Objective To explore the efficacy and safety of oral solution of magnesium sodium potassium sulfate in bowel preparation before colonoscopy. Methods Patients who planned to undergo colonoscopy at the digestive department of the Ninth People’s Hospital, affiliated to School of Medicine of Shanghai Jiao Tong University from January 2023 to August 2023 were selected and eligible subjects were divided into two groups: Group A took polyethylene glycol （PEG） and Group B took oral solution of magnesium sodium potassium sulfate （OSS）. The quality, drug tolerance, and safety of intestinal preparation were evaluated. The quality of bowel preparation was evaluated by the boston bowel preparation scale （BBPS）. Results The right colon BBPS score of Group B was (2.39±0.82) points, which was significantly higher than of Group A (2.11±0.43) points （P<0.05）. The overall score of Group B was higher than that of Group A （P<0.05）. OSS was easier to take than PEG, with a good taste and overall sensation. Patients were willing to use OSS to clean their bowels even when they were willing to undergo another examination （P<0.05）. There was a significant difference in nausea and vomiting symptoms between the two groups （P<0.05）, and there were no significant changes in renal function and electrolytes before and after medication in the two groups of patients. Conclusion OSS had a higher quality of bowel cleaning and was easier for patients to accept.

BACKGROUND:The occurrence of neuronal axonal injury can result in neurological dysfunction,and the facilitation of axonal elongation is anticipated to play a pivotal role in the treatment of diseases affecting the nervous system.OBJECTIVE:To investigate whether ectomesenchymal stem cells-derived extracellular vesicles can promote neuronal axonal elongation.METHODS:(1)Ectomesenchymal stem cells were obtained from nasal mucosa using the tissue adherence method,and the specific markers of were identified through immunofluorescence.Ectomesenchymal stem cells-derived extracellular vesicles were acquired via ultracentrifugation and identified.(2)Ectomesenchymal stem cells-derived extracellular vesicles(0,0.5,1.0,1.5 mg/mL)were incubated with PC12 cells for 72 hours.The cytotoxicity and proliferation of ectomesenchymal stem cells-derived extracellular vesicles on PC12 cells were assessed using the CCK-8 assay.(3)Ectomesenchymal stem cells-derived extracellular vesicles(1.0 mg/mL)were incubated with PC12 cells or neurons for 72 hours.The changes in axon length were observed using microscopic analysis.The expression levels of axon-related markers β3-tubulin(early stage),growth associated protein 43(middle stage),and neurofilament 200(mature stage)were analyzed through real-time fluorescence quantitative PCR and Western blotting.These investigations aimed to explore the potential of ectomesenchymal stem cells-derived extracellular vesicles in promoting neurite elongation within PC12 cells or neurons.RESULTS AND CONCLUSION:(1)The majority of the acquired ectomesenchymal stem cells exhibited a spindle-shaped morphology,while a minority displayed irregular shapes,and demonstrated high expression levels of mesenchymal stem cell-specific markers Nestin,CD44,and Vimentin.The obtained ectomesenchymal stem cells-derived extracellular vesicles fulfilled the biological criteria for extracellular vesicles.(2)Within the detected protein concentration range of 0.5 to 1.5 mg/mL,the proliferation of PC12 cells was promoted by ectomesenchymal stem cells-derived extracellular vesicles,and this effect was further enhanced with increasing concentrations.(3)Ectomesenchymal stem cells-derived extracellular vesicles increased the length of axons in PC12 cells and neurons and the expression of axon-related markers β3-tubulin,growth associated protein 43,and neurofilament 200.Above findings suggest that ectomesenchymal stem cells-derived extracellular vesicles have the potential to enhance neuronal axonal elongation.

Objective:To investigate the short-term clinical efficacy of two fixation methods, mini-titanium plate fixation and suture suspension, in cervical posterior unilateral laminoplasty, and to explore the relationship between changes in the cervical sagittal sequence and therapeutic outcomes.Methods:A retrospective analysis was conducted on 55 patients who underwent cervical posterior unilateral laminoplasty with mini-titanium plate fixation and 50 patients with suture suspension at the First People's Hospital of Lianyungang from September 2020 to January 2023. All patients were followed up for 12 months, and the axial symptoms was recorded. The main clinical efficacy evaluations included before surgery and 12 months after surgery visual analog score (VAS) for neck pain, Japanese Orthopaedic Association score (JOA) and neck disability index (NDI). Four parameters were recorded before surgery and 12 months after surgery to assess the sagittal sequence: C 2-7 sagittal vertical axis (C 2-7SVA), T 1 slope angle (T 1s), C 2-7Cobb angle and cervical range of motion. Results:The mini-titanium plate fixation group had 5 cases of axial symptoms, while the traditional suture suspension group had 16 cases; the postoperative VAS, JOA and C 2-7Cobb angle in the mini-titanium plate fixation group were all less than those in the suture suspension group, with statistically significant differences ( P<0.05). Specifically, the postoperative VAS in the mini-titanium plate fixation group was (1.93 ± 1.42) points, and (2.67 ± 2.15) points in the suture suspension group ( P = 0.049); the JOA was (10.39 ± 2.20) points in the mini-titanium plate fixation group and (9.62 ± 1.52) points in the suture suspension group ( P = 0.012); the C 2-7Cobb angle was (21.087 ± 3.564)° in the mini-titanium plate fixation group and (23.092 ± 1.265)° in the suture suspension group ( P = 0.003). There was no statistical difference in operation time and blood loss between two groups ( P>0.05). The postoperative C 2-7SVA, T 1s and range of motion in the traditional suture suspension group were less than those in the mini-titanium plate fixation group, with statistically significant differences ( P<0.05). Specifically, the postoperative C 2-7SVA was (25.700 ± 3.035) mm in the mini-titanium plate fixation group and (23.946 ± 3.079) mm in the suture suspension group ( P = 0.004); the postoperative T 1s was (28.770 ± 2.361)° in the mini-titanium plate fixation group and (26.746 ± 3.198)° in the suture suspension group ( P = 0.004); the postoperative range of motion was (32.651 ± 4.995)° in the mini-titanium plate fixation group and (28.672 ± 5.874)° in the suture suspension group ( P = 0.003). Conclusions:Cervical posterior unilateral laminoplasty with mini-titanium plate fixation can effectively improve VAS, JOA, and restore neurological function, maintaining the cervical spine's sagittal balance, stability, and maximum range of motion.

BACKGROUND:The occurrence of neuronal axonal injury can result in neurological dysfunction,and the facilitation of axonal elongation is anticipated to play a pivotal role in the treatment of diseases affecting the nervous system.OBJECTIVE:To investigate whether ectomesenchymal stem cells-derived extracellular vesicles can promote neuronal axonal elongation.METHODS:(1)Ectomesenchymal stem cells were obtained from nasal mucosa using the tissue adherence method,and the specific markers of were identified through immunofluorescence.Ectomesenchymal stem cells-derived extracellular vesicles were acquired via ultracentrifugation and identified.(2)Ectomesenchymal stem cells-derived extracellular vesicles(0,0.5,1.0,1.5 mg/mL)were incubated with PC12 cells for 72 hours.The cytotoxicity and proliferation of ectomesenchymal stem cells-derived extracellular vesicles on PC12 cells were assessed using the CCK-8 assay.(3)Ectomesenchymal stem cells-derived extracellular vesicles(1.0 mg/mL)were incubated with PC12 cells or neurons for 72 hours.The changes in axon length were observed using microscopic analysis.The expression levels of axon-related markers β3-tubulin(early stage),growth associated protein 43(middle stage),and neurofilament 200(mature stage)were analyzed through real-time fluorescence quantitative PCR and Western blotting.These investigations aimed to explore the potential of ectomesenchymal stem cells-derived extracellular vesicles in promoting neurite elongation within PC12 cells or neurons.RESULTS AND CONCLUSION:(1)The majority of the acquired ectomesenchymal stem cells exhibited a spindle-shaped morphology,while a minority displayed irregular shapes,and demonstrated high expression levels of mesenchymal stem cell-specific markers Nestin,CD44,and Vimentin.The obtained ectomesenchymal stem cells-derived extracellular vesicles fulfilled the biological criteria for extracellular vesicles.(2)Within the detected protein concentration range of 0.5 to 1.5 mg/mL,the proliferation of PC12 cells was promoted by ectomesenchymal stem cells-derived extracellular vesicles,and this effect was further enhanced with increasing concentrations.(3)Ectomesenchymal stem cells-derived extracellular vesicles increased the length of axons in PC12 cells and neurons and the expression of axon-related markers β3-tubulin,growth associated protein 43,and neurofilament 200.Above findings suggest that ectomesenchymal stem cells-derived extracellular vesicles have the potential to enhance neuronal axonal elongation.

Objective:To investigate the short-term clinical efficacy of two fixation methods, mini-titanium plate fixation and suture suspension, in cervical posterior unilateral laminoplasty, and to explore the relationship between changes in the cervical sagittal sequence and therapeutic outcomes.Methods:A retrospective analysis was conducted on 55 patients who underwent cervical posterior unilateral laminoplasty with mini-titanium plate fixation and 50 patients with suture suspension at the First People's Hospital of Lianyungang from September 2020 to January 2023. All patients were followed up for 12 months, and the axial symptoms was recorded. The main clinical efficacy evaluations included before surgery and 12 months after surgery visual analog score (VAS) for neck pain, Japanese Orthopaedic Association score (JOA) and neck disability index (NDI). Four parameters were recorded before surgery and 12 months after surgery to assess the sagittal sequence: C 2-7 sagittal vertical axis (C 2-7SVA), T 1 slope angle (T 1s), C 2-7Cobb angle and cervical range of motion. Results:The mini-titanium plate fixation group had 5 cases of axial symptoms, while the traditional suture suspension group had 16 cases; the postoperative VAS, JOA and C 2-7Cobb angle in the mini-titanium plate fixation group were all less than those in the suture suspension group, with statistically significant differences ( P<0.05). Specifically, the postoperative VAS in the mini-titanium plate fixation group was (1.93 ± 1.42) points, and (2.67 ± 2.15) points in the suture suspension group ( P = 0.049); the JOA was (10.39 ± 2.20) points in the mini-titanium plate fixation group and (9.62 ± 1.52) points in the suture suspension group ( P = 0.012); the C 2-7Cobb angle was (21.087 ± 3.564)° in the mini-titanium plate fixation group and (23.092 ± 1.265)° in the suture suspension group ( P = 0.003). There was no statistical difference in operation time and blood loss between two groups ( P>0.05). The postoperative C 2-7SVA, T 1s and range of motion in the traditional suture suspension group were less than those in the mini-titanium plate fixation group, with statistically significant differences ( P<0.05). Specifically, the postoperative C 2-7SVA was (25.700 ± 3.035) mm in the mini-titanium plate fixation group and (23.946 ± 3.079) mm in the suture suspension group ( P = 0.004); the postoperative T 1s was (28.770 ± 2.361)° in the mini-titanium plate fixation group and (26.746 ± 3.198)° in the suture suspension group ( P = 0.004); the postoperative range of motion was (32.651 ± 4.995)° in the mini-titanium plate fixation group and (28.672 ± 5.874)° in the suture suspension group ( P = 0.003). Conclusions:Cervical posterior unilateral laminoplasty with mini-titanium plate fixation can effectively improve VAS, JOA, and restore neurological function, maintaining the cervical spine's sagittal balance, stability, and maximum range of motion.

Objective analyze the clinical efficacy of percutaneous endoscopic lumbar posterior fusion(PE-PLIF)in the treatment of lumbar spondylolisthesis and evaluate its safety and effectiveness.Methods From January 2018 to December 2021,46 patients with grade Ⅰ degenerative lumbar spondylolisthesis underwent PE-PLIF surgery in the Department of Orthopedics of our hospital.General data such as age,gender,body mass index(BMI),operative time,blood loss and fluoroscopy were collected.Visual analogue scale(VAS)and Oswestry Disability Index(ODI)scores were compared before surgery,3 days and 12 months after surgery to analyze the efficacy.Macnab was used to evaluate patient satisfaction,and Lenke was used to evaluate fusion.Follow-up was 1.2 to 3.3 years.Results The average operative time of the patients was(143.76±34.39)min,the average intraoperative fluoroscopy was(6.98±0.75)times,and the average hospitalization was(9.13±3.68)days.The VAS scores before low back pain ranged from 2 to 9,with an average of(6.14±2.79).The VAS score at 3 days after operation was 0-5,with an average of(2.02±1.52)points,and the difference was statistically significant compared with that before operation(P＜0.05).The VAS score at 12 months after surgery was 0 to 3,with an average of(1.09±0.92)points,which was significantly improved compared with 3 days after surgery,and the difference was statistically significant(P＜0.05).VAS scores of patients before lower extremity pain ranged from 4 to 9 points,with an average of(6.58±2.20)points.The VAS score at 3 days after surgery was 0-5,with an average of(1.72±1.45)points,and the difference was statistically significant compared with that before surgery(P＜0.05).The VAS score at 12 months after surgery was 0～3,with an average of(1.13±0.95),and the difference was statistically significant compared with 3 days after surgery(P＜0.05).ODI score of patients decreased from(77.25±9.82)％before surgery to(15.73±9.86)％after 12 months of follow-up,with statistical significance(P＜0.05).Postoperative complications included cerebrospinal fluid leakage in 3 cases,radiculopathy in 2 cases,incomplete reduction in 1 case,and open surgical revision of internal fixation rupture in 1 case.According to Macnab criteria,27 patients were excellent(58.7％),15 were good(32.6％),and 4 were average(8.7％),with no adverse evaluation.Conclusion The results of this study indicate that PE-PLIF is a safe and effective treatment for mild lumbar spondylolisthesis.

Objective analyze the clinical efficacy of percutaneous endoscopic lumbar posterior fusion(PE-PLIF)in the treatment of lumbar spondylolisthesis and evaluate its safety and effectiveness.Methods From January 2018 to December 2021,46 patients with grade Ⅰ degenerative lumbar spondylolisthesis underwent PE-PLIF surgery in the Department of Orthopedics of our hospital.General data such as age,gender,body mass index(BMI),operative time,blood loss and fluoroscopy were collected.Visual analogue scale(VAS)and Oswestry Disability Index(ODI)scores were compared before surgery,3 days and 12 months after surgery to analyze the efficacy.Macnab was used to evaluate patient satisfaction,and Lenke was used to evaluate fusion.Follow-up was 1.2 to 3.3 years.Results The average operative time of the patients was(143.76±34.39)min,the average intraoperative fluoroscopy was(6.98±0.75)times,and the average hospitalization was(9.13±3.68)days.The VAS scores before low back pain ranged from 2 to 9,with an average of(6.14±2.79).The VAS score at 3 days after operation was 0-5,with an average of(2.02±1.52)points,and the difference was statistically significant compared with that before operation(P＜0.05).The VAS score at 12 months after surgery was 0 to 3,with an average of(1.09±0.92)points,which was significantly improved compared with 3 days after surgery,and the difference was statistically significant(P＜0.05).VAS scores of patients before lower extremity pain ranged from 4 to 9 points,with an average of(6.58±2.20)points.The VAS score at 3 days after surgery was 0-5,with an average of(1.72±1.45)points,and the difference was statistically significant compared with that before surgery(P＜0.05).The VAS score at 12 months after surgery was 0～3,with an average of(1.13±0.95),and the difference was statistically significant compared with 3 days after surgery(P＜0.05).ODI score of patients decreased from(77.25±9.82)％before surgery to(15.73±9.86)％after 12 months of follow-up,with statistical significance(P＜0.05).Postoperative complications included cerebrospinal fluid leakage in 3 cases,radiculopathy in 2 cases,incomplete reduction in 1 case,and open surgical revision of internal fixation rupture in 1 case.According to Macnab criteria,27 patients were excellent(58.7％),15 were good(32.6％),and 4 were average(8.7％),with no adverse evaluation.Conclusion The results of this study indicate that PE-PLIF is a safe and effective treatment for mild lumbar spondylolisthesis.