Objective:To analyze the protective effect of neurotracheal catheter monitoring on recurrent laryngeal nerve in patients with bilateral cervical lymph node dissection of thyroid cancer.Methods:The clinical data of 92 patients undergoing bilateral cervical lymph node dissection for thyroid cancer at the First People's Hospital of Shangqiu from Jul 2019 to Aug 2022 were retrospectively analyzed. Patients were divided into control group (routine exposure, 52 cases) and study group (intraoperative neurotrachatic catheter monitoring, 40 cases) The general data, perioperative indicators, parathyroid function, vocal cord function, voice disorder index, quality of life and postoperative complications were compared between the two groups.Results:The intraoperative blood loss in the study group [(12.3±3.3) ml] was less than that in the control group [(16.9±4.0) ml]. The exposure time [(8.7±2.6) min], operation time [(4.0±0.8) h] and postoperative hospitalization time [(3.2±0.9) d] were shorter than those of control group [(14.4±3.6) min, (4.5±1.2) h, (5.7±1.3) d] ( t=5.770, 8.391, 2.387, 10.853, all P<0.05);Amplitude perturbation (4.85%± 0.58%), fundamental frequency perturbation (0.28%±0.17%), standardized noise energy [(-20.3±4.4) dB], VHI-10 score [(1.6±0.5) score], Quality of life scale for cancer patients 1 month after surgery the TG-V4 score [(43.7±4.8) points] was lower than that of control group [(3.05%±0.54%), (0.42%±0.16%), (-14.6±3.3) dB, (3.3±0.4) points, (50.4±5.6) points]. The harmonic noise ratio [(24.9±4.1) dB] was higher than that of the control group [(20.3±4.4) dB] ( t=10.446, 4.049, 7.036, 19.076, 6.116, 5.144, all P<0.001);The incidence of postoperative complications in the study group (8%) was lower than that in the control group (23%) ( χ2=4.020, P=0.045). Conclusion:Neurotracheal catheter monitoring during bilateral cervical lymph node dissection for thyroid cancer can improve vocal cord function, reduce recurrent laryngeal nerve injury, reduce voice disturbance and improve quality of life.

Objective:To explore the anatomical parameters of the ideal trajectory for pedicle screw fixation through the lamina in the treatment of L 5 spondylolysis. Methods:CT data from 40 male patients with bilateral L 5 spondylolysis (age, 24.95±4.01 years; range, 20-36 years), treated at the 940th Hospital of PLA Joint Logistics Support Force between January 2021 and June 2024, were analyzed. Three-dimensional vertebral models were reconstructed using this data. Measurements included the lumbosacral angle, the thickness at the midpoint of the superior and inferior lamina edges, mid-lamina thickness, the distance from the lateral edge of the lamina to the spinous process midline, the thickness at the defect of the pars interarticularis, and the vertical diameter of the defect. The screws were inserted from the inferior edge of the lamina, passing through the pars interarticularis defect, and exiting at the superior edge of the pedicle. In the vertical direction of the lamina, the inferior and superior edges of the lamina were divided into three zones, named A, B, C (for the inferior lamina edge) and 1, 2, 3 (for the superior pedicle edge). Seven trajectories (A2, A3, B1, B2, B3, C2, and C3) were designed by combining these zones. Screws with diameters of 5.0, 4.5, 4.0, and 3.5 mm were sequentially inserted along each trajectory. Screw trajectories with an insertion success rate ≥95% were selected and evaluated for feasibility. Parameters such as screw length, medial inclination angle, caudal inclination angle, and entry point position were measured. The ideal trajectory and screw dimensions were determined by considering anatomical features, screw characteristics, and insertion safety. Results:The measurement results from the 3D model showed that the lumbosacral angle was 36.22°±5.23°, and the midpoint thickness of the superior lamina edge was 4.14±0.66 mm (left) and 4.18±0.65 mm (right), the mid-lamina thickness was 6.73±0.72 mm (left) and 6.72±0.70 mm (right), the midpoint thickness of the inferior lamina edge was 6.50±0.56 mm (left) and 6.50±0.66 mm (right), the distance from the lateral edge of the lamina to the spinous process midline was 25.95±2.86 mm (left) and 26.39±3.10 mm (right), the thickness at the pars defect was 9.67±0.57 mm (left) and 9.67±0.51 mm (right), and the vertical diameter of the pars defect was 18.76±2.16 mm (left) and 19.26±2.03 mm (right). No statistically significant differences were found between the left and right sides for these parameters ( P>0.05). The trajectories considered feasible and with an insertion success rate ≥95% were B2, B3, C2, and C3. Safe screw diameters were B2 (4.5 mm), B3 (4.0 mm), C2 (4.0 mm), and C3 (3.5 mm). Corresponding screw lengths were B2 (38.28±2.34 mm), B3 (37.03±2.99 mm), C2 (38.37±2.42 mm), and C3 (36.88±2.87 mm). The caudal inclination angles were B2 (52.73°±5.29°), B3 (55.06°± 4.46°), C2 (49.09°±3.92°), and C3 (50.18°±4.36°). The medial inclination angles were B2 (21.21°±3.01°), B3 (5.11°±1.58°), C2 (22.55°±2.46°), and C3 (12.59°±1.80°). The distances from the entry point to the spinous process midline were B2 (13.23±1.68 mm), B3 (13.15±1.46 mm), C2 (11.12±0.64 mm), and C3 (11.09±0.65 mm). The distances from the entry point to the root of the spinous process were B2 (8.23±1.46 mm), B3 (8.21±1.31 mm), C2 (6.65 ±0.76 mm), and C3 (6.67±0.72 mm). Differences in screw length, caudal inclination angle, medial inclination angle, and entry point position across trajectories were statistically significant ( P<0.05). Conclusion:The ideal screw trajectory for L 5 spondylolysis involves insertion through the midpoint of the entry zone, passing through the pars defect, and exiting at the midpoint of the superior edge of the pedicle. The optimal entry point is located on the inferior edge of the lamina, 8.23±1.46 mm from the root of the spinous process and 13.23±1.68 mm from the spinous process midline. The screw should be placed at a caudal inclination angle of 52.73°±5.29° and a medial inclination angle of 21.21°±3.01°. The recommended screw length is 38.28±2.34 mm, with a diameter of 4.5 mm (range, 4.5-5.0 mm).

Objective:To explore the anatomical parameters of the ideal trajectory for pedicle screw fixation through the lamina in the treatment of L 5 spondylolysis. Methods:CT data from 40 male patients with bilateral L 5 spondylolysis (age, 24.95±4.01 years; range, 20-36 years), treated at the 940th Hospital of PLA Joint Logistics Support Force between January 2021 and June 2024, were analyzed. Three-dimensional vertebral models were reconstructed using this data. Measurements included the lumbosacral angle, the thickness at the midpoint of the superior and inferior lamina edges, mid-lamina thickness, the distance from the lateral edge of the lamina to the spinous process midline, the thickness at the defect of the pars interarticularis, and the vertical diameter of the defect. The screws were inserted from the inferior edge of the lamina, passing through the pars interarticularis defect, and exiting at the superior edge of the pedicle. In the vertical direction of the lamina, the inferior and superior edges of the lamina were divided into three zones, named A, B, C (for the inferior lamina edge) and 1, 2, 3 (for the superior pedicle edge). Seven trajectories (A2, A3, B1, B2, B3, C2, and C3) were designed by combining these zones. Screws with diameters of 5.0, 4.5, 4.0, and 3.5 mm were sequentially inserted along each trajectory. Screw trajectories with an insertion success rate ≥95% were selected and evaluated for feasibility. Parameters such as screw length, medial inclination angle, caudal inclination angle, and entry point position were measured. The ideal trajectory and screw dimensions were determined by considering anatomical features, screw characteristics, and insertion safety. Results:The measurement results from the 3D model showed that the lumbosacral angle was 36.22°±5.23°, and the midpoint thickness of the superior lamina edge was 4.14±0.66 mm (left) and 4.18±0.65 mm (right), the mid-lamina thickness was 6.73±0.72 mm (left) and 6.72±0.70 mm (right), the midpoint thickness of the inferior lamina edge was 6.50±0.56 mm (left) and 6.50±0.66 mm (right), the distance from the lateral edge of the lamina to the spinous process midline was 25.95±2.86 mm (left) and 26.39±3.10 mm (right), the thickness at the pars defect was 9.67±0.57 mm (left) and 9.67±0.51 mm (right), and the vertical diameter of the pars defect was 18.76±2.16 mm (left) and 19.26±2.03 mm (right). No statistically significant differences were found between the left and right sides for these parameters ( P>0.05). The trajectories considered feasible and with an insertion success rate ≥95% were B2, B3, C2, and C3. Safe screw diameters were B2 (4.5 mm), B3 (4.0 mm), C2 (4.0 mm), and C3 (3.5 mm). Corresponding screw lengths were B2 (38.28±2.34 mm), B3 (37.03±2.99 mm), C2 (38.37±2.42 mm), and C3 (36.88±2.87 mm). The caudal inclination angles were B2 (52.73°±5.29°), B3 (55.06°± 4.46°), C2 (49.09°±3.92°), and C3 (50.18°±4.36°). The medial inclination angles were B2 (21.21°±3.01°), B3 (5.11°±1.58°), C2 (22.55°±2.46°), and C3 (12.59°±1.80°). The distances from the entry point to the spinous process midline were B2 (13.23±1.68 mm), B3 (13.15±1.46 mm), C2 (11.12±0.64 mm), and C3 (11.09±0.65 mm). The distances from the entry point to the root of the spinous process were B2 (8.23±1.46 mm), B3 (8.21±1.31 mm), C2 (6.65 ±0.76 mm), and C3 (6.67±0.72 mm). Differences in screw length, caudal inclination angle, medial inclination angle, and entry point position across trajectories were statistically significant ( P<0.05). Conclusion:The ideal screw trajectory for L 5 spondylolysis involves insertion through the midpoint of the entry zone, passing through the pars defect, and exiting at the midpoint of the superior edge of the pedicle. The optimal entry point is located on the inferior edge of the lamina, 8.23±1.46 mm from the root of the spinous process and 13.23±1.68 mm from the spinous process midline. The screw should be placed at a caudal inclination angle of 52.73°±5.29° and a medial inclination angle of 21.21°±3.01°. The recommended screw length is 38.28±2.34 mm, with a diameter of 4.5 mm (range, 4.5-5.0 mm).

Objective:To investigate the differences between the expression levels of ribosomal protein L32 (RPL32) in human breast cancer tissue and normal breast tissue and the effects on the proliferation of breast cancer cells.Methods:Paraffin samples of breast cancer tissues and adjacent tissues (more than 3 cm from the tumor margin) were collected from 56 breast cancer patients in the Department of Thyroid and Breast Surgery of the First People's Hospital of Shangqiu City from July 2020 to May 2022. The expression of RPL32 in 56 breast cancer patients and their corresponding paracancer tissues was detected by immunohistochemistry. MCF7 cells were divided into experimental group (ribosomal protein L32, RPL32) and control group (negative control, NC). MCF7 cells in experimental group were transfected with RPL32-siRNA vector, while MCF7 cells in control group were transfected with scramble siRNA vector. RPL32 mRNA content in each group was detected by RT-PCR. The expressions of RPL32 and P53 in the experimental group and control group were detected by western blot. The proliferative ability of cells in each group was detected by CCK8 assay. The clonogenesis ability of each group of cells was detected by clone formation experiment.Results:The positive rate of RPL32 in breast cancer patients was 8.93% (5/56), and the expression rate of RPL32 in paracancer tissues was 78.57% (44/56). The expression rate of RPL32 in breast cancer patients was significantly higher than that in paracancer tissues, with statistical significance ( P=0.007). After transfection with siRNA vector, the mRNA content of RPL32 in MCF7 cells of experimental group and control group decreased, and the protein expression level of RPL32 was 1.09±0.21 and 0.40±0.11, respectively. The expression levels of P53 protein were 1.24±0.32 and 0.37±0.09, respectively. The absorbance of CCK8 at 120 h was 1.11±0.24 and 2.19±0.28, respectively, and the proliferation ability of MCF7 cells in the experimental group was significantly decreased ( P=0.043). The results of clone formation experiment showed that the cell clone formation rate of the experimental group and the control group was (21.11±3.46) % and (58.75±4.29) %, respectively, and the cell clone formation of the experimental group was decreased ( P=0.026) . Conclusions:The expression of RPL32 is significantly increased in breast cancer, which may be related to the malignant degree of breast cancer. Inhibition of RPL32 expression in breast cancer cells affects its proliferation ability.

Total knee arthroplasty is an effective method for the treatment of end-stage knee osteoarthrosis, which can effectively relieve joint pain and reconstruct the integrity of the joint. Whether the posterior cruciate ligament should be preserved during surgery or not, which is still in dispute. In recent years, posterior cruciate-retaining and substituting total knee prostheses are both applied in clinical practice. Both domestic and international studies have shown that there are no significant difference in patient satisfaction, knee flexion, survival rate of the prosthesis and the main clinical manifestations between two prostheses. However, posterior cruciate-retaining total knee prosthesis is more consistent with the normal physiology and biomechanics of the human body. The gait is more balanced and proprioceptive when walking up and down the stairs, but when the joints are buckling, the femur is abnormal to move back to the tibia, resulting in abnormal motion. While posterior cruciate-substituting total knee prosthesis can correct severe deformity of the knee, and keep better balance between flexion and extension of the knee joint, but there is a potential complication of patellar clunk syndrome. Therefore, under the same conditions, the younger patients may prefer to chose posterior cruciate-retaining total knee prosthesis, while elder patients may prefer to chose posterior cruciate-substituting total knee prosthesis. This paper reviews the function of posterior cruciate ligament, as well as the advantages and disadvantages of two prostheses, so as to provide some references for clinic.