Objectives:To analyze the clinical characteristics of upper cervical vertebrae with dumbbell schwannoma,and to explore its clinical symptoms,imaging features,and treatment plans.Methods:A retro-spective analysis was performed on 14 patients with upper cervical intra-and extraspinal dumbbell-shaped schwannoma admitted to the Spinal Surgery Department of Southern Theater General Hospital from January 2022 to June 2024,including 9 males and 5 females,aged 43.64±11.96 years(25-61 years).According to the location,size,scope of the tumor,and relationship with the surrounding important tissue structure in upper cervical spine,the relevant clinical treatment data were analyzed and the surgical treatment plan was dis-cussed.Cervical X-ray,CT and MRI examinations were regularly performed after surgery to evaluate the con-ditions of complete resection of tumor and recurrence,the stability of the upper cervical spine and whether the internal fixation was loose or broken.The recovery of spinal nerve function and pain improvement were evaluated by the Japanese Orthopaedic Association(JOA)and visual analogue scale(VAS)scores.Results:All the patients underwent complete tumor resection in one stage,and the postoperative JOA score(10.14±1.55 vs 13.86±1.06,P=0.005)and VAS score(2.42±1.29 vs 0.64±0.71,P=0.000)were statistically different from those before surgery.Postoperative tumor histopathology was confirmed as schwannoma in all the 14 patients.The follow-up time was 6 months to 2 years.No recurrence of tumor was found,neurological symptoms were significantly improved,and no upper cervical instability appeared.Conclusions:For patients with intra-and extra-spinal dumbbell-shaped schwannoma in the upper cervical spine,complete resection of the tumor in one stage of posterior approach can be given priority.If the important stable tissue structure of the upper cervical spine is destroyed,upper cervical spine fixation and fusion should be performed to ensure the stabil-ity of upper cervical spine after tumor resection.

Ferroptosis of chondrocytes is a significant contributor to osteoarthritis(OA),for which there is still a lack of safe and effective therapeutic drugs targeting ferroptosis.Here,we screen for anti-ferroptotic drugs in Food and Drug Administration(FDA)-approved drug library via a high-throughput manner in chondrocytes.We identified a group of FDA-approved anti-ferroptotic drugs,among which vitamin K showed the most powerful protective effect.Further study demonstrated that vitamin K effectively inhibited ferroptosis and alleviated the extracellular matrix(ECM)degradation in chondrocytes.Intra-articular injection of vitamin K inhibited ferroptosis and alleviated OA phenotype in destabilization of the medial meniscus(DMM)mouse model.Mechanistically,transcriptome sequencing and knockdown experiments revealed that the anti-ferroptotic effects of vitamin K depended on growth arrest-specific 6(Gas6).Furthermore,exogenous expression of Gas6 was found to inhibit ferroptosis through the AXL receptor tyrosine kinase(AXL)/phosphatidylinositol 3-kinase(PI3K)/AKT serine/threonine kinase(AKT)axis.Together,we demonstrate that vitamin K inhibits ferroptosis and alleviates OA progression via enhancing Gas6 expression and its downstream pathway of AXL/PI3K/AKT axis,indicating vitamin K as well as Gas6 to serve as a potential therapeutic target for OA and other ferroptosis-related diseases.

Ferroptosis of chondrocytes is a significant contributor to osteoarthritis (OA), for which there is still a lack of safe and effective therapeutic drugs targeting ferroptosis. Here, we screen for anti-ferroptotic drugs in Food and Drug Administration (FDA)-approved drug library via a high-throughput manner in chondrocytes. We identified a group of FDA-approved anti-ferroptotic drugs, among which vitamin K showed the most powerful protective effect. Further study demonstrated that vitamin K effectively inhibited ferroptosis and alleviated the extracellular matrix (ECM) degradation in chondrocytes. Intra-articular injection of vitamin K inhibited ferroptosis and alleviated OA phenotype in destabilization of the medial meniscus (DMM) mouse model. Mechanistically, transcriptome sequencing and knockdown experiments revealed that the anti-ferroptotic effects of vitamin K depended on growth arrest-specific 6 (Gas6). Furthermore, exogenous expression of Gas6 was found to inhibit ferroptosis through the AXL receptor tyrosine kinase (AXL)/phosphatidylinositol 3-kinase (PI3K)/AKT serine/threonine kinase (AKT) axis. Together, we demonstrate that vitamin K inhibits ferroptosis and alleviates OA progression via enhancing Gas6 expression and its downstream pathway of AXL/PI3K/AKT axis, indicating vitamin K as well as Gas6 to serve as a potential therapeutic target for OA and other ferroptosis-related diseases.

Objectives:To analyze the clinical characteristics of upper cervical vertebrae with dumbbell schwannoma,and to explore its clinical symptoms,imaging features,and treatment plans.Methods:A retro-spective analysis was performed on 14 patients with upper cervical intra-and extraspinal dumbbell-shaped schwannoma admitted to the Spinal Surgery Department of Southern Theater General Hospital from January 2022 to June 2024,including 9 males and 5 females,aged 43.64±11.96 years(25-61 years).According to the location,size,scope of the tumor,and relationship with the surrounding important tissue structure in upper cervical spine,the relevant clinical treatment data were analyzed and the surgical treatment plan was dis-cussed.Cervical X-ray,CT and MRI examinations were regularly performed after surgery to evaluate the con-ditions of complete resection of tumor and recurrence,the stability of the upper cervical spine and whether the internal fixation was loose or broken.The recovery of spinal nerve function and pain improvement were evaluated by the Japanese Orthopaedic Association(JOA)and visual analogue scale(VAS)scores.Results:All the patients underwent complete tumor resection in one stage,and the postoperative JOA score(10.14±1.55 vs 13.86±1.06,P=0.005)and VAS score(2.42±1.29 vs 0.64±0.71,P=0.000)were statistically different from those before surgery.Postoperative tumor histopathology was confirmed as schwannoma in all the 14 patients.The follow-up time was 6 months to 2 years.No recurrence of tumor was found,neurological symptoms were significantly improved,and no upper cervical instability appeared.Conclusions:For patients with intra-and extra-spinal dumbbell-shaped schwannoma in the upper cervical spine,complete resection of the tumor in one stage of posterior approach can be given priority.If the important stable tissue structure of the upper cervical spine is destroyed,upper cervical spine fixation and fusion should be performed to ensure the stabil-ity of upper cervical spine after tumor resection.

Objective:To evaluate the feasibility of using cortical bone trajectory (CBT) screws in the osteoporotic thoracolumbar fixation by comparing the bone CT values at the bone-screw interface between traditional trajectory (TT) screws and CBT screws in patients with different bone densities.Methods:The high-resolution CT imaging data of thoracolumbar segments following thoracic or lumbar spine fractures from April 2020 to October 2022 were collected at The Second Hospital Affiliated to Wenzhou Medical University for retrospective analysis. They were divided into 3 groups: a normal bone mass group, an osteopenia group and an osteoporosis group. From each group 30 cases were chosen (90 cases in total, 36 males and 54 females). All the data were imported into Mimics 18.0 for three-dimensional bone reconstruction in which placement of TT and CBT screws was simulated on the vertebrae from T10 to L2 (non-fractured vertebrae). Regions of interest (ROI) where each simulated screw intersected the bone were segmented to measure their CT bone values. For each vertebra in each group, the relative difference percentage in average CT value of ROI between TT and CBT screws was calculated. The CT values of ROI were compared in the same group between TT and CBT screws from T10 to L2; the CT values of ROI were compared in the same screws among the 3 groups from T10 to L2; the CT values of ROI were compared between the CBT screws in the osteopenia and osteoporosis groups and the TT screws in the normal bone mass group; the relative difference percentages in average CT value of ROI between CBT and TT screws were compared between the 3 groups from T10 to L2.Results:The average CT value of ROI for CBT screws was significantly higher than that for TT screws from T10 to L2 in every group ( P< 0.001); as for the CT values of ROI for CBT and TT screws from T10 to L2, the osteoporosis group0.05). At T10, T12, and L1, the relative difference percentage in average CT value of ROI between CBT and TT screws was significantly higher in the osteopenia and osteoporosis groups than that in the normal bone mass group ( P<0.05), but there was no such a difference between the osteopenia and the osteoporosis groups ( P>0.05). At T11 and L2, there was no significant difference between the 3 groups in the relative difference percentage in average CT value of ROI between CBT and TT screws ( P>0.05). Conclusions:As bone mass decreases, both CBT and TT screws lead to a significant decrease in the bone density at the bone-screw interface. In patients with osteoporosis, CBT screws can still lead to a higher bone density at the bone-screw interface than TT screws, thus providing a higher strength at the bone-screw interface.

Objective:To observe the effect of speech training based on mirror neuron theory on children with functional articulation disorder (FAD).Methods:Fifty children with FAD were randomly divided into a training group and a control group, each of 25. Both groups received 30 minutes of conventional speech training 5 times a week for 24 weeks, while the training group was additionally given 20 minutes of speech training based on mirror neuron theory simultaneously. Before and after the intervention, both groups were evaluated using the articulation speech ability assessment scale and the oral motor ability assessment scale.Results:Before the treatment, there were no significant differences between the 2 groups in any of the measurements. After the treatment, significant improvement was observed in all of the measurements for both groups, but at that point the training group′s articulation, motor ability of the lower jaw, tongue and lips were all significantly superior to the control group′s averages.Conclusions:Speech training based on mirror neuron theory can significantly improve the articulation, intelligibility and oral motor functioning of children with functional articulation disorder.

Objective To understand the etiological features of diarrhea in Xiangyang city and to provide a scientific basis for the prevention and control of diarrhea. Methods A total of 1 142 stool samples were collected from diarrheal patients admitted to the First People's Hospital of Xiangyang from 2013 to 2017 anwere tested for pathogens. The pathogenic composition, population characteristics and time distribution of diarrheal patients were analyzed. Results Of the 1 142 diarrheal patients, 737 patients (64.54%) were tested negatively. Of the 405 patients tested positively, adenovirus was the most prevalent, with proportion of 38.27% (155 patients), followed by norovirus and rotavirus. Only 20 patients (4.94%) were tested as bacterial infection. Infectious diarrhea showed obvious seasonality, with largest infectious proportion in April-June. Patients younger than 1 year old were the most susceptible to infectious diarrhea and the proportion was 29.63% (120 patients). Conclusions The majority of infectious diarrhea was viral diarrhea, and the main pathogen was adenovirus and norovirus. Only a very small proportion of diarrhea was due to bacterial infection. The guidance for infant's feeding and the surveillance and control of virus diarrhea for infants should be strengthened.

Objective To investigate the epidemiological characteristics of COVID-19 outbreaks in Xiangyang, and to provide a scientific basis for curbing the development of the epidemic. Methods A retrospective epidemiological investigation was conducted to analyze the epidemiological characteristics of confirmed COVID-19 cases in the city from January 1 to April 30, 2020. Results Confirmed COVID-19 cases were reported throughout the city, and the epidemic situation decreased significantly after February. The median age of confirmed cases was 47 years old, and most of them were 25-65 years old (86.89%). The average interval time between first diagnosis and admission was 5.23 days, while the average interval time between diagnosis and confirmation was 1.69 days. As time went on, the time intervals between the first diagnosis and admission and between diagnosis and confirmation were significantly shortened. The higher the proportion of previous underlying diseases was, the more serious the COVID-19 infection was (χ²=44.40, P<0.05). Conclusion The infection of COVID-19 in Xiangyang is highly contagious, but the cluster epidemic was mainly mild. Novel coronavirus infection is closely related to occupational exposure, with young and middle-aged people being high-risk populations. Early diagnosis, early isolation, comprehensive treatment and active control of chronic underlying diseases are crucial to the control of COVID-19.

Objective To explore the problems of health poverty faced by a special group of people with disabilities and the difficulties in the practice of health poverty alleviation, so as to provide a scientific basis for the health poverty alleviation of the disabled. Methods A self-made questionnaire was used for one-to-one survey, and a database was established by Excel. SPSS was used for descriptive analysis and horizontal comparison. Results The participation rate of basic medical insurance for the disabled was relatively high (93.40%), and the medical insurance payment was mainly paid by individuals (70.13%). The satisfaction of medical insurance was low (43.12%), and 84.64% of the disabled thought that their medical expenses were high. 45.22% of the families of disabled patients met the universal standard of catastrophic health expenditure. Compared with Shandong Province, the basic medical insurance coverage rate of the disabled in Hubei Province was slightly lower, the satisfaction rate of medical insurance was higher, and the proportion of catastrophic health expenditure of families was larger. The analysis of the results showed that the disabled people with a lower disability level, children and middle-aged with disabilities, the disabled people with less or more family members, and the disabled people without the minimum living subsistence allowances were not satisfied with the medical insurance. Conclusion The basic medical insurance in the two places has alleviated the difficulty of medical treatment for the disabled to a certain extent, but the family burden of diseases of the disabled was still heavy. The level of medical security for people with disabilities should be improved, and their economic burden of disease should be reduced, so as to improve the satisfaction of medical insurance.

Objective:There were 92 kinds of compound preparations containing Ophiopogonis Radix in the 2015 edition of Chinese Pharmacopoeia， but there was no effective method to identify these compound preparations. Because Ophiopogonis Radix and Liriopes Radix are similar in appearance， it is easy to be confused in application. The aim of this study was to set up a thin layer chromatography （TLC） to identify compound preparations containing Ophiopogonis Radix and distinguish Ophiopogonis Radix and Liriopes Radix in the forms of decoction pieces and standard decoction. Method:In this study， decoction pieces of Ophiopogonis Radix and Liriopes Radix were collected and separately prepared as standard decoction. TLC was used to qualitatively identify decoction pieces and standard decoction of Ophiopogonis Radix and Liriopes Radix， and compound preparations containing Ophiopogonis Radix. In the TLC， the lower solution of chloroform-methanol-water （65∶35∶10） was selected as the developing agent and 10% sulfuric acid ethanol solution as the chromogenic agent. Result:The resolution of this TLC was good. Decoction pieces， standard decoction and preparations of Ophiopogonis Radix had the same characteristic strips， which were two bright white fluorescent strips under ultraviolet lamp （365 nm）. But these two characteristic strips were not existed in the TLC of decoction pieces and standard decoction of Liriopes Radix. The corresponding components of both of these two strips were identified as mixture containing saponins by LC-MSⁿ， including ophiopogonin Ra， Tb， ophiopogonin D'， borneol glycoside， ophiopogonin C and Liriope muscari baily saponins C. Conclusion:The established TLC method， which has significant advantages such as high specificity and sensitivity， can be applied to the characteristic identification of decoction pieces and standard decoction of Ophiopogonis Radix， the identification of compound preparations containing Ophiopogonis Radix， and the distinction of Ophiopogonis Radix and Liriopes Radix， thus serving as an effective method to qualitatively identify Ophiopogonis Radix and its compound preparations.