The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

Objective:To explore potential predictors of refractory Mycoplasma pneumoniae pneumonia (RMPP) in early stage. Methods:The prospective multicenter study was conducted in Zhejiang, China from May 1 st, 2019 to January 31 st, 2020. A total of 1 428 patients with fever >48 hours to <120 hours were studied. Their clinical data and oral pharyngeal swab samples were collected; Mycoplasma pneumoniae DNA in pharyngeal swab specimens was detected. Patients with positive Mycoplasma pneumoniae DNA results underwent a series of tests, including chest X-ray, complete blood count, C-reactive protein, lactate dehydrogenase (LDH), and procalcitonin. According to the occurrence of RMPP, the patients were divided into two groups, RMPP group and general Mycoplasma pneumoniae pneumonia (GMPP) group. Measurement data between the 2 groups were compared using Mann-Whitney U test. Logistic regression analyses were used to examine the associations between clinical data and RMPP. Receiver operating characteristic (ROC) curves were used to analyse the power of the markers for predicting RMPP. Results:A total of 1 428 patients finished the study, with 801 boys and 627 girls, aged 4.3 (2.7, 6.3) years. Mycoplasma pneumoniae DNA was positive in 534 cases (37.4%), of whom 446 cases (83.5%) were diagnosed with Mycoplasma pneumoniae pneumonia, including 251 boys and 195 girls, aged 5.2 (3.3, 6.9) years. Macrolides-resistant variation was positive in 410 cases (91.9%). Fifty-five cases were with RMPP, 391 cases with GMPP. The peak body temperature before the first visit and LDH levels in RMPP patients were higher than that in GMPP patients (39.6 (39.1, 40.0) vs. 39.2 (38.9, 39.7) ℃, 333 (279, 392) vs. 311 (259, 359) U/L, both P<0.05). Logistic regression showed the prediction probability π=exp (-29.7+0.667×Peak body temperature (℃)+0.004×LDH (U/L))/(1+exp (-29.7+0.667×Peak body temperature (℃)+0.004 × LDH (U/L))), the cut-off value to predict RMPP was 0.12, with a consensus of probability forecast of 0.89, sensitivity of 0.89, and specificity of 0.67; and the area under ROC curve was 0.682 (95% CI 0.593-0.771, P<0.01). Conclusion:In MPP patients with fever over 48 to <120 hours, a prediction probability π of RMPP can be calculated based on the peak body temperature and LDH level before the first visit, which can facilitate early identification of RMPP.

The technology of three-dimensional(3D)printing emerged in the late 1970s and has since undergone considerable development to find numerous applications in mechanical engineering,industrial design,and biomedicine.In biomedical science,several studies have initially found that 3D printing technology can play an important role in the treatment of diseases in hepatopancreatobiliary surgery.For example,3D printing technology has been applied to create detailed anatomical models of disease organs for preoperative personalized surgical strategies,surgical simulation,intraoperative navigation,medical training,and patient education.Moreover,cancer models have been created using 3D printing technology for the research and selection of chemotherapy drugs.With the aim to clarify the development and application of 3D printing technology in hepatopancreatobiliary surgery,we introduce seven common types of 3D printing technology and review the status of research and application of 3D printing technology in the field of hepatopancreatobiliary surgery.

Objective: To investigate the core information about tuberculosis prevention and control knowledge among residents in Jiangxi Province, so as to provide insights into formulation of health education strategy for tuberculosis prevention and control. Methods: Permanent residents at ages of 15 years and older were sampled from Jiangxi Province using a multi-stage stratified cluster sampling method from January to June 2021. Participants' demographic features and access to health education for tuberculosis prevention and control were collected through questionnaires, and the awareness of core information about tuberculosis prevention and control was investigated according to Key Points for Core Information and Knowledge about Tuberculosis Prevention and Control (2016 version). Results: A total of 1 280 questionnaires were allocated, and 1 217 valid questionnaires were recovered, with an effective recovery rate of 95.08%. The respondents included 605 men (49.71%) and 612 women (50.29%), and had a mean age of (50.05±15.78) years. The overall awareness of core information of tuberculosis prevention and control was 80.46%, and the awareness rates of “Pulmonary tuberculosis is suspected and timely healthcare-seeking is required if you have cough or expectoration for more than 2 weeks”, “Pulmonary tuberculosis is mainly transmitted via respiratory tract, and everyone is likely to be infected”, “No spit anywhere, covering mouth and nose when coughing or sneezing, and wearing a mouth mask may reduce the transmission of pulmonary tuberculosis”, “Pulmonary tuberculosis is a chronic infectious disease that poses a long-term damage to health” and “Most patients may be cured and others are avoided to be infected following standard whole-process treatment” were 90.22%, 86.52%, 85.95%, 80.03% and 59.57%, respectively. There were 491 respondents that were aware of all core information about tuberculosis prevention and control (40.35%), and network was the predominant route for acquiring health education about tuberculosis prevention and control (62.08%, 586/944). Conclusions The overall awareness of core information about tuberculosis prevention and control did not achieve the target set in the 13th Five-year Plan for Tuberculosis Prevention and Control, and the awareness of tuberculosis treatment-related knowledge was low.

【Objective】 To explore the effect of low levels of calcium on the biological characteristics of ameloblasts. 【Methods】 Rat primary ameloblasts were cultured in standard DMEM medium. After five days they were identified by RT-PCR and immunohistochemistry. Then 0, 0.6 and 1.2 mmoL/L Ca²⁺ and 100 mL/L fetal bovine serum were added into DMEM medium without calcium. After 48 hours, the cell morphology was observed by inverted microscope. The proliferation and apoptosis of cells were separately examined by MTT and AnnexinV-PI. Real-time quantitative PCR was used to detect the expression levels of amelogenin and KLK4 mRNA. 【Results】 After Five days in standard DMEM medium, the cells were shaped like the paving pattern. RT-PCR showed that both amelogenin and KLK4 were expressed in the cells. Immunohistochemical staining showed that most cells had positive staining for amelogenin. After 48 hours of calcium intervention, some cells in 1.2 mmoL/L Ca²⁺ group had higher nuclear density and poor light transmittance, and more high columnar cells could be observed in 1.2 mmoL/L Ca²⁺ group than those in 0 and 0.6 mmoL/L Ca²⁺ groups. With the decrease in calcium concentration in the medium, MTT showed that the proliferation activity of ameloblasts reduced (P<0.01). Annexin V-PI showed that the percentage of apoptotic cells decreased, and there was a significant difference between 1.2 mmoL/L and 0 mmoL/L Ca²⁺ groups (P<0.05). Real time-PCR showed that the expressions of amelogenin and KLK4 mRNA reduced (P<0.01). 【Conclusion】 Low-level calcium may inhibit the differentiation of ameloblasts, thereby affecting the formation of enamel mineralization.

Objective:To determine whether amoxicillin had an effect on the enamel mineralization of SD rats.Methods:Eighteen SD rats were randomly divided into three groups. The rats in the control group were given distilled water. The rats in two experimental groups were administered 50 or 100 mg/kg amoxicillin by intragastric administration from day 3 to day 17 after birth. The general condition, the structure of liver and kidney, the enamel surface changes of mandibular first molars and incisors were observed. The changes of Ca/P ratio on enamel surface were analyzed by X-ray energy dispersive spectrometer (EDS). The surface morphology after phosphoric acid treatment was examined by scanning electron microscopy (SEM). Histological changes in the ameloblasts of mandibular incisors were analyzed by hematoxylin and eosin (HE) staining.Results:Compared with the control group, the general conditions as well as liver and kidney structures of SD rats in 50 and 100 mg amoxicillin groups had no significant differences. There was no obvious chalky changes on the first mandibular molars of SD rats in each group. All the incisors in 50 and 100 mg groups showed different degrees of chalkiness in the labial incisal 1/3 enamel. X-ray EDS analysis showed that the Ca/P ratios of occlusal and incisal 1/3 enamel in 50 and 100 mg groups (occlusal 1/3 of mandibular first molars: 1.51±0.03 and 1.52±0.02, incisal 1/3 of mandibular incisors: 1.46±0.01 and 1.43±0.01) was significantly lower than that in the control group (occlusal 1/3 of mandibular first molars: 1.67±0.41, incisal1/3 of mandibular incisors: 1.73±0.07) ( P<0.05). However, there was no significant differences in the cervical 1/3 Ca/P ratio of mandibular first molars and incisors among the three groups (mandibular first molars: 1.56±0.04 for control group, 1.59±0.05 for 50 mg group and 1.57±0.04 for 100 mg group; incisors: 1.52±0.02 for control group, 1.47±0.01 for 50 mg group and 1.51±0.03 for 100 mg group) ( P>0.05). SEM observation showed that the enamel rods of the first molars and incisors in the 50 and 100 mg group varied in size and arranged disorderly. The spaces between the enamel rods were larger than that in the control group and some areas even appeared large pits. HE staining showed that the gaps between ameloblasts in 50 and 100 mg groups were significantly wider than that in the control group. Conclusions:Intake of amoxicillin during the period of enamel development of SD rats might affect enamel mineralization.

Objective:Understand the status of brushing teeth behavior of preschoolers in Shaanxi Province, to provide basis for oral health of preschoolers.Methods:By adopting the methods of multi-stage, stratified, geometric and cluster sampling, 1 370 kindergarten students at the age of 3-5 in Shaanxi Province were sampled as respondents to implement oral health questionnaire.Results:49.2%(674/1 370) children brushed their teeth every day, including only 14.8%(203/1 370) children brushing their teeth twice or above. Therefore, the difference of the brushing frequency (≥ 1 time/day) between urban and rural areas had obvious statistical significance ( χ2 value was 47.588, P<0.01). 98.7%(741/750) children used toothpaste, including only 6.9% (51/741) using toothpaste with fluoride. Therefore, the use of toothpaste between urban and rural areas has no statistical significance. Only 0.5% (4/751) children started to brush their teeth when their first deciduous tooth erupted. Therefore, the age for children starting to brush their teeth between urban and rural areas had obvious statistical significance ( χ2 value was 24.217, P<0.01). 65.2% (490/751)parents never helped their children to brush teeth, parents in rural areas even reached to 72.8% (227/312). Therefore, the brushing frequency for parents helping their children to brush teeth between urban and rural areas had statistical difference ( χ2 value was 16.192, P<0.01). Conclusions:The status of brushing teeth behavior of preschoolers in Shaanxi Province is lower than the national level, and the level in rural areas is obviously lower that in urban areas. The education and cultivation on brushing teeth behavior should be further strengthened in the future propaganda and education, especially, the power of propaganda on children and parents in rural areas should be strengthened.

OBJECTIVE: To explore the molecular basis for a pedigree affected with coagulation factor V (FV) deficiency. METHODS: Clinical data of the patient and his family members was analyzed. Targeted capture and next-generation sequencing (NGS) and Sanger sequencing were carried out to detect potential variant of the FV gene. RESULTS: The patient presented with jaundice and prolonged prothrombin time (PT) and activated partial thromboplastic time (APTT). V factor activity measured only 0.1% of the normal level, though the patient had no sign of bleeding. A paternal heterozygous variant c.653T>C (p.F218S) and a maternal heterozygous variant c.3642_3643del (p.P1215Rfs*175) were identified in the FV gene of the patient. His elder brother was a heterozygous carrier of the c.653T>C (p.F218S) variant. c.653T>C(p.F218S) was a known pathogenic variant, while the c.3642_3643del (p.P1215Rfs*175) variant was unreported previously. CONCLUSION Mutations of the FV gene probably underlie the hereditary coagulation factor V deficiency in this patient. NGS combined with Sanger sequencing has detected potential variant with efficiency and provided a reliable basis for clinical and prenatal diagnosis for this family.
Aged ; Factor V ; Factor V Deficiency ; genetics ; Genetic Variation ; Heterozygote ; Humans ; Male ; Mutation ; Pedigree ; Phenotype

OBJECTIVE:To observe the clinical efficacy and safety of of heat-sensitive moxibustion combined with modified Pipa qingfei decoction for acne vulgaris.METHODS:A total of 120 patients with acne vulgaris were randomly divided into control group and observation group,with 60 cases in each group.Control group was given Minocycline hydrochloride capsules 50 mg/d,bid.Observation group was given heat-sensitive moxibustion (every other day) combined with modified Pipa qingfei decoction (one dose every day,decocting to 300 mL,morning and night).Both groups were treated for 42 d.Skin lesion score and serum testosterone level were observed in 2 groups before treatment,1st and 90th day after the end of treatment.Clinical efficacies were evaluated in 2 groups on 1st and 90th day after the end of treatment,and the occurrence of ADR was observed in 2 groups during treatment.RESULTS:Before observation,there was no significant difference in these indexes.On 1st day after the end of treatment,the scores of skin lesion items and serum testosterone level in 2 groups were all decreased significantly compared to before treatment,and the scorns of skin lesion items in observation group were significantly lower than control group (P＜0.05);there was no significant difference in the serum testosterone level between 2 groups (P＞0.05).On 90th day after the end of treatment,the scores of skin lesion items and serum testosterone level in control group had no statistical significance compared to before treatment (P＞0.05).The scores of skin lesion items and serum testosterone level in observation group were decreased significantly compared before treatment,and were significantly lower than control group at corresponding period (P＜0.05).On 1st and 90th day after the end of treatment,total response rates of observation group were 85.00％ and 73.33％,which were significantly higher than 73.33％ and 55.00％ of control group,with statistical isgnificance (P＜0.05).There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:The heat-sensitive moxibustion combined with modified Pipa qingfei decoction can significantly reduce the scores of skin lesion and serum testosterone levels,improves the symptoms of skin lesions,and shows good safety.

Objective To investigate the predictive value of thromboelastography (TEG) parameters for hematoma enlargement after intracerebral hemorrhage.Methods Patients with primary intracerebral hemorrhage within 6 h after onset admitted to the Second People's Hospital of Changshu between March 2016 and March 2018 were enrolled prospectively.Hematoma enlargement was defined as the volume of hematoma detected by CT within 48 h after onset increased by ＞ 12.5 cm3 or ＞ 33％ compared with that at admission.The baseline data in the hematoma enlargement group and the non-hematoma enlargement group were compared.Multiple logistic regression analysis was used to determine the independent correlation between TEG parameters and hematoma enlargement.The receiver operating characteristic (ROC) curve was used to analyze the predictive value of TEG parameters for hematoma enlargement.Results A total of 141 patients with intracerebral hemorrhage were enrolled,of which 38 (27.0％) had hematoma enlargement.Compared with the non-hematoma enlargement group,the baseline National Institutes of Health Stroke Scale score (P =0.001),thrombin time (P =0.022),fasting blood glucose (P =0.007),hematoma ruptured into the ventricle (P =0.001),baseline hematoma volume (P =0.001),and coagulation reaction time measured by TEG (P=0.002) were significantly increased in the hematoma enlargement group,while the baseline Glasgow Coma Scale score (P =0.001) and α angle measured by TEG (P =0.021) were significantly decreased.Multivariate logistic regression analysis showed that after adjusting confounding factors,the prolonged coagulation reaction time (odds ratio [OR] 3.436,95％ confidence interval [CI] 1.083-9.905;P =0.036) and decreased α angle (OR 0.777,95％ CI0.656-0.921;P =0.004) were the independent predictors of hematoma enlargement after intracerebral hemorrhage.The area under the curve of coagulation reaction time predicting hematoma enlargement was 0.680 (95％ CI 0.588-0.772;P =0.004),and the sensitivity and specificity were 84.2％ and 52.4％ when 4.0 min was the cut-off value.The area under the curve of α angle predicting hematoma enlargement was 0.636 (95％ CI 0.534-0.738;P =0.007).The sensitivity and specificity were 73.7％ and 57.3％ when the cut-off value was 65.1 °.Conclusion The prolonged coagulation reaction time and the decrease of α angle detected by TEG had certain predictive value for hematoma enlargement after cerebral hemorrhage.