Objectives:To investigate the short-term effect of soft endoscope-assisted single-segment cervical artificial disc replacement(ADR)in the treatment of cervical spondylosis.Methods:A retrospective analysis was conducted on the clinical data of 24 cases of cervical spondylosis treated with soft endoscope-assisted single-segment ADR in our hospital from June 2023 to May 2024,of which,8 cases were male and 16 cas-es were female,aged 25 to 68 years old(47.0±11.9 years old).There were 7 cases of cervical spondylotic radiculopathy,14 cases of cervical spondylotic myelopathy,and 3 cases of mixed cervical spondylosis.All of the patients were with single-segment lesions,including 2 cases of C3/4,6 cases of C4/5,12 cases of C5/6,and 4 cases of C6/7.The length of surgical incision,intraoperative bleeding,operative time,postoperative drainage,hospitalization time and complications were recorded;Prevertebral soft tissue edema was evaluated;Japanese Orthopaedic Association(JOA)score was assessed for cervical spine motor function,and visual analog scale(VAS)score was evaluated for neck and shoulder pain on 1d before surgery,at 1 week after surgery,1 month and 3 months after surgery.Results:Surgery was successfully completed in all patients,and no com-plications such as spinal cord/nerve root injury or cerebrospinal fluid leakage were detected during the opera-tion.Operative time was 34-123min(66.6±20.8min),length of surgical incision was 2.5-3cm(2.6±0.2cm),intra-operative bleeding volume was 5-50mL(19.6±12.6mL),postoperative drainage volume was 0-60mL(13.5±18.8mL),and postoperative hospitalization time was 3-8d(5.1±1.6d).No postoperative complications such as cervical subcutaneous hematoma and dysphagia were observed.Postoperative imaging revealed no significant prevertebral soft tissue edema.The postoperative VAS and JOA scores were significantly improved at all time points compared with the preoperative values(P＜0.05).The overall efficacy was assessed according to the im-provement rate of JOA score at 3 months after surgery:12 cases were excellent,12 cases were good,and the rate of excellent and good was 100％(24/24).Conclusions:Soft endoscope-assisted single-segment ADR for the treatment of cervical spondylosis is small in trauma and short in operative time,which has certain clinical application prospects.

Objectives:To investigate the short-term effect of soft endoscope-assisted single-segment cervical artificial disc replacement(ADR)in the treatment of cervical spondylosis.Methods:A retrospective analysis was conducted on the clinical data of 24 cases of cervical spondylosis treated with soft endoscope-assisted single-segment ADR in our hospital from June 2023 to May 2024,of which,8 cases were male and 16 cas-es were female,aged 25 to 68 years old(47.0±11.9 years old).There were 7 cases of cervical spondylotic radiculopathy,14 cases of cervical spondylotic myelopathy,and 3 cases of mixed cervical spondylosis.All of the patients were with single-segment lesions,including 2 cases of C3/4,6 cases of C4/5,12 cases of C5/6,and 4 cases of C6/7.The length of surgical incision,intraoperative bleeding,operative time,postoperative drainage,hospitalization time and complications were recorded;Prevertebral soft tissue edema was evaluated;Japanese Orthopaedic Association(JOA)score was assessed for cervical spine motor function,and visual analog scale(VAS)score was evaluated for neck and shoulder pain on 1d before surgery,at 1 week after surgery,1 month and 3 months after surgery.Results:Surgery was successfully completed in all patients,and no com-plications such as spinal cord/nerve root injury or cerebrospinal fluid leakage were detected during the opera-tion.Operative time was 34-123min(66.6±20.8min),length of surgical incision was 2.5-3cm(2.6±0.2cm),intra-operative bleeding volume was 5-50mL(19.6±12.6mL),postoperative drainage volume was 0-60mL(13.5±18.8mL),and postoperative hospitalization time was 3-8d(5.1±1.6d).No postoperative complications such as cervical subcutaneous hematoma and dysphagia were observed.Postoperative imaging revealed no significant prevertebral soft tissue edema.The postoperative VAS and JOA scores were significantly improved at all time points compared with the preoperative values(P＜0.05).The overall efficacy was assessed according to the im-provement rate of JOA score at 3 months after surgery:12 cases were excellent,12 cases were good,and the rate of excellent and good was 100％(24/24).Conclusions:Soft endoscope-assisted single-segment ADR for the treatment of cervical spondylosis is small in trauma and short in operative time,which has certain clinical application prospects.

Objective: To evaluate the outcomes of splenectomy in the treatment of relapsed/refractory autoimmune hemolytic anemia (AIHA). Methods: Retrospective analysis was performed in 30 cases with relapsed/refractory AIHA who were treated with splenectomy in our hospital. The pre- and post-operative blood routine indexes and responses were followed up. Results: Among the 30 relapsed/refractory AIHA patients, 20 were pure AIHA (including 13 patients with warm antibody AIHA, 2 with warm-cold double antibody AIHA and 5 with Coombs negative AIHA) and 10 were Evans syndrome. The short-term response was evaluated 10-14 days after operation, and the overall response rate (ORR) of short-term response was 90% [12 cases in complete response (CR), 6 cases in partial response (PR)] in 20 therapeutic evaluable cases. Among 13 patients with long-term follow-up data, except 3 patients with Evans syndrome died (2 cases were refractory to splenectomy, 1 case relapsed after surgery), the ORR of 10 patients with relapsed/refractory pure AIHA at 6 months and 12 months were 90% (9/10) and 70% (7/10), respectively, with a median follow-up of 14 (4-156) months. At the end of follow-up, 3 cases had maintained CR for more than 3 years. Conclusion The short-term response of splenectomy as a second-line treatment for relapsed/refractory AIHA is satisfactory, and long-term outcome of splenectomy is up to 70% at 1 year. Approximately one-third of patients could maintain sustained remission.

Objective To study the association of maternal calcium supplementation and dietary calcium intake with the preterm birth so that to provide scientific basis for effective intervention of preterm birth. Methods Normal pregnant women who were followed up all through to childbirth in Gansu Provincial Maternity and Child Care Hospital were selected. Multivariate logistic regression was used to evaluate the associ-ation of calcium supplementation and intake with preterm birth. Results After confounding factors were adjus-ted, pregnant women who took calcium supplement for more than 3 months before and/or during pregnancy had the risk of preterm birth reduced by 14% which was dose-responding ( OR=0. 86, 95% CI=0. 77-0. 96, P<0. 05). Through stratifying by trimesters of pregnancy, it was found that calcium supplement in the third trimes-ter was a protective factor for preterm birth and especially significant in early and very early pregnancy ( OR=0. 75, 95% CI=0. 62-0. 92, P<0. 05). Through stratifying by dietary calcium intake, pregnant women who took dietary calcium more than 465. 55 mg/d had the risk of preterm birth significantly reduced which was shown by the reduction of preterm birth of different degrees, controlled preterm labor and spontaneous premature dilivery (OR=0. 66, 95% CI=0. 53-0. 82, P<0. 05). Conclusion Appropriate calcium supplementation or dietary calcium intake before and during pregnancy can reduce the risk of preterm birth, which is especially sig-nificant in late pregnancy.

Objective To study the relationship between the rheumatoid arthritis (RA) flatfoot and flexor pollicis longus tendon (FHL) lesion.Methods A total of 120 rheumatoid arthritis flatfoot patients (120 feet) was admitted to our hospital,and were examined by uhrasonography.Foot flexor hallucis longus tendon lesions were analyzed.Theses patients were divided into intact tendon group (group A) with 48 cases,tendon inflammation group (group B) with 45 cases,and tendon rupture group (C group) with 27 cases according to the ultrasound flexor hallucis longus tendon lesions degree.Foot bearing radiographs of all patients were measured,and hallux valgus angle between the first and second metatarsal bones were measured,and the relationship between the flexor pollicis longus tendon lesion degree and hallux valgus angle were analyzed.Results There were 48 cases (40％)with normal FHL,45 cases(37.5％)with FHlL inflammation,and 21 cases(22.5％) with FHL fractures.It revealed that HVA was positively correlated with IMA in group A and B (P ＜ 0.05).But there was no correlation between HVA and IMA in group C (P ＞ 0.05).Conclusion FHL is a common RA flatfoot disease,but FHL is not the initial cause of RA hallux valgus,but is positively correlated with the degree of hallux valgus.

Objective To study the relationship between the rheumatoid arthritis (RA) flatfoot and flexor pollicis longus tendon (FHL) lesion.Methods A total of 120 rheumatoid arthritis flatfoot patients (120 feet) was admitted to our hospital,and were examined by uhrasonography.Foot flexor hallucis longus tendon lesions were analyzed.Theses patients were divided into intact tendon group (group A) with 48 cases,tendon inflammation group (group B) with 45 cases,and tendon rupture group (C group) with 27 cases according to the ultrasound flexor hallucis longus tendon lesions degree.Foot bearing radiographs of all patients were measured,and hallux valgus angle between the first and second metatarsal bones were measured,and the relationship between the flexor pollicis longus tendon lesion degree and hallux valgus angle were analyzed.Results There were 48 cases (40％)with normal FHL,45 cases(37.5％)with FHlL inflammation,and 21 cases(22.5％) with FHL fractures.It revealed that HVA was positively correlated with IMA in group A and B (P ＜ 0.05).But there was no correlation between HVA and IMA in group C (P ＞ 0.05).Conclusion FHL is a common RA flatfoot disease,but FHL is not the initial cause of RA hallux valgus,but is positively correlated with the degree of hallux valgus.

Objective To assess the correlation between tenosynovitis or rupture of the flexor hallucis longus (FHL) and pes planus in patients with rheumatoid arthritis (RA).Methods The data of 47 RA patients (97 feet) with painful feet was retrospectively analyzed which was collected From February 2008 to June 2011.In accordance with the results of the FHL changes got by ultrasonography,the patients were divided into 3 groups.Group A consisted of those with normal FHL (27 feet).Group B consisted of those with FHL tenosynovitis (40 feet),and Group C eonsisted of those with FHL rupture (27 feet).Load bearing lateral radiographs were taken for all the patients.The correlation study was carried out based on the pes planus-related parameters,such as the measurement of heel pitch angle (HPA) and tarsal and 1st metatarsal angle (TM1).Factors like patients' age and course of disease were also taken into the consideration during the study.Results The mean age of those in group A was 49.9±9.2 years vs.56.2±9.2 years in group B and 54.7±8.0 years in group C.The mean duration was 4.7±2.6 years in Group A vs.16.2±7.4 years in Group B 5°±3.6° in Group C.The mean TM1 was 2.5°±2.2° in Group A vs.6.5°±3.2° in Group B and 11.2°±4.9° in Group C.Significant statistics difference were found among the three groups in these parameters.HPA＜ 20° was found among 6/27 feet in group A,31/40 in group B and 27/27 in group C.TM1 ＞4° was found among 5/27 feet in group A,30/40 in group B and 27/27 in group C.Conclusion FHL changes were common in RA patients and its severitv had positive correlation to pes planus.These changes were affected by age and duration,and could be evaluated effectively by ultrasound.

OBJECTIVE To investigate the drug resistance of ESBLs-producing Escherichia coli and Klebsiella pneumoniae in local nosocomial infection,for guiding the clinical drug resistance. METHODS ATB analysis system was used for identification of bacteria,extra-susceptibility tests were detected by K-B method. RESULTS The isolation rate of ESBLs-producing E. coli and the K. pneumoniae was 29.9% and 30.8%,respectively. The drug susceptibility was indicated the resistance rate of ESBLs producing strains to antibacterial agents except imipenem was higher than that of non-ESBLs producing strains. CONCLUSIONS Detecting drug resistance of ESBLs producing strains is of important significance for guiding the clinical rational use of antibacterials and controling the epidemics.