Objective To investigate the impact of different treatment options on lumbar function, pain intensity, and anterior vertebral height in elderly patients with thoracolumbar vertebral compression fractures. Methods The clinical data of 102 elderly patients with thoracolumbar vertebral compression fractures who completed 1-year follow-up were retrospectively analyzed. They were divided into conservative group (32 cases), percutaneous kyphoplasty (PKP) group (35 cases), and percutaneous vertebroplasty (PVP) group (35 cases) based on different treatment options. One year after treatment, the clinical efficacy and complications of the three groups were evaluated. The Visual Analogue Scale (VAS) score, Japanese Orthopedic Association (JOA) score, Cobb angle, and anterior vertebral height were compared before and 1 year after treatment among the three groups. Results The excellent and good rates of the PKP group and PVP group were higher than those of the conservative group (P < 0.05). There was no significant difference in the excellent and good rates between the PKP group and PVP group (P>0.05). There was no significant difference in occurrence of complications among the three groups (P>0.05). One year after treatment, the VAS scores of the three groups were lower than before treatment, and the JOA scores were higher than before treatment, and the VAS scores of the PKP group and PVP group were lower than those of the conservative group, and the JOA scores were higher than those of the conservative group (P < 0.05). The VAS score of the PKP group was lower than that of the PVP group, and the JOA score was higher than that of the PVP group (P < 0.05). One year after treatment, the Cobb angles of the three groups were smaller than before treatment, and the anterior vertebral heights were higher than before treatment, and the Cobb angles of the PKP group and PVP group were smaller than those of the conservative group, and the anterior vertebral heights were higher than those of the conservative group (P < 0.05). The Cobb angle of the PKP group was smaller than that of the PVP group, and the anterior vertebral height was higher than that of the PVP group, the difference in anterior vertebral height was greater than that of the PVP group (P < 0.05). Conclusion Compared with conservative treatment, surgery can improve the clinical efficacy of elderly patients with thoracolumbar vertebral compression fractures. PKP is superior to PVP in reducing pain of patients, improving lumbar function and Cobb angle, and anterior vertebral height. Moreover, it has better safety.

Objective:To explore the value of machine learning models based on multiple structural MRI features for diagnosis of Parkinson disease (PD).Methods:The clinical and imaging data of 60 PD patients (PD group) diagnosed in the Neurology Department of the Second Affiliated Hospital of Soochow University from November 2017 to August 2019 and 56 normal elderly people (NC group) recruited from the community were retrospectively analyzed. All subjects underwent brain MR imaging. Multiple structural MRI features were extracted from cerebellum, deep nuclei and of brain cortex based on different partition templates. The Mann-Whitney U test, as well as least absolute shrinkage and selection operator regression were used to select the most discriminating features. Finally, logistic regression (LR) and linear discriminant analysis (LDA) classifier combined with the 5-fold cross-validation scheme were used to construct the models based on structural features of cerebellum, deep nuclei and cortex, and a combined model based on all features. The receiver operating characteristic curves were drawn, and the diagnostic performance and clinical net benefit of each model were evaluated by the area under curve (AUC) and the decision curve analysis (DCA). Results:In total, four cerebellum (asymmetry index of Lobule Ⅵ volume, asymmetry index of Lobule ⅦB cortical thickness, asymmetry index of total gray matter volume and absolute value of right Lobule Ⅵ gray matter volume), 3 deep nuclei (absolute value of right nucleus accumbens volume, absolute and relative value of total nucleus accumbens volume) and 3 cortex features (local gyration index of left PFm, local fractal dimension of right superior frontal gyrus and sulcal depth of left superior occipital gyrus) were selected as the most discriminating features, and the related models were constructed. In validation set, the AUC of cerebellum, deep nuclei, cortex and combined models for diagnosis of PD based on LR classifier were 0.692, 0.641, 0.747 and 0.816; the AUC of cerebellum, deep nuclei, cortex and combined models for diagnosis of PD based on LDA classifier were 0.726, 0.610, 0.752 and 0.818. The diagnostic efficiency of the combined models based on LR and LDA classifiers were significantly better than those of other models ( P<0.05). The DCA curve demonstrated that the combined models based on LR and LDA classifiers showed the highest clinical net benefit. Conclusion:The combined models with all structural features of cerebellum, deep nuclei and cortex included based on LR and LDA classifiers showed favorable performance and clinical net benefit for diagnosis of PD, which have the potential application value in clinical diagnosis.

Presynaptic dopaminergic PET imaging is a useful method for the diagnosis of parkinsonism. Based on the expert consensus on operation and clinical application of dopamine transporter brain PET imaging technology published in 2020, this paper further recommends the relevant elements of result interpretation of presynaptic dopaminergic PET imaging.

OBJECTIVE: To explore the pathogenesis of two siblings (including a fetus) from a pedigree affected with Joubert syndrome. METHODS: Peripheral blood samples of the proband and his parents as well as amniotic fluid and abortion tissues of the fetus were collected. Part of the samples were used for the extraction of DNA, and whole exome sequencing (WES) was carried out to screen potential variants in the proband and his parents. Suspected variants were subjected to bioinformatics analysis with consideration of the clinical phenotype, and were verified by Sanger sequencing of the proband, fetus and their parents.The remainders were used for the extraction of RNA, and the mechanism of splicing variant was validated by reverse transcription-PCR (RT-PCR). RESULTS: WES showed that both patients have carried c.175C>T (p.R59X) and c.553+1G>A compound heterozygous variants of the TMEM237 gene. Among these, c.175C>T was a nonsense mutation inherited from the asymptomatic mother, while c.553+1G>A was an alternative splicing mutation inherited from the asymptomatic father. RT-PCR showed that this variant has resulted in aberrant splicing by exon skipping. CONCLUSION The compound heterozygous variants of the TMEM237 gene probably underlay the etiology of Joubert syndrome in this pedigree. Above finding has enriched the phenotype and variant spectrum of the TMEM237 gene, and facilitated genetic counseling and prenatal diagnosis for the family.
Abnormalities, Multiple/genetics* ; Cerebellum/abnormalities* ; Eye Abnormalities ; Female ; Genotype ; Humans ; Kidney Diseases, Cystic ; Mutation ; Pedigree ; Phenotype ; Pregnancy ; Retina/abnormalities*

The medical imaging technology (MIT) specialty hasn't been set up for a long time in China, and the mode of educating students in other institutions vary greatly among different universities. There are several disadvantages in MIT specialty set up in the Affiliated hospitals of universities, such as unreasonable curriculum system, imperfections in teaching and research department, and inadequate guidance on students' innovation ability. Therefore, the solutions for alleviating the above problems that are unfavorable factors to education are proposed, so as to further improve the model of MIT specialty set up in the affiliated hospitals of universities and produce more competent graduates.

Objective:To ananlyze the toxic effects and mechanisms of Cr (Ⅵ) subchronic exposure based on metabonomics techniques.Methods:Twenty-nine female Sprague-Dawley rats were randomly divided into control group, low dose group and high dose group, 10, 9, 10, respectively. The control group, low dose group and high dose group were treated with 0, 10, 50 mg/L Cr (Ⅵ) for 90 days respec tively. The serum samples of rats with different dose of Cr (Ⅵ) treatment were detected Using UPLC-Q-TOF-MS/MS technique and data was analyzed by PCA, PLS-DA and OPLS-DA to compare with metabolic profile in different Cr (Ⅵ) dose treatments. Pathway analysis was performed using MetaboAnalyst 4.0 software.Results:UPLC-Q- TOF-MS/MS has stable detection performance and reliable experimental data. The control group, low Cr (Ⅵ) and high Cr (Ⅵ ) metabolic profiles of rats serum differences was obviously, and there is significant difference of serum metabolic profile among rats treated with different dose of Cr (Ⅵ) . 18 differential metabolites were screened between Cr (Ⅵ) low dose group and control group, 23 differential metabolites between Cr (Ⅵ) high dose group and control group. Compared to control group, there were 13 differential metabolites in both Cr (Ⅵ) high dose group and Cr (Ⅵ ) low dose group, such as 3-Hydroxy-11Z-octadecenoylcarnitine, Anserine, Farnesyl pyrophosphate, Linoleoyl ethanolamid e, Linoleyl carnitine, Lithocholate 3-O-glucuronide, LysoPC [20∶2(11Z, 14Z) ], LysoPC[20∶3 (5Z, 8Z, 11Z) ], LysoPC[22∶2(13Z, 16Z) ], PG[16∶0/22∶5(7Z, 10Z, 13Z, 16Z, 19Z) ], PI[18∶1 (11Z) /20∶4(5Z, 8Z, 11Z, 14Z) ], PI[20∶3(5Z, 8Z, 11Z) /18∶0], Serotonin. These differential metabolites were related to Glycerophospholipid metabolism, Tryptophan metabolism, Pentose and glucuronate interconversions, Terpenoid backbone biosynthesis.Conclusion:Cr (Ⅵ) subchronic exposure could induce the significant difference of serum metabolic profile. The differential metabolites induced by Cr (Ⅵ) subchronic ex- posure were mainly related to amino acid and lipid metabolism.

Objective:To ananlyze the toxic effects and mechanisms of Cr (Ⅵ) subchronic exposure based on metabonomics techniques.Methods:Twenty-nine female Sprague-Dawley rats were randomly divided into control group, low dose group and high dose group, 10, 9, 10, respectively. The control group, low dose group and high dose group were treated with 0, 10, 50 mg/L Cr (Ⅵ) for 90 days respec tively. The serum samples of rats with different dose of Cr (Ⅵ) treatment were detected Using UPLC-Q-TOF-MS/MS technique and data was analyzed by PCA, PLS-DA and OPLS-DA to compare with metabolic profile in different Cr (Ⅵ) dose treatments. Pathway analysis was performed using MetaboAnalyst 4.0 software.Results:UPLC-Q- TOF-MS/MS has stable detection performance and reliable experimental data. The control group, low Cr (Ⅵ) and high Cr (Ⅵ ) metabolic profiles of rats serum differences was obviously, and there is significant difference of serum metabolic profile among rats treated with different dose of Cr (Ⅵ) . 18 differential metabolites were screened between Cr (Ⅵ) low dose group and control group, 23 differential metabolites between Cr (Ⅵ) high dose group and control group. Compared to control group, there were 13 differential metabolites in both Cr (Ⅵ) high dose group and Cr (Ⅵ ) low dose group, such as 3-Hydroxy-11Z-octadecenoylcarnitine, Anserine, Farnesyl pyrophosphate, Linoleoyl ethanolamid e, Linoleyl carnitine, Lithocholate 3-O-glucuronide, LysoPC [20∶2(11Z, 14Z) ], LysoPC[20∶3 (5Z, 8Z, 11Z) ], LysoPC[22∶2(13Z, 16Z) ], PG[16∶0/22∶5(7Z, 10Z, 13Z, 16Z, 19Z) ], PI[18∶1 (11Z) /20∶4(5Z, 8Z, 11Z, 14Z) ], PI[20∶3(5Z, 8Z, 11Z) /18∶0], Serotonin. These differential metabolites were related to Glycerophospholipid metabolism, Tryptophan metabolism, Pentose and glucuronate interconversions, Terpenoid backbone biosynthesis.Conclusion:Cr (Ⅵ) subchronic exposure could induce the significant difference of serum metabolic profile. The differential metabolites induced by Cr (Ⅵ) subchronic ex- posure were mainly related to amino acid and lipid metabolism.

Objective:To analysis perinatal outcome and pregnancy complications in the third trimester in excessive fast weight gain pregnant women who had normal 75 g oral glucose tolerance test(OGTT) at the second trimester.Methods:422 pregnant women who examined and delivered in Department of Obstetrics,the Second Hospital of Tianjin Medical University from October 2015 to September 2016 were selected randomly for this study.All of them had normal pre-pregnancy body mass index (BMI) and 75 g OGTT test at 24-27 +6 gestational weeks.Mass growth more than 4000 g from 28-36 gestational weeks (average mass growth rate ≥500 g/w) were enrolled in study group(n =103),while others were included in control group(n =319).Statistical analysis was performed by t test and x 2 test.Results.The incidence rate of Gestational diabetes mellitus(GDM) (7.8％),gestational hypertensive (6.8％),mild preeclampsia (4.9％),premature rupture of membranes (PROM)(12.6％) and polyhydramnios(4.9％) in study group was significant higher than those in control group (2.8％,2.5％,1.9％,7.2％,1.3％).The rate of cesarean section (39.8％),macrosomia (10.7％),and neonatal hypoglycemia(4.9％)in study group was significant higher than those in control group (34.2％,6.0％,2.5％).The average birth weight in the study group was significant higher than that in the control group(3677-±351 g vs 3328 -±367g,P＜O.01).There was no significant difference in Apgar score between two groups(P ＞0.05).Conclusions:In the second trimester 75 g OGTT test normal pregnant women,poor diet and exercise management and excessive fast weight gain may increase the incidence of pregnancy complications and poorer perinatal outcomes.

Objective To investigate the expression and prognostic significance of P-JAK2, P-STAT3 and mutant p53 in cervical lesions. Methods A total of 153 cervical biopsies of patients from Gynecology Department, The Second Hospital of Tianjin Medical University were recruited during December 2013 to June 2015. Fifty-seven cases of squamous carcinoma of cervix (SCC), 36 cases of low grade intraepithelial neoplasia (LSIL), 30 patients with high grade intraepithelial neoplasia (HSIL) and 30 cases of normal cervix (NC) were included in the study. Gene chip method was used to detect high-risk hu-man papillpmavirus(HR-HPV)infection. Hematoxylin-eosin staining was used to make pathological diagnosis. Immunohis-tochemical assay was used for the detection of P-JAK2, P-STAT3 and mutant type p53 protein expression in cervical le-sions. Results (1) HR-HPV infection rate and P-JAK2 expression were significantly higher in SCC group than those of HSIL group, LSIL group and NC group (P<0.05). (2) The expression of P-STAT3 and mutant type p53 were significantly higher in SCC group than those of LSIL group and NC group (P<0.05). However, there was no significant difference between SCC group and HSIL group. (3) The positive expressions of P-JAK2 and P-STAT3 showed significant differences in different FIGO stages, histopathological grade, lymph node metastasis and HR-HPV infection in SCC group, respectively ( P<0.05). There were significant differences in the positive expression of mutant type p53 between different FIGO stages and HR-HPV infection (P<0.05). (4) There was positive correlation between P-JAK2, P-STAT3, positive expression of mutant type p53 and HR-HPV infection in SCC tissues (P<0.05). There was a positive correlation between P-STAT3, p53 expression and HR-HPV infection (P<0.05). There was a positive correlation between mutant p53 expression and HR-HPV infection (P<0.05). Conclusion P-JAK2, P-STAT3 and mutant p53 protein expression rates are high in SCC group than those of NC and SIL groups, which may be associated with HR-HPV infection, cervical cancer occurrence and progression.

Objective To study the inhibitory effect of antimicrobial peptide LL-37 on Candida albicans through its ability to promote the secretion of immune factors by vaginal epithelial cells. Methods (1) LL-37 prokaryotic expression vector pET-Duet/LL-37 was constructed and its expression was induced in Escherichia coli M15. The expressed LL-37 fusion protein was purified and identified by western blot. Antifungal activity of the purified protein was initially identified by Kirby-Bauer (K-B) method. (2) Purified LL-37 protein was added to human vaginal epithelial cells co-cultured with Candida, and inhibitory effect on Candida growth was determined by the glucose consumption method. Interferon γ (IFN-γ), interleukin 10 (IL-10) concentration and IFN-γ/IL-10 ratio were measured by ELISA at different time points. Results (1) LL-37 fusion protein was purified to 96% purity at a concentration of 433.92 μg/ml, and was shown to possess anti-fungal activity confirmed by the K-B method. (2) A Candida-vaginal epithelial cells co-culture system was successfully constructed. LL-37 recombinant protein inhibited the growth of Candida with absorbance values significantly higher in the treatment group compared to the control group at all measured time points (12-hour:3.008±0.003 versus 2.967±0.003, 24-hour:2.941±0.003 versus 2.601±0.003, 48-hour:2.893 ± 0.004 versus 2.409 ± 0.003; all P<0.01). Furthermore, the rate of decrease was also much slower compared to the control group. In both control and experimental groups, IFN-γ and IL-10 secretion levels were observed to rise at first peaking at 24 hours and subsequently decrease. For each time period, IFN-γconcentration in the experimental group was significantly higher at 24 hours compared to the control group [(104.00 ± 1.07) versus (85.17 ± 0.28) pg/ml, P<0.01]. In contrast, IL-10 concentrations were significantly lower than the control group at all time points (P<0.01). IFN-γ/IL-10 ratio was also observed to be significantly higher than the control group at all measured time points (P<0.01). Conclusions (1) Recombinant protein LL-37 could significantly inhibit the growth of Candida. (2) By influencing the secretion of immune factors such as IFN-γ, IL-10, etc, recombinant protein LL-37 is able to adjust vaginal epithelial cells local immunity, and enhance resistance to Candida infection.