of essential epilepsy patients should be pay more attention and reduce the dangerous factors in order to improve the life quality.