Methods: Thirty patients with PDVO of the lumbar or thoracic spine treated with transforaminal interbody debridement and fusion (TIDF) with AIBG between March 2014 and May 2022 were reviewed (AIBG group). For comparative analysis, 28 PDVO patients who underwent TIDF without AIBG between January 2009 and June 2011 were enrolled (non-AIBG group). The minimum follow-up duration was 2 years. Clinical characteristics and surgical indications were comparable in the two groups. C-reactive protein (CRP) levels and the postoperative antibiotics course were compared between the two groups. Results: Surgical treatment for PDVO resulted in clinical improvement and adequate infection control. Despite the shorter postoperative intravenous antibiotic duration (mean: 19.0 days vs. 39.8 days), the AIBG group had significantly lower CRP levels at postoperative 4 and 6 weeks. The mean Visual Analog Scale pain scores improved from 7.3 preoperatively to 2.2 at 6 weeks postoperatively. The average angle correction at the last follow-up was 7.9°. Conclusions TIDF with AIBG for PDVO can achieve local infection control with a faster reduction in CRP levels, leading to a shorter antibiotic duration.

Methods: Thirty patients with PDVO of the lumbar or thoracic spine treated with transforaminal interbody debridement and fusion (TIDF) with AIBG between March 2014 and May 2022 were reviewed (AIBG group). For comparative analysis, 28 PDVO patients who underwent TIDF without AIBG between January 2009 and June 2011 were enrolled (non-AIBG group). The minimum follow-up duration was 2 years. Clinical characteristics and surgical indications were comparable in the two groups. C-reactive protein (CRP) levels and the postoperative antibiotics course were compared between the two groups. Results: Surgical treatment for PDVO resulted in clinical improvement and adequate infection control. Despite the shorter postoperative intravenous antibiotic duration (mean: 19.0 days vs. 39.8 days), the AIBG group had significantly lower CRP levels at postoperative 4 and 6 weeks. The mean Visual Analog Scale pain scores improved from 7.3 preoperatively to 2.2 at 6 weeks postoperatively. The average angle correction at the last follow-up was 7.9°. Conclusions TIDF with AIBG for PDVO can achieve local infection control with a faster reduction in CRP levels, leading to a shorter antibiotic duration.

Methods: Thirty patients with PDVO of the lumbar or thoracic spine treated with transforaminal interbody debridement and fusion (TIDF) with AIBG between March 2014 and May 2022 were reviewed (AIBG group). For comparative analysis, 28 PDVO patients who underwent TIDF without AIBG between January 2009 and June 2011 were enrolled (non-AIBG group). The minimum follow-up duration was 2 years. Clinical characteristics and surgical indications were comparable in the two groups. C-reactive protein (CRP) levels and the postoperative antibiotics course were compared between the two groups. Results: Surgical treatment for PDVO resulted in clinical improvement and adequate infection control. Despite the shorter postoperative intravenous antibiotic duration (mean: 19.0 days vs. 39.8 days), the AIBG group had significantly lower CRP levels at postoperative 4 and 6 weeks. The mean Visual Analog Scale pain scores improved from 7.3 preoperatively to 2.2 at 6 weeks postoperatively. The average angle correction at the last follow-up was 7.9°. Conclusions TIDF with AIBG for PDVO can achieve local infection control with a faster reduction in CRP levels, leading to a shorter antibiotic duration.

A 68-year-old patient with non-small cell lung squamous carcinoma who received 6 cycles of sintilimab combination chemotherapy and sintilimab 200 mg,ivd,monotherapy developed severe diarrhea,abdominal pain,blood in the stool and other discomforts,and ultrasound and colonoscopy demonstrated extensive congestion and inflammation in the intestinal tract,and the pathologic biopsy was comprehensively considered to be an acute immune enteritis.Immunotherapy was suspended,adequate glucocorticoids and symptomatic treatment were given,and the patient's diarrhea and blood in stool improved after 2 days,and the symptoms were relieved and returned to normal after 6 days.The association between the patient's immune enteritis and sintilimab was assessed as probably relerant.This article reviews the literature on the case of immune-associated enteritis caused by sintilimab,describes how to use experimental methods and enteroscopy to detect the pathological changes in the clinic;and combines them with the clinical manifestations of diarrhea and blood in the stools to make the diagnosis and differentiation;and then refers to the guideline grading for timely management;and discusses the case to improve the clinicians'ability to recognize and deal with the relevant scenarios.

Objective: To analyze the predictive factors for neck pain and cervical spine function after laminoplasty for degenerative cervical myelopathy (DCM) using K-means for longitudinal data (KML). Methods: In this prospective cohort study, we collected clinical and radiographic data from patients with DCM who underwent cervical laminoplasty. A novel index of surgical outcome, “neck function,” which comprises neck pain and cervical spine function according to the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire, was proposed. We treated surgical outcomes as longitudinal rather than cross-sectional data and used KML for analysis. Patients were categorized as having good or poor outcomes based on the KML graph of neck pain and cervical spine function. Results: From 2016 to 2020, 104 patients underwent laminoplasty for DCM; however, 35 patients were excluded because of loss to follow-up or incomplete data. The authors found that central canal stenosis (odds ratio [OR], 17.93; 95% confidence interval [CI], 1.26–254.73; p=0.03) and preoperative neck pain (OR per 1 point increase=1.49; 95% CI, 1.12–1.99; p=0.006) were 2 negative predictive factors and that a positive K-line during flexion was a positive predictive factor (OR, 0.11; 95% CI, 0.01–0.87; p=0.036) for neck function after laminoplasty. Conclusion Central canal stenosis, preoperative neck pain and a K-line during flexion were found to be predictive of postoperative neck pain and cervical spine function after laminoplasty. To achieve better surgical outcomes for neck function, the authors suggest the utilization of these determinants as a guiding framework for the selection of surgical approaches for DCM.

Objective To construct a perioperative exercise program for older frail patients with colorectal cancer,and to verify its effect.Methods Based on Goal-directed Theory and literature review,expert consultation was carried out to establish the perioperative exercise program for older frail patients with colorectal cancer.Then,from July to December 2022,the perioperative exercise program was established for older frail patients with colorectal cancer hospitalized in the General Surgery Department of a tertiary A hospital in Suzhou by convenience sampling method for preliminary application.It was divided in to the intervention group and the control group by the ward.The intervention group was applied with the constructed perioperative exercise program on the basis of routine perioperative nursing.The safety,feasibility and intervention effect of the program were evaluated.Results 15 experts were included for 2 rounds of expert consultations.The authority coefficient was 0.880;the coefficient of variation was＜0.250;the Kendall concordance coefficient was 0.167 and 0.224,respectively.The final program contained 4 stages:preoperative exercise,postoperative bed rest,sitting and standing exercise.In the end,54 specific interventions were constructed.During the preliminary application,all the patients completed the program.Generalized estimation equation showed that,on the interaction effect,there was no statistical difference(P=0.752);there were significant differences on the intervention effect and the time effect(P＜0.05).At discharge,there were significant differences in timed up and go test and Barthel Index between the 2 groups(P＜0.05).Only 2 patients experienced mild pain in the intervention group,and no other adverse events occurred.Conclusion The perioperative exercise program for older frail patients with colorectal cancer,based on Goal-directed Theory,is scientific,reliable and safe.It has been preliminarily verified in improving postoperative physical function,activities of daily living and early postoperative recovery of elderly frail patients with colorectal cancer.

Objective:To determine the median effective dose (ED 50) and 95% effective dose (ED 95) of remimazolam for gastroscopy when combined with propofol in pediatric patients of different ages. Methods:This was a prospective study. American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ pediatric patients, aged 3-12 yr, who underwent painless gastroscopy in Hainan Women and Children′s Medical Center from January to February 2024, were divided into the following groups: preschool group (3-6 yr) and school-age group (7-12 yr). Penehyclidine 0.01 mg/kg, afentanil 8 μg/kg and corresponding doses of remimazolam and propofol 1 mg/kg were intravenously injected, and gastroscopy was performed when the Modified Observer′s Assessment of Alertness/Sedation Scale score)≤1. Up-and-down sequential allocation was used. A positive response was defined as bucking, nausea, vomiting, body movement, and frowning occurred when the gastroscope entered the pharynx. The initial dose of remimazolam was 0.2 mg/kg, and the dose of remimazolam was increased/decreased by 0.02 mg/kg each time in the next patient. Probit regression method was applied to calculate the ED 50, ED 95 and 95% confidence interval ( CI) of remimazolam inhibiting responses to gastroscope placement when combined with propofol. The anesthesia-related adverse events were recorded. Results:A total of 27 pediatric patients completed the trial in preschool group and 26 cases in school-age group. The ED 50 of remimazolam was 0.266 mg/kg (95% CI 0.249-0.285 mg/kg) and the ED 95 was 0.302 mg/kg (95% CI 0.283-0.409 mg/kg) in preschool group. The ED 50 of remimazolam was 0.16 mg/kg (95% CI 0.147-0.170 mg/kg) and ED 95 was 0.183 mg/kg (95% CI 0.172-0.234 mg/kg) in school-age group. The ED 50 and ED 95 were significantly decreased in school-age group as compared with preschool group ( P<0.05). During anesthesia, 3 patients suffered hypotension (11%) in preschool group, and 3 patients suffered hypotension (12%), 2 patients suffered respiratory depression (8%), 2 patients suffered hiccup (8%), 1 patient suffered injection pain (4%) and 1 patient suffered muscle rigidity (4%) in school-age group. There was no significant difference in the incidence of adverse reactions between the two groups ( P>0.05). Conclusions:When combined with propofol, the ED 50 of remimazolam for gastroscopy in preschool and school-age pediatric patients is 0.266 mg/kg and 0.160 mg/kg, respectively, and the ED 95 is 0.302 mg/kg and 0.183 mg/kg, respectively, indicating a stronger anesthetic potency in school-age children. The probability of adverse reactions is low when the two are combined.

AIM To investigate the effects of Moluodan Dami Pills on chronic atrophic gastritis(CAG)rats and their mechanism.METHODS The rat models were randomly divided into the model group,the low-dose group and high-dose Moluodan Dami Pills groups(2.43 g/kg and 4.86 g/kg),and vitamin A group(0.32 g/kg),following the 16 weeks successful induction of CAG by five-factor modeling method,in contrast to another 10 normal rats of the control group.After 8 weeks corresponding administration,the rats of each group had their general physiological status and pH value of gastric juice assessed;their pathological changes of gastric mucosa observed by naked eyes combined with HE staining;their changes of gastrin-secreting cells(G cells)and somatostatin-secreting cells(D cells)in gastric mucosa observed by immunohistochemistry;and their serum levels of pepsinogen Ⅰ/pepsinogen Ⅱ(PG Ⅰ/PG Ⅱ)ratio,TNF-α and IL-6 detected by ELISA.RESULTS Compared with the model group,the groups intervened with Moluodan Damei Pills and vitamin A displayed lower pH values of gastric juice(P＜0.05),improved pathological changes of gastric mucosa,increased G and D cells counts(P＜0.05,P＜0.01),increased ratio of serum PGⅠ/PGⅡ,and decreased levels of IL-6 and TNF-α(P＜0.05,P＜0.01).CONCLUSION Moluodan Dami Pills can effectively improve the symptoms of CAG rats through its influence on the number and secretion abilityof G and D cells,the levels of serum PG Ⅰ/PG Ⅱ ratio and inflammatory factors.

Objective:To observe the intervention effect of aerobic Baduanjin exercise combined with treadmill train-ing on chronic obstructive pulmonary disease(COPD)complicated chronic heart failure(CHF).Methods:A total of 180 COPD+CHF patients who were treated in Mianyang Central Hospital from January 2019 to June 2021 were selected.They were equally divided into control group(basic treatment and intervention)and experimental group(received aerobic Baduanjin exercise combined with treadmill training based on control group)by random number table method,both groups were intervened for 12 weeks.COPD assessment test(CAT)score,left ventricular ejec-tion fraction(LVEF),left ventricular end systolic volume(LVESV),left ventricular end diastolic volume(LV-EDV),scores of modified medical research council(mMRC)and Minnesota living with heart failure questionnaire(MLHFQ)were compared between two groups before,4,8 and 12 weeks after intervention.Results:During 12-week intervention,CAT score,LVESV,LVEDV,scores of mMRC and MLHFQ showed a gradual decreasing trend,while LVEF showed a gradual increasing trend in two groups,P＜0.05 or＜0.01.Compared with control group after 12-week intervention,there were significant reductions in CAT score[(17.47±3.96)points vs.(13.36±3.42)points],LVEDV[(139.44±7.12)ml vs.(131.74±6.47)ml],LVESV[(81.84±8.54)ml vs.(74.29±9.18)ml],scores of mMRC[(1.67±0.47)points vs.(1.42±0.50)points],each dimension and total score of MLHFQ[(40.07±6.86)points vs.(32.54±6.61)points],and significant rise in LVEF[(41.29±4.76)％vs.(44.56±4.42)％]in experimental group(P＜0.001 all).Conclusion:Aerobic Baduanjin exercise combined with treadmill training based on basic treatment can significantly improve cardiopulmonary function,re-lieve dyspnea and improve quality of life in COPD+CHF patients,which is worth promoting.

Objective: To analyze the predictive factors for neck pain and cervical spine function after laminoplasty for degenerative cervical myelopathy (DCM) using K-means for longitudinal data (KML). Methods: In this prospective cohort study, we collected clinical and radiographic data from patients with DCM who underwent cervical laminoplasty. A novel index of surgical outcome, “neck function,” which comprises neck pain and cervical spine function according to the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire, was proposed. We treated surgical outcomes as longitudinal rather than cross-sectional data and used KML for analysis. Patients were categorized as having good or poor outcomes based on the KML graph of neck pain and cervical spine function. Results: From 2016 to 2020, 104 patients underwent laminoplasty for DCM; however, 35 patients were excluded because of loss to follow-up or incomplete data. The authors found that central canal stenosis (odds ratio [OR], 17.93; 95% confidence interval [CI], 1.26–254.73; p=0.03) and preoperative neck pain (OR per 1 point increase=1.49; 95% CI, 1.12–1.99; p=0.006) were 2 negative predictive factors and that a positive K-line during flexion was a positive predictive factor (OR, 0.11; 95% CI, 0.01–0.87; p=0.036) for neck function after laminoplasty. Conclusion Central canal stenosis, preoperative neck pain and a K-line during flexion were found to be predictive of postoperative neck pain and cervical spine function after laminoplasty. To achieve better surgical outcomes for neck function, the authors suggest the utilization of these determinants as a guiding framework for the selection of surgical approaches for DCM.