Objective To investigate the short-term efficacy of CT-guided microwave ablation(MWA)combined with percutaneous vertebroplasty(PVP)for spinal metastases,and to analyze the risk factors for postoperative cement leakage.Methods The clinical data of 50 patients with spinal metastases(74 diseased vertebrae in total),who were treated with CT-guided MW A combined with PVP at the authors'hospital from January 2020 to June 2023,were retrospectively analyzed.Numerical Pain Rating Scale(NRS),daily morphine consumption(DMC)and Activity of Daily Living Scale(ADL)were used to evaluate the short-term efficacy.Regular postoperative CT reexamination was carried out to assess the condition of local tumor control and bone cement leakage.Univariate analysis and multivariate binary logistic analysis of gender,age,maximum diameter of metastatic lesion,type of metastasis,Tomita classification of primary tumor,level of affected vertebrae,injected volume of bone cement,injection side,pathological fracture,and posterior vertebral wall rupture were performed to determine the risk factors for postoperative occurrence of bone cement leakage.Results The preoperative,and the postoperative one-day,one-week,one-month,3-month and 6-month NRS were(7.24±1.41),(4.76±1.45),(3.42±1.34),(2.86±0.90),(2.20±0.57),(1.66±0.72)points respectively.The preoperative,and the postoperative one-day,one-week,one-month,3-month and 6-month DMC were(110.40±94.61),(66.10±51.23),(47.30±37.49),(32.90±22.84),(25.60±18.97),(15.36±13.43)mg respectively.The preoperative,and the postoperative one-week,one-month,3-month and 6-month ADL were(40.80±11.45),(53.20±6.68),(60.40±5.14),(62.90±4.75),(64.80±4.51)points respectively.The differences in NRS,DMC,ADL between their preoperative values and postoperative 6-month values were statistically significant(all P＜0.05).Postoperative 6-month imaging follow-up check revealed that tumor was controlled in 46 patients and the tumor recurrence rate was 8％(4/50),and mild bone cement leakage occurred in 17 of 74 vertebrae(22.97％).Multivariate regression analysis indicated that pathological fracture(OR=9.581,95％CI=2.292-40.055,P=0.002)and rupture of posterior wall of vertebra(OR=5.105,95％CI=1.041-25.022,P=0.044)were the independent risk factors for bone cement leakage,the pathological fracture(OR=35.333,95％CI=4.029-309.840,P=0.001)was the independent risk factor for cortical bone cement leakage.No independent risk factor for vascular bone cement leakage was observed.The rupture of posterior wall of vertebra(OR=48.400,95％CI=4.725-495.753,P=0.001)was the independent risk factor for leakage of bone cement in spinal canal.Conclusion MW A combined with PVP can rapidly relieve pain,improve the ability of daily activity and quality of life of patients with spinal metastases,which can be further improved within 6 months after treatment.The combination use of MW A and PVP carries lower incidence of bone cement leakage.The pathological fracture and posterior wall rupture of vertebra are the independent risk factors for bone cement leakage.

Objective To evaluate the reliability and validity of the Reflective Function Questionnaire for Youth(RFQY). Methods School sample:a total of 1 813 students from the fifth grade primary school to the second grade high school were selected for the study(aged 10 to 17 years). Clinical patients:another 52 adolescents(aged under 17 years)with borderline trait who attended Department of Psychiatry in Shengjing Hospital were recruited. All subjects completed the RFQY,basic empathy scale( BES )and emotional intelligence scale(EIS). After 3 weeks,85 students were randomly selected and filled in the questionaires again. Results The internal consistency of the RFQY was 0.73,and the test?retest reliability was 0.686(P<0.001). The RFQY scores of the school students were significantly higher than those in clinical patients(8.71±0.65 vs 8.10±0.89,P<0.001). The RFQY scores of male students were significantly lower than those in female students(8.61±0.67 vs 8.78±0.63,P<0.001). The score increased with the age increased(P<0.001). Conclusion The Chinese version of RFQY shows good reliability and validity , which can be used to measure the reflective function of adolescents in China .