OBJECTIVE: To compare the effectiveness of different puncture methods of the flexible bone cement delivery device in unilateral percutaneous curved vertebroplasty for osteoporotic vertebral upper 1/3 compression fractures. METHODS: A retrospective analysis was conducted on the clinical data of 67 patients with osteoporotic vertebral upper 1/3 compression fractures who were admitted and met the selection criteria between January 2023 and April 2024. The patients were divided into two groups based on the puncture method of the flexible bone cement delivery device: the oblique puncture group ( n=37) and the parallel puncture group ( n=30). There was no significant difference ( P>0.05) between the two groups in terms of gender, age, bone mineral density (T value), distribution of fractured vertebrae, time from injury to operation, and preoperative visual analogue scale (VAS) score for pain, Oswestry disability index (ODI), anterior vertebral height of the fractured vertebra, and Cobb angle of the fractured vertebra. The following parameters were compared between the two groups: operation time, incidence of secondary puncture, incidence of bone cement leakage, volume of injected bone cement, bone cement distribution score, as well as VAS score, ODI, anterior vertebral height of the fractured vertebra, and Cobb angle of the fractured vertebra at 1 day after operation and at last follow-up. RESULTS: Two cases in the oblique puncture group and 7 cases in the parallel puncture group underwent secondary puncture during operation, and the difference in the incidence of secondary puncture was significant ( P<0.05). No complications such as bone cement hypersensitivity, bone cement embolism, nerve injury, or epidural hematoma occurred in both groups. There was no significant difference in operation time, volume of injected bone cement, incidence of bone cement leakage, distribution score and rating of bone cement between the two groups ( P>0.05). All patients were followed up 6-18 months (mean, 12.0 months), and there was no significant difference in the follow-up time between the two groups ( P>0.05). No further fracture collapse or compression occurred in the fractured vertebra during follow-up. Both groups exhibited significant improvements in VAS score, ODI, anterior vertebral height, and Cobb angle of the fractured vertebra after operation compared to baseline ( P<0.05). There were also significant differences between the two time points after operation ( P<0.05). However, there was no significant difference in the above indicators between the two groups ( P>0.05). CONCLUSION For osteoporotic vertebral upper 1/3 compression fractures treated with unilateral percutaneous curved vertebroplasty, both oblique and parallel puncture methods of the flexible bone cement delivery device can effectively relieve pain, but the former is more conducive to reducing the incidence of secondary puncture.
Humans ; Bone Cements/therapeutic use* ; Fractures, Compression/surgery* ; Retrospective Studies ; Vertebroplasty/instrumentation* ; Osteoporotic Fractures/surgery* ; Spinal Fractures/surgery* ; Female ; Male ; Aged ; Middle Aged ; Treatment Outcome ; Punctures/methods* ; Aged, 80 and over

The translocator protein (TSPO) positron emission tomography (PET) can noninvasively detect neuroinflammation associated with epileptogenesis and epilepsy. This study explored the role of the TSPO-targeting radioligand [¹⁸F]F-TFQC, an m-trifluoromethyl ER176 analog, in the PET neuroimaging of epileptic rats. Initially, [¹⁸F]F-TFQC was synthesized with a radiochemical yield of 8%-10% (EOS), a radiochemical purity of over 99%, and a specific activity of 38.21 ± 1.73 MBq/nmol (EOS). After determining that [¹⁸F]F-TFQC exhibited good biochemical properties, [¹⁸F]F-TFQC PET neuroimaging was performed in epileptic rats at multiple time points in various stages of disease progression. PET imaging showed specific [¹⁸F]F-TFQC uptake in the right hippocampus (KA-injected site, i.e., epileptogenic zone), which was most pronounced at 1 week (T/NT 1.63 ± 0.21) and 1 month (T/NT 1.66 ± 0.20). The PET results were further validated using autoradiography and pathological analysis. Thus, [¹⁸F]F-TFQC can reflect the TSPO levels and localize the epileptogenic zone, thereby offering the potential for monitoring neuroinflammation and guiding anti-inflammatory treatment in patients with epilepsy.

BACKGROUND:Percutaneous curved vertebroplasty has the advantages of minimal trauma and bone cement dispersion,but whether it is safe and effective for the treatment of compression fractures in the upper 1/3 of the vertebral body needs further study.OBJECTIVE:To investigate the clinical efficacy of percutaneous curved vertebroplasty in the treatment of the upper 1/3 compression fractures of the osteoporotic vertebrae.METHODS:Medical records of 66 patients with osteoporotic thoracolumbar upper 1/3 compression fracture admitted to Department of Orthopedics of PLA Rocket Force Characteristic Medical Center from January 2020 to June 2023 were retrospectively analyzed.Among them,32 cases were treated with percutaneous curved vertebroplasty(observation group)and 34 cases were treated with"noncoplanar bipedicular puncture"percutaneous vertebroplasty(control group).Pain visual analog scale score,Oswestry Disability Index,anterior edge height of injured vertebra,and Cobb angle of injured vertebra were compared and analyzed between the two groups before surgery,the first day after surgery,and the last follow-up.The operative time,bone cement leakage rate,bone cement injection volume,and bone cement dispersion score of the two groups were statistically analyzed.RESULTS AND CONCLUSION:(1)The operations were successfully completed in both groups of patients,and no complications such as bone cement allergy,bone cement embolism,nerve damage,or epidural hematoma occurred.(2)Pain visual analog scale score,Oswestry disability index,anterior edge height,and Cobb angle of injured vertebra of the two groups at the first day after surgery and the last follow-up were all better than those before surgery,with statistically significant difference(P＜0.05),but there was no statistical significance between the two groups(P＞0.05).The Oswestry disability index of the two groups at the last follow-up was better than that on the first day after surgery(P＜0.05).(3)The operation time and bone cement leakage rate of the observation group were lower than those of the control group,and the differences were statistically significant(P＜0.05).(4)There were no significant differences in bone cement injection volume and bone cement dispersion score between the two groups(P＞0.05).(5)The results show that percutaneous curved vertebroplasty in the treatment of osteoporotic vertebrae compression fractures in the upper 1/3 of the vertebral body can effectively relieve pain,maintain vertebral height,and reduce operative time and bone cement leakage rate.

BACKGROUND:Percutaneous curved vertebroplasty has the advantages of minimal trauma and bone cement dispersion,but whether it is safe and effective for the treatment of compression fractures in the upper 1/3 of the vertebral body needs further study.OBJECTIVE:To investigate the clinical efficacy of percutaneous curved vertebroplasty in the treatment of the upper 1/3 compression fractures of the osteoporotic vertebrae.METHODS:Medical records of 66 patients with osteoporotic thoracolumbar upper 1/3 compression fracture admitted to Department of Orthopedics of PLA Rocket Force Characteristic Medical Center from January 2020 to June 2023 were retrospectively analyzed.Among them,32 cases were treated with percutaneous curved vertebroplasty(observation group)and 34 cases were treated with"noncoplanar bipedicular puncture"percutaneous vertebroplasty(control group).Pain visual analog scale score,Oswestry Disability Index,anterior edge height of injured vertebra,and Cobb angle of injured vertebra were compared and analyzed between the two groups before surgery,the first day after surgery,and the last follow-up.The operative time,bone cement leakage rate,bone cement injection volume,and bone cement dispersion score of the two groups were statistically analyzed.RESULTS AND CONCLUSION:(1)The operations were successfully completed in both groups of patients,and no complications such as bone cement allergy,bone cement embolism,nerve damage,or epidural hematoma occurred.(2)Pain visual analog scale score,Oswestry disability index,anterior edge height,and Cobb angle of injured vertebra of the two groups at the first day after surgery and the last follow-up were all better than those before surgery,with statistically significant difference(P＜0.05),but there was no statistical significance between the two groups(P＞0.05).The Oswestry disability index of the two groups at the last follow-up was better than that on the first day after surgery(P＜0.05).(3)The operation time and bone cement leakage rate of the observation group were lower than those of the control group,and the differences were statistically significant(P＜0.05).(4)There were no significant differences in bone cement injection volume and bone cement dispersion score between the two groups(P＞0.05).(5)The results show that percutaneous curved vertebroplasty in the treatment of osteoporotic vertebrae compression fractures in the upper 1/3 of the vertebral body can effectively relieve pain,maintain vertebral height,and reduce operative time and bone cement leakage rate.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Objective:To design a visual allocation system of emergency medical equipment based on the Internet of Things technology,and to realize the coordinated allocation of emergency medical equipment in hospitals.Methods:The client and server(C/S)architecture was adopted,and the design of emergency medical equipment visual allocation system was mainly based on Bluetooth 5.1 technology,with automatic acquisition and automatic analysis of Bluetooth positioning tag,low power consumption sensor and signal communication of Bluetooth Internet of Things base station.The sample data of 150 pieces of equipment managed by the traditional allocation center mode of The 900th Hospital of People's Liberation Army Joint Logistics Support Force from January to December 2021 were selected,and the sample data of 150 pieces of equipment allocation during the application of the visual allocation system from June 2022 to June 2023 were randomly selected,and the allocation response time and the allocation warehousing in and out time were compared.A total of 40 ventilator devices were randomly selected during the traditional allocation center mode and the visual allocation period,with 20 ventilators in each mode,the start-up rate,utilization rate and profitability of medical equipment during the service period were compared.Results:The visual allocation system can realize the functions of automatic equipment positioning,emergency deployment,ledger management,remote repair report and benefit analysis.The allocation response time,allocation outbound time and allocation inbound time of the visual allocation system were(19.61±3.119)min,(11.73±2.104)min,(10.21±2.165)min,respectively,which were shorter than(54.98±3.999)min,(21.54±2.811)min,(16.80±2.000)min of the traditional allocation center mode,the difference was statistically significant(t=85.407,34.229,27.395,P<0.05).The start-up rate,utilization rate and profitability of ventilator equipment using visual allocation mode were 78.24%,51.23%and 82.76%,respectively,which were higher than 43.52%,36.26%and 47.83%of the traditional allocation center mode,the difference was statistically significant(x2=8.792,7.813,12.216,P<0.05).Conclusion:The visual allocation system of emergency medical equipment based on the Internet of Things technology can realize the functions of emergency medical equipment allocation and storage,equipment positioning and use status analysis,provide a theoretical basis for the allocation of hospital emergency medical equipment,and maximize the role of emergency medical equipment.

Objective:To prevent the occurrence of children′s unintentional injuries, clinical characteristics were analyzed for 1 379 children hospitalized for unintentional injuries over a 5-year period at the First Affiliated Hospital of Xiamen University.Methods:We searched the First Affiliated Hospital of Xiamen University Pediatric Refined Management Database for all cases of children aged 0-14 years who were hospitalized for unintentional injuries from January 1, 2015 to December 31, 2019.Descriptive statistics were calculated for age, gender, season of injury, location of residence, education level of the child′s parents/guardians, injury etiology and outcome, and cost of treatment.Results:Of 1 379 cases, 894 children(64.8%) were boys and 485(35.2%) were girls.The majority of cases were 1-5 years old(61.6%, n=849). The top three causes of unintentional injuries were foreign bodies(38.1%, n=526), falls(27.0%, n=372), and burns(17.1%, n=236). Children′s unintentional injuries occurred most frequently during the summer(29.0%). More children came from rural locations(56.3%, n=777). Approximately half of the parents/guardians had attained an education level of junior high school or below(50.5%, n=696). There were 47 cases(3.4%) resulting in death or permanent injury and 292 cases(21.2%) resulting in disability.Children injured in traffic accidents had the longest average length of hospital stay [11(7, 18)d] and incurred the highest healthcare costs per case[11 130.32(5 389.69, 24 216.90)RMB]. Conclusion:Children′s unintentional injuries are concentrated among rural boys aged 1-5 years, foreign bodies are the most common cause of unintentional injuries.Children from families with low parental/guardian education levels may be at heightened risk of unintentional injuries.

Objective:To compare the efficacy and safety of gemcitabine and epirubicin curing for patients with non-muscle invasive bladder cancer (NMIBC).Methods:From October 2014 to October 2017, 86 patients with NMIBC diagnosed by transurethral resection of bladder tumor (TURBT) in Wenling Hospital Affiliated to Wenzhou Medical University were analyzed retrospectively. Among them, 42 were treated with gemcitabine (gemcitabine group) and the other 44 with epirubicin (epirubicin group). In gemcitabine group, there were 37 males and 5 females. The average age was 63.9 (48-81) years old. 30 cases were single tumor while 12 cases were multiple. 35 cases with tumor diameter less than 3cm and 7 cases with tumor diameter greater than 3cm. There were 28 cases in T a stage and 14 cases in T 1 stage. 13 patients’ tumor were high grade and 29 patients’ tumor were low grade. In the epirubicin group, there were 36 males and 8 females. The average age was 65.4 (48-88) years. 31 cases were single tumor while 13 cases were multiple. 36 cases with tumor diameter less than 3cm and 8 cases with tumor diameter greater than 3cm. There were 30 cases in T a stage and 14 cases in T 1 stage. 15 patients’ tumor were high grade and 29 patients’ tumor were low grade. There was no significant difference in the above general information between the two groups ( P > 0.05). The two groups were treated with epirubicin or gemcitabine within 24 hours after operation, and bladder perfusion once a week was performed continuously after the first week of operation, a total of 8 times, and after that once a month till one year after operation. The clinical efficacy and adverse reactions were compared between the two groups. Kaplan-Meier was used to compare the recurrence free survival time of tumor after operation. The prognostic factors were analyzed by Cox proportional hazards model. Results:The adverse reactions of the two groups were mainly bladder irritation, gross hematuria, fever, nausea and vomiting. The incidence of bladder irritation and gross hematuria in epirubicin group was 25.0% (11 / 44) and 18.2% (8 / 44), which were significantly higher than those in gemcitabine group [7.1% (3/42) and 2.4% (1/42)], and the difference was statistically significant ( P<0.05). There was no significant difference in other adverse reactions between the two groups ( P> 0.05). Kaplan-Meier survival analysis showed that the median tumor recurrence free survival time of gemcitabine group was 29.7 (6.3-58.8) months, and the 1-year and 2-year tumor recurrence free survival rates were 71.4% (30/42) and 45.2% (19/42), respectively; the median tumor recurrence free survival time of epirubicin group was 28.8 (4.5-57.8) months, and the 1-year and 2-year tumor recurrence free survival rates were 70.5% (31/44) and 47.7% (21/44), respectively. There was no difference in the tumor recurrence free survival rates between the two groups( P>0.05). Cox analysis showed that age ( HR=1.1, 95% CI 1.034-1.113) and tumor grade ( HR=12.2, 95% CI 5.776-25.680) were independent risk factors for prognosis. Conclusions:The efficacy of bladder perfusion chemotherapy with gemcitabine and epirubicin in patients with NMIBC was not significantly different, but the incidence of adverse reactions with gemcitabine was lower, which was safe and reliable. The risk factors affecting postoperative survival rates of NMIBC were patient's age and tumor grade.

Objective:To explore the feasibility and safety of long-term home mechanical ventilation(HMV) in children with chronic respiratory failure.Methods:Clinical data of 11 children with chronic respiratory failure, who underwent HMV with the care of the First Affiliated Hospital of Xiamen University from January 2013 to December 2019, were retrospectively reviewed. The clinical manifestation, growth and development, quality of life, adverse events and prognosis of HMV children were analyzed.Results:There were 8 boys and 3 girls with the onset age of 26 days to 13 years old; and the age at starting HMV was 3 months to 13 years old. Eight children were diagnosed as neuromuscular diseases, and 3 children were diagnosed as respiratory diseases. The duration of institutional mechanical ventilation was 2 weeks to 8 months. Six patients underwent invasive HMV via a tracheostomy, and 5 received non-invasive ventilation via nasal and face masks. Bi-level positive airway pressure ventilation mode was applied in all the patients. The duration of HMV was 3 months to 27 months. During follow-up, no HMV related adverse events were observed. Both the quality of life and nutritional status were improved in all cases. One patient lost follow-up 9 months later and 1 patient died of severe adenovirus pneumonia during hospitalization for examination, the remaining 9 cases survived. Liberation from HMV was obtained in 4 patients. The frequency of readmission was 1 to 2 times.Conclusion:It is suggested that long-term HMV is safe and feasible for children with chronic respiratory failure.

Objective To establish a HPLC method for simultaneous determination of oleanolic acid and ursolic acid and provide the basis for quality control of Hawthorn extract .Methods Chromatographic separation was performed on Agilent Zorbax SB C18 column(250 mm × 4 .6 mm ,5 μm) with mobile phase of methanol (A)-0 .06 mol/L ammonium acetate solution (B) (85∶15 ,V/V ) under isocratic elution for 30 min .The flow rate was set at 0 .8 ml/min and the detection was set at the wavelength of 210 nm .Results Oleanolic acid and ursolic acid showed good linearity (r> 0 .999 5) in the ranges of 0 .496-2.480 g and 0 .498-9 .960 g ,respectively .Repeatability ,precision ,recovery and stability were conform to the method valida-tion requirements of China Pharmacopoeia .Conclusion The method could provide the basis for the quality control of Hawthorn extract and its preparation .