OBJECTIVE: To compare the effectiveness of percutaneous short-segment injured vertebra pedicle screw fixation combined with bone grafting versus percutaneous short-segment injured vertebra pedicle screw fixation alone for the treatment of thoracolumbar fractures. METHODS: The clinical data of 54 patients with single-level thoracolumbar fractures who met the selection criteria between January 2023 and February 2024 were retrospectively analysed. Based on whether bone grafting was performed on the injured vertebra, the patients were divided into a control group (28 cases, percutaneous short-segment injured vertebra pedicle screw fixation alone) and a study group (26 cases, percutaneous short-segment injured vertebra pedicle screw fixation combined with bone grafting using a self-made minimally invasive bone grafting funnel). No significant difference was observed between the two groups ( P>0.05) in baseline data, including age, gender, surgical segment, cause of injury, AO classification, and preoperative anterior-vertebral height compression ratio, mid-vertebral height compression ratio, Cobb angle, visual analogue scale (VAS) score, and Oswestry Disability Index (ODI). The operation time, intraoperative blood loss, fracture healing status, removal time of internal fixator, and complications were recorded and compared between the two groups. Effectiveness was assessed using anterior-vertebral height compression ratio, mid-vertebral height compression ratio, Cobb angle, VAS scores, and ODI taken preoperatively, at 1 week postoperatively, and at last follow-up. RESULTS: All patients in both groups successfully underwent surgery. The operation time and intraoperative blood loss in the control group were significantly less than those in the study group ( P<0.05). No significant difference was observed in the follow-up time between the study group [(14.46±2.00) months] and control group [(14.36±1.83) months] ( P>0.05). The fracture healing time of the study group was significantly shorter than that of the control group ( P<0.05). One patient in the study group was found to have bilateral titanium rod breakage by X-ray reexamination at 8 months after operation, and there was no subsequent vertebral height collapse occurred, and the internal fixator was removed following complete fracture healing. The other patients had no complication such as spinal cord injury, internal fixator loosening and breakage. There was no significant difference in the removal time of internal fixator between the two groups ( P<0.05). The anterior-vertebral height compression ratio, mid-vertebral height compression ratio, Cobb angle, VAS score, and ODI significantly improved in both groups at 1 week after operation and at last follow-up ( P<0.05). Among them, the VAS score, and ODI further improved at last follow-up when compared with at 1 week after operation, Cobb angle lost a little at 1 week after operation, while anterior-vertebral height compression ratio and mid-vertebral height compression ratio slightly increased when compared with 1 week after operation, and the differences were significant ( P<0.05). There was no significant difference between the two groups in Cobb angle at last follow-up, VAS score and ODI at 1 week after operation ( P>0.05), while the other indicators in the study group were significantly better than those in the control group at all time points ( P<0.05). CONCLUSION Compared to percutaneous short-segment injured vertebra pedicle screw fixation alone, the technique combined with intravertebral bone grafting can shorten fracture healing time, effectively restore and maintain vertebral body height, correct kyphotic deformity, and improve clinical outcomes for patients with thoracolumbar fractures.
Humans ; Thoracic Vertebrae/surgery* ; Pedicle Screws ; Lumbar Vertebrae/surgery* ; Spinal Fractures/surgery* ; Bone Transplantation/methods* ; Fracture Fixation, Internal/instrumentation* ; Male ; Female ; Retrospective Studies ; Adult ; Middle Aged ; Treatment Outcome ; Minimally Invasive Surgical Procedures/methods* ; Operative Time ; Aged

Objective To investigate the fluctuations in the population density of Aedes albopictus and changes in the population density of Ae. albopictus in different geographical areas and different breeding habitats in Guangdong Province from 2018 to 2023, so as to provide insights into prevention and control of mosquito-borne infectious diseases in the province. Methods Ae. albopictus surveillance sites were assigned in 1 609 townships (streets) from 121 districts (counties) of 21 cities in Guangdong Province during the period between March and November from 2018 to 2023. The surveillance of the population density of Ae. albopictus was performed once a month in each surveillance site, and once a month in specific settings in cities where dengue were highly prevalent in Guangdong Province from December to February of the next year during the period from 2018 through 2023. Four streets (villages) were selected in each surveillance site according to the geographic orientation, and mosquito ovitraps were assigned in gardens, rooftops or public green belts at residential areas, parks, hospitals and construction sites. All mosquito ovitraps were collected, and the mosquito ovitrap index (MOI) was calculated. The population density of Ae. albopictus was classified into four grades in each surveillance site according to MOI, including no risk, low risk, medium risk and high risk. The risk classification of the Ae. albopictus density was analyzed in each surveillance site each year from 2018 to 2023, and the population density of Ae. albopictus was analyzed at different months and in different geographical areas and breeding habitats. Results A total of 118 241 Ae. albopictus surveillance sites were assigned in 21 cities of Guangdong Province from 2018 to 2023, and there were 68.26% of the surveillance sites with the population density of Ae. albopictus that met the requirements for dengue prevention and control, among which low, medium and high risk surveillance sites accounted for 23.61%, 6.67% and 1.47%. The risk classification of the Ae. albopictus density increased rapidly in Guangdong Province since April to May each year from 2018 to 2023, and then gradually reduced since September to October, with the peak during the period between May and July. The mean MOI was 4.21 at each surveillance site in Guangdong Province during the period from 2018 to 2023, with 4.69, 4.80, 4.38, 3.82, 3.38, and 4.33 from 2018 to 2023, respectively. The MOI was 4.35, 4.43, 3.53 and 3.58 in the Pearl River Delta region, and eastern, western, and northern Guangdong Province, respectively, and was 4.18, 5.44, 4.75, 3.24, 4.27 and 3.70 in residential areas, parks, construction sites, hospitals, waste collection stations, and other breeding habitats, respectively. Conclusions The population density of adult Ae. albopictus peaked in Guangdong Province during the period between May and July from 2018 to 2023, with a high density of Ae. albopictus in the Pearl River Delta region and eastern Guangdong Province. Targeted Ae. albopictus control measures are recommended to be implemented prior to the peak of the Ae. albopictus population density to reduce the development of mosquito-borne infectious diseases.

Objective:To evaluate the clinical efficacy and safety of secukinumab in the treatment of moderate to severe the adults with plaque psoriasis.Methods:The clinical data from 183 adult patients with moderate to severe plaque psoriasis treated with secukinumab were collected.The patients received subcutaneous injections of secukinumab once a week at weeks 0,1,2,3,and 4,followed by an injection every 4 weeks,with each dose of 300 mg.The follow-up period was 52 weeks.The psoriasis area and severity index(PASI),body surface area(BSA),investigator global assessment(IGA),and dermatology life quality index(DLQI)scores of the patients with psoriasis were caculated.The clinical efficacy and safety of secukinumab in the treatment of moderate to severe plaque psoriasis were evaluated,and the influencing factors were analyzed.Results:Compared with week 0,the PASI、BSA、IGA and DLQI scores of the patients were significantly decreased at weeks 4,12,24,and 52 of secukinumab treatment(P<0.05).After treated with secukinumab,the percentages of the patients achieving PASI 75,PASI 90,and PASI 100 at week 4 were 95.6%,84.2%,and 47.5%,respectively;at week 12,they were 97.3%,95.6%,and 78.7%,respectively;at week 24,they were 97.8%,96.7%,and 84.2%,respectively;and at week 52,they were 98.4%,97.8%,and 83.6%,respectively.The percentages of the patients with BSA≤1%at weeks 4,12,24,and 52 were 80.9%,94.5%,95.6%,and 94.0%,respectively.The percentages of the patients with IGA score of 0/1 at week 4,12,24,and 52 were 86.3%,97.3%,96.7%,and 95.6%,respectively.The percentages of the patients with DLQI score of 0/1 at weeks 4,12,24,and 52 were 76.6%,89.1%,92.9%,and 91.8%,respectively.At week 4 of secukinumab treatment,there were significant differences in age,body mass index(BMI),disease duration,baseline PASI score,and history of previous biologic treatment between the patients in two groups(P<0.05).At week 24 of secukinumab treatment,there were significant differences in age and BMI between the patients in two groups(P<0.05).At week 4,BMI≥25 kg·m-2,disease duration≥10 years,baseline PASI score≥10,and a history of previous biologic treatment were risk factors affecting the recovery of the patient(P<0.05).At week 24,age≥40 years was a risk factor affecting the recovery of the patient(P<0.05).During the treatment period,44 out of 183 psoriasis patients reported 49 adverse reactions,and the adverse reaction rate was 24.0%.No serious adverse events or fatal adverse reactions occurred.The adverse reactions included upper respiratory tract infections in 23 cases,eczema-like skin lesions in 10 cases,skin fungal infections in 6 cases,urticaria in 3 cases,mild liver function abnormalities in 2 cases,folliculitis in 2 cases,conjunctivitis in 2 cases,and otitis media in 1 case.Conclusion:Secukinumab treatment for the adult patients with moderate to severe plaque psoriasis is rapid-acting and has lasting efficacy.The BMI,disease duration,baseline PASI score,history of previous biologic treatment,and age are the factors influencing the clinical efficacy of secukinumab.The overall safety is good,and secukinumab may be used as a first-line treatment option for moderate to severe plaque psoriasis.

Objective:To investigate serum vitamin A and vitamin D status in children aged 2-<7 years in 20 cities in China.Methods:A cross-sectional study was conducted. A total of 2 924 healthy children aged 2-<7 years were recruited from September 2018 to September 2019 from 20 cities in China, categorized by age groups of 2-<3 years, 3-<5 years, and 5-<7 years. The demographic and economic characteristics and health-related information of the enrolled children were investigated. Body weight and height were measured by professional staff members. The serum vitamin A and vitamin D levels were detected by high-performance liquid chromatography-tandem mass spectrometry. Chi-square test and Logistic regression were applied to analyze the association between vitamin A and vitamin D deficiency and insufficiency as well as their underlying impact factors.Results:The age of the 2 924 enrolled children was 4.33 (3.42, 5.17) years. There were 1 726 males (59.03%) and 1 198 females (40.97%). The prevalences of vitamin A and vitamin D deficiency in enrolled children were 2.19% (64/2 924) and 3.52% (103/2 924), respectively, and the insufficiency rates were 29.27% (856/2 924) and 22.20% (649/2 924), respectively. Children with both vitamin A and vitamin D deficiencies or insufficiencies were found in 10.50% (307/2 924) of cases. Both vitamin A ( χ2=7.91 and 8.06, both P=0.005) and vitamin D ( χ2=71.35 and 115.10, both P<0.001) insufficiency rates were higher in children aged 3-<5 and 5-<7 years than those in children aged 2-<3 years. Vitamin A and vitamin D supplementation in the last 3 months was a protective factor for vitamin A and D deficiency and insufficiency, respectively ( OR=0.68 and 0.22, 95% CI 0.49-0.95 and 0.13-0.40, both P<0.05). The rates of vitamin A and D insufficiency was higher in children with annual household incomes <60 000 RMB than in those with annual household incomes ≥60 000 RMB ( χ2=34.11 and 10.43, both P<0.01). Northwest and Southwest had the highest rates of vitamin A and vitamin D insufficiency in children aged 2-<7 yeas, respectively ( χ2=93.22 and 202.54, both P<0.001). Conclusions:Among 20 cities in China, children aged 2-<7 years experience high rates of vitamin A and vitamin D insufficiency, which are affected by age, family economic level, vitamin A and vitamin D supplementation, and regional economic level. The current results suggest that high level of attention should be paid to vitamin A and vitamin D nutritional status of preschool children.

Objective To investigate the current status and awareness of pharmaceutical services in hospitals in Guizhou province and to provide a reference for exploring and carrying out pharmaceutical service fees.Methods The questionnaire was designed by the"wjx.cn"website.Three kinds of questionnaires were designed for pharmacists,doctors,nurses,and patients as the research objects,with corresponding differences in some questions,and promoted on WeChat,Dingxiangyuan,and other network platforms.Results A total of 655 questionnaires were collected,and 639 valid questionnaires were recovered,with an effective recovery rate of 97.56%.324 pharmacists(50.70%),82 doctors and nurses(12.83%),233 patients(36.46%)were surveyed.The average approval score of these three groups of respondents on pharmaceutical service fees was 4.67,4.23,and 4.22,respectively(full score:5).Conclusions Overall,pharmacists'professional services have received support from medical staff and patients.However,patients'pharmaceutical service projects currently focus on dispensing services.The recognition of pharmacists'work and the public's awareness of pharmaceutical services can be improved by enhancing the professional ability of pharmacists,strengthening publicity and guidance,and exploring"Internet+pharmaceutical services",etc.,to promote the sustainable development of pharmaceutical services.

The extremely low bioavailability of oral paclitaxel (PTX) mainly due to the complicated gastrointestinal environment, the obstruction of intestinal mucus layer and epithelium barrier. Thus, it is of great significance to construct a coordinative delivery system which can overcome multiple intestinal physicochemical obstacles simultaneously. In this work, a high-density PEGylation-based glycocholic acid-decorated micelles (PTX@GNPs) was constructed by a novel polymer, 9-Fluorenylmethoxycarbonyl-polyethylene glycocholic acid (Fmoc-PEG-GCA). The Fmoc motif in this polymer could encapsulate PTX via π‒π stacking to form the core of micelles, and the low molecular weight and non-long hydrophobic chain of Fmoc ensures the high-density of PEG. Based on this versatile and flexible carriers, PTX@GNPs possess mucus trapping escape ability due to the flexible PEG, and excellent intestine epithelium targeting attributed to the high affinity of GCA with apical sodium-dependent bile acid transporter. The in vitro and in vivo results showed that this oral micelle could enhance oral bioavailability of PTX, and exhibited similar antitumor efficacy to Taxol injection via intravenous route. In addition, oral PTX@GNPs administered with lower dosage within shorter interval could increase in vivo retention time of PTX, which supposed to remodel immune microenvironment and enhance oral chemotherapy efficacy by synergistic effect.

Peptide‒drug conjugates (PDCs) are drug delivery systems consisting of a drug covalently coupled to a multifunctional peptide via a cleavable linker. As an emerging prodrug strategy, PDCs not only preserve the function and bioactivity of the peptides but also release the drugs responsively with the cleavable property of the linkers. Given the ability to significantly improve the circulation stability and targeting of drugs in vivo and reduce the toxic side effects of drugs, PDCs have already been extensively applied in drug delivery. Herein, we review the types and mechanisms of peptides, linkers and drugs used to construct PDCs, and summarize the clinical applications and challenges of PDC drugs.

In recent years, immune checkpoint inhibitors (ICIs) have greatly improved the survival rate of non-small cell lung cancer (NSCLC) patients without driver mutation. Compared with wild-type tumors, tumors with epidermal growth factor receptor (EGFR) mutations have greater heterogeneity in immune microenvironment characteristics such as programmed cell death ligand 1 (PD-L1) and tumor mutational burden (TMB). Whether ICIs is suitable for NSCLC patients with EGFR mutation has been controversial. Clinical studies have shown that immunomonotherapy has no significant effect on patients with EGFR mutant NSCLC. ICIs combined with chemotherapy and antiangiogenic drugs show good survival benefits. This paper overviews the clinical research and related mechanism of ICIs single drug or combination therapy inadvanced NSCLC patients with EGFR mutation.
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B7-H1 Antigen/metabolism* ; Carcinoma, Non-Small-Cell Lung/pathology* ; ErbB Receptors/metabolism* ; Humans ; Immune Checkpoint Inhibitors/therapeutic use* ; Ligands ; Lung Neoplasms/pathology* ; Mutation ; Tumor Microenvironment

In the past 20 years, with the development of molecular biology, the treatment of non-small cell lung cancer (NSCLC) has been developing. Targeted therapy has improved the survival period of patients with positive mutation of tumor driver gene. More and more targets have been found gradually. Drugs targeting different driving genes have brought the treatment of NSCLC into a promising target era. Among the many driving genes of NSCLC, the fusion of transfection proto oncogene (RET) is the addition of the epidermal growth factor receptor (EGFR), analytic lymphama kinase (ALK) and c-ros oncogene 1-receptor tyrosine kinase (ROS1) are emerging targets. Targeted drugs for RET gene fusion have been constantly updated. Recently, new high selective RET inhibitors blu-667 and loxo-292 have made important breakthroughs. This paper will review the review of the fusion mutation of RET gene in NSCLC, the detection methods, clinicopathological characteristics, targeted treatment and the research progress after drug resistance.
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"Liquid biopsy" have been intensively studied in recent decades. The exosomes carry their maternal partial functional proteins and genes. As a form of intercellular vesicular transport, exosome-mediated intercellular communication participates in a variety of physiological and pathological processes. The information transmission mediated by exosomes is associated with pathophysiological status and plays an important role in the pathogenesis of cancer. Their detection may be beneficial for the diagnosis and treatment of tumor. This article reviews advances in knowledge on the exosome properties, the effect of exosomes on malignant tumorigenesis, and their clinical application. The data will provide a reference for clinical practitioners.