Objective: Based on spinopelvic parameters and biomechanical principles, the pedicle-facet joint (PFJ) morphological characteristics of isthmic and degenerative spondylolisthesis were analyzed, and the mechanism of their onset and progression was discussed. Methods: This retrospective cross-sectional study included 194 patients with L5 spondylolysis or L5–S1 low-grade isthmic spondylolisthesis (IS group), 172 patients with L4–5 degenerative spondylolisthesis (DS group), and 366 patients with nonlumbar spondylolysis (NL group). The spinopelvic parameters and PFJ morphological parameters of the patients were measured, the differences in these parameters among and within the 3 groups were compared, and the correlations were analyzed. Results: Sacral slope (SS) and lumbar lordosis (LL) were the highest in the IS group, the second highest in the DS group, and the lowest in the NL group. Among the 3 groups, the L4 facet joint angle (FJA) was the largest in the IS group, the second largest in the NL group, and the smallest in the DS group. The L4 pedicle-facet joint angle (PFA) was the largest in the DS group, the second largest in the IS group, and the smallest in the NL group. Pearson correlation analysis showed that within each group, SS and LL were negatively correlated with FJA and positively correlated with PFA. Conclusion This study found a correlation between the PFJ morphological characteristics of patients with lumbar spondylolisthesis and spinopelvic parameters, suggesting that the morphological characteristics of PFJs may be caused by varying stresses under different spinopelvic morphologies.

Objective: Based on spinopelvic parameters and biomechanical principles, the pedicle-facet joint (PFJ) morphological characteristics of isthmic and degenerative spondylolisthesis were analyzed, and the mechanism of their onset and progression was discussed. Methods: This retrospective cross-sectional study included 194 patients with L5 spondylolysis or L5–S1 low-grade isthmic spondylolisthesis (IS group), 172 patients with L4–5 degenerative spondylolisthesis (DS group), and 366 patients with nonlumbar spondylolysis (NL group). The spinopelvic parameters and PFJ morphological parameters of the patients were measured, the differences in these parameters among and within the 3 groups were compared, and the correlations were analyzed. Results: Sacral slope (SS) and lumbar lordosis (LL) were the highest in the IS group, the second highest in the DS group, and the lowest in the NL group. Among the 3 groups, the L4 facet joint angle (FJA) was the largest in the IS group, the second largest in the NL group, and the smallest in the DS group. The L4 pedicle-facet joint angle (PFA) was the largest in the DS group, the second largest in the IS group, and the smallest in the NL group. Pearson correlation analysis showed that within each group, SS and LL were negatively correlated with FJA and positively correlated with PFA. Conclusion This study found a correlation between the PFJ morphological characteristics of patients with lumbar spondylolisthesis and spinopelvic parameters, suggesting that the morphological characteristics of PFJs may be caused by varying stresses under different spinopelvic morphologies.

Objective: Based on spinopelvic parameters and biomechanical principles, the pedicle-facet joint (PFJ) morphological characteristics of isthmic and degenerative spondylolisthesis were analyzed, and the mechanism of their onset and progression was discussed. Methods: This retrospective cross-sectional study included 194 patients with L5 spondylolysis or L5–S1 low-grade isthmic spondylolisthesis (IS group), 172 patients with L4–5 degenerative spondylolisthesis (DS group), and 366 patients with nonlumbar spondylolysis (NL group). The spinopelvic parameters and PFJ morphological parameters of the patients were measured, the differences in these parameters among and within the 3 groups were compared, and the correlations were analyzed. Results: Sacral slope (SS) and lumbar lordosis (LL) were the highest in the IS group, the second highest in the DS group, and the lowest in the NL group. Among the 3 groups, the L4 facet joint angle (FJA) was the largest in the IS group, the second largest in the NL group, and the smallest in the DS group. The L4 pedicle-facet joint angle (PFA) was the largest in the DS group, the second largest in the IS group, and the smallest in the NL group. Pearson correlation analysis showed that within each group, SS and LL were negatively correlated with FJA and positively correlated with PFA. Conclusion This study found a correlation between the PFJ morphological characteristics of patients with lumbar spondylolisthesis and spinopelvic parameters, suggesting that the morphological characteristics of PFJs may be caused by varying stresses under different spinopelvic morphologies.

Objective: Based on spinopelvic parameters and biomechanical principles, the pedicle-facet joint (PFJ) morphological characteristics of isthmic and degenerative spondylolisthesis were analyzed, and the mechanism of their onset and progression was discussed. Methods: This retrospective cross-sectional study included 194 patients with L5 spondylolysis or L5–S1 low-grade isthmic spondylolisthesis (IS group), 172 patients with L4–5 degenerative spondylolisthesis (DS group), and 366 patients with nonlumbar spondylolysis (NL group). The spinopelvic parameters and PFJ morphological parameters of the patients were measured, the differences in these parameters among and within the 3 groups were compared, and the correlations were analyzed. Results: Sacral slope (SS) and lumbar lordosis (LL) were the highest in the IS group, the second highest in the DS group, and the lowest in the NL group. Among the 3 groups, the L4 facet joint angle (FJA) was the largest in the IS group, the second largest in the NL group, and the smallest in the DS group. The L4 pedicle-facet joint angle (PFA) was the largest in the DS group, the second largest in the IS group, and the smallest in the NL group. Pearson correlation analysis showed that within each group, SS and LL were negatively correlated with FJA and positively correlated with PFA. Conclusion This study found a correlation between the PFJ morphological characteristics of patients with lumbar spondylolisthesis and spinopelvic parameters, suggesting that the morphological characteristics of PFJs may be caused by varying stresses under different spinopelvic morphologies.

Objective: Based on spinopelvic parameters and biomechanical principles, the pedicle-facet joint (PFJ) morphological characteristics of isthmic and degenerative spondylolisthesis were analyzed, and the mechanism of their onset and progression was discussed. Methods: This retrospective cross-sectional study included 194 patients with L5 spondylolysis or L5–S1 low-grade isthmic spondylolisthesis (IS group), 172 patients with L4–5 degenerative spondylolisthesis (DS group), and 366 patients with nonlumbar spondylolysis (NL group). The spinopelvic parameters and PFJ morphological parameters of the patients were measured, the differences in these parameters among and within the 3 groups were compared, and the correlations were analyzed. Results: Sacral slope (SS) and lumbar lordosis (LL) were the highest in the IS group, the second highest in the DS group, and the lowest in the NL group. Among the 3 groups, the L4 facet joint angle (FJA) was the largest in the IS group, the second largest in the NL group, and the smallest in the DS group. The L4 pedicle-facet joint angle (PFA) was the largest in the DS group, the second largest in the IS group, and the smallest in the NL group. Pearson correlation analysis showed that within each group, SS and LL were negatively correlated with FJA and positively correlated with PFA. Conclusion This study found a correlation between the PFJ morphological characteristics of patients with lumbar spondylolisthesis and spinopelvic parameters, suggesting that the morphological characteristics of PFJs may be caused by varying stresses under different spinopelvic morphologies.

BACKGROUND:NOD-like receptor thermal protein domain associated protein 3 (NLRP3) inflammasome is closely related to neuroinflammation after spinal cord injury,in which microglial polarization and pyroptosis play a key role.Targeted regulation of NLRP3 can induce microglial polarization from M1 proinflammatory phenotype to M2 anti-inflammatory phenotype and regulate microglial pyroptosis,which is a promising therapeutic strategy.OBJECTIVE:To summarize the molecular mechanism and therapeutic strategies of NLRP3 inflammasome in microglia after spinal cord injury.METHODS:Databases of PubMed,Web of Science,and CNKI were searched for the articles with search terms "spinal cord injury,NLRP3,microglia,polarization,pyroptosis" in English and "spinal cord injury,NLRP3,microglia,polarization,pyroptosis,inflammation" in Chinese.Finally,a total of 79 articles were included according to the inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1) Currently,there is no consensus on the complex pathogenesis of spinal cord injury.A large number of studies have shown that spinal cord injury is closely related to inflammatory factors and signaling pathways.The NLRP3 inflammasome is a hot topic in current research as a mechanism of disease and a breakthrough in treatment.(2) The NLRP3 inflammasome plays a key role in the inflammatory response,oxidative stress,and neuronal recovery after spinal cord injury.(3) Microglia are immune cells in the brain and spinal cord and are the most important regulatory factors in secondary spinal cord injury.After spinal cord injury,microglia adjust the internal environment,mainly manifested as polarization and necrosis,produce a large number of inflammatory factors,hinder the nerve regeneration and functional recovery of spinal cord injury,and regulating the phenotype change of microglia is another key factor in the treatment of spinal cord injury.(4) The NLRP3 inflammasome is closely related to microglia.After spinal cord injury,NLRP3 is mainly expressed in microglia,which promotes the polarization of microglia to M1 and accelerates the production of cleavage proteins,further disrupting the microenvironment and aggravating the progression of spinal cord injury.(5) Many molecules participate in the regulation of NLRP3 inflammasomes in microglia,involving signaling pathways.Among them,nuclear factor-κB and MAPK signaling pathways promote NLRP3 inflammasome,while the rest inhibit this inflammasome.(6) At present,a large number of exogenous molecules and drugs regulate NLRP3 inflammasomes,with a wide range of clinical application prospects.Relevant drugs are in the clinical trial stage and obtain good effects,such as the NLRP3-specific inhibitor MCC950.However,key issues such as how to precisely control targeted delivery and the impact on other tissues and organs urgently need to be resolved.With the deepening of research,it is expected to make new breakthroughs in delaying the treatment of spinal cord injury in the future.

BACKGROUND:NOD-like receptor thermal protein domain associated protein 3 (NLRP3) inflammasome is closely related to neuroinflammation after spinal cord injury,in which microglial polarization and pyroptosis play a key role.Targeted regulation of NLRP3 can induce microglial polarization from M1 proinflammatory phenotype to M2 anti-inflammatory phenotype and regulate microglial pyroptosis,which is a promising therapeutic strategy.OBJECTIVE:To summarize the molecular mechanism and therapeutic strategies of NLRP3 inflammasome in microglia after spinal cord injury.METHODS:Databases of PubMed,Web of Science,and CNKI were searched for the articles with search terms "spinal cord injury,NLRP3,microglia,polarization,pyroptosis" in English and "spinal cord injury,NLRP3,microglia,polarization,pyroptosis,inflammation" in Chinese.Finally,a total of 79 articles were included according to the inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1) Currently,there is no consensus on the complex pathogenesis of spinal cord injury.A large number of studies have shown that spinal cord injury is closely related to inflammatory factors and signaling pathways.The NLRP3 inflammasome is a hot topic in current research as a mechanism of disease and a breakthrough in treatment.(2) The NLRP3 inflammasome plays a key role in the inflammatory response,oxidative stress,and neuronal recovery after spinal cord injury.(3) Microglia are immune cells in the brain and spinal cord and are the most important regulatory factors in secondary spinal cord injury.After spinal cord injury,microglia adjust the internal environment,mainly manifested as polarization and necrosis,produce a large number of inflammatory factors,hinder the nerve regeneration and functional recovery of spinal cord injury,and regulating the phenotype change of microglia is another key factor in the treatment of spinal cord injury.(4) The NLRP3 inflammasome is closely related to microglia.After spinal cord injury,NLRP3 is mainly expressed in microglia,which promotes the polarization of microglia to M1 and accelerates the production of cleavage proteins,further disrupting the microenvironment and aggravating the progression of spinal cord injury.(5) Many molecules participate in the regulation of NLRP3 inflammasomes in microglia,involving signaling pathways.Among them,nuclear factor-κB and MAPK signaling pathways promote NLRP3 inflammasome,while the rest inhibit this inflammasome.(6) At present,a large number of exogenous molecules and drugs regulate NLRP3 inflammasomes,with a wide range of clinical application prospects.Relevant drugs are in the clinical trial stage and obtain good effects,such as the NLRP3-specific inhibitor MCC950.However,key issues such as how to precisely control targeted delivery and the impact on other tissues and organs urgently need to be resolved.With the deepening of research,it is expected to make new breakthroughs in delaying the treatment of spinal cord injury in the future.

Objective To explore the predictive value of lung function test parameters combined with assessment test(CAT)score of chronic obstructive pulmonary disease(COPD)for acute attack in elderly COPD patients.Methods A total of 150 elderly COPD patients admitted to Shanghai Sixth People's Hospital from June 2020 to December 2022 were retrospectively enrolled.According to the diagnostic criteria of acute attack of COPD,the patients were divided into acute attack group(n=45)and stable group(n=105).The clinical basic data,forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),forced expiratory volume in 3 seconds(FEV3),percentage of FEV1 to predicted value(FEV1%),FEV1/FVC and FEV1/FEV3 were compared between the 2 groups.Respiratory symptoms and COPD severity were assessed by St.George's respiratory questionnaire(SGRQ),modified British Medical Research Council respiratory questionnaire(mMRC),and CAT questionnaire.Correlation analysis and binary logistic regression analysis were used to determine independent risk factors for acute attack in elderly COPD patients.Receiver operator characteristic(ROC)curves were drawn to evaluate the independent and combined predictive value of risk factors.Results FEV1,FVC,FEV1%,FEV1/FVC,and FEV1/FEV3 in the acute attack group were significantly lower than those in the control group(P<0.05).The scores of SGRQ,mMRC and CAT in the acute attack group were significantly higher than those in the control group(P<0.05).Correlation analysis showed that FEV1,FVC,FEV1%,and FEV1/FVC were negatively correlated with acute attack of COPD,while mMRC and CAT scores were positively correlated with acute attack of COPD(P<0.05).Logistic regression analysis showed that the decrease of FEV1 and the increases of mMRC and CAT scores were the risk factors of acute attack of COPD in elderly patients.ROC analysis showed that FEV1 and CAT were of high value in independent prediction of acute attack of COPD in elderly patients.Conclusion Lung function test parameters and scores related to various respiratory symptoms in elderly patients with COPD will change significantly during acute attack.FEV1 and CAT are important independent risk factors and predictors of acute attack,which can be used for early monitoring,evaluation and prevention of acute attack in elderly patients with COPD in the future.

Objective: To analyze the characteristics and influencing factors of care-seeking delay of adolescent tuberculosis patients in Dongguan City from 2009 to 2018, so as to provide theoretical basis for the tuberculosis control. Methods: The study participants were 8 899 adolescent tuberculosis patients in Dongguan from 2009 to 2018. The Rank-sum test and multiple linear regression were used to analyze the influencing factors of care-seeking days, and the χ 2 test and Logistic regression were used to analyze the influencing factors of care-seeking delay. Results: The median care-seeking days among adolescent tuberculosis patients were 18(6-46) days in Dongguan City from 2009 to 2018, and the prevalence of the care-seeking delay was 56.6%. Multiple linear regression indicated that care-seeking delays were positively associated with being women (B=0.20), living in rural areas (B=0.10), pathogen-positive patients (B=0.69), patients from 2014 to 2018 (B=0.21), and junior school students (B=0.98). Multivariate Logistic regression indicated that care-seeking delay were positively associated with being women (OR=1.35, 95%CI=1.23-1.47), living in rural areas (OR=1.21, 95%CI=1.08-1.37), pathogen-positive patients (OR=2.51, 95%CI=2.26-2.79), patients from 2014 to 2018 (OR=1.24, 95%CI=1.14-1.35), junior-school students (OR=7.58, 95%CI=1.45-39.65), high-school students (OR=5.26, 95%CI=1.04-26.52), university students (OR=7.06, 95%CI=1.39-35.99), and non-students (OR=5.23, 95%CI=1.05-26.08)(P<0.05). Conclusion The prevention and control of tuberculosis among adolescent patients in Dongguan urgently needs to be strengthened. In the future, attention should be paid to the prevalence of care-seeking delay among female, rural, and student tuberculosis patients, and a reasonable prevention and control policy for adolescent patients should be formulated.

Objective: To investigate the occupational health survey of 1-brominepropane (1-BP) enterprises and understand the impact of 1-BP on the health of occupational exposure population. Methods: The occupational health data of 15 1-BP workers were collected from 3 time nodes in 0 months, June and December, and the effects of occupational exposure to 1-BP on health were analyzed. Results: In the workplace with pure 1-BP, the mean air concentration in the workplace was 26.8 mg/m³, and the personal contact level was 29.7 to 63.4 mg/m³. The occupational health monitoring data showed that white blood cell count (WBC) , red blood cell count (RBC) , aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were compared in 0 months, June, and 12 months, the difference was statistically significant (P<0.05) . Conclusion During the 12 months observation period, the occupational exposure to 1-BP caused the number of peripheral blood erythrocyte and leukocyte count and the level of alanine transaminase in the workers, but it did not exceed the normal reference range.