Objectives:To observe the changes in spinopelvic sagittal plane parameters after percutaneous kyphoplasty(PKP)in patients with osteoporotic vertebral compression fracture(OVCF),and to explore their impacts on adjacent vertebral compression fracture(AVCF).Methods:201 patients with OVCF who underwent PKP in our hospital from May 2018 to November 2022 were selected as the study subjects.The patients were followed up for 2 years after PKP surgery,and were divided into AVCF group(n=44)and non AVCF group(n=157)based on whether AVCF occurred during the follow-up period.The spinopelvic sagittal parameters,visual analogue scale(VAS)scores,and Oswestry disability index(ODI)were compared between the two groups of patients before operation and at 1 week,1 month,and 3 months after surgery.Pearson correlation test was used to analyze the correlations between the spinopelvic sagittal parameters in the AVCF group and non AVCF group at 3 months after surgery;Logistic regression analysis was used to evaluate the correlation between spinopelvic sagittal parameters and AVCF after PKP surgery.The receiver operating charactertics(ROC)curve was drawn to analyze the predictive value of various spinopelvic sagittal parameters for AVCF in patients with OVCF after PKP.Results:The baseline VAS score and ODI of patients in the AVCF group were significantly higher than those in the non AVCF group(P＜0.05).3 months after surgery,the VAS score and ODI of both groups were significantly reduced,and the non AVCF group was significantly lower than the AVCF group(P＜0.05).There were significant differences in pelvic tilt(PT),sagittal vertical axis(SVA),T1 pelvic angle(TPA),sacral slope(SS),lumbar lordosis(LL),and pelvic incidence(PI)between the two groups at different time points(P＜0.05).The non AVCF group showed a significant difference in thoracic kyphosis(TK)before and after operation(P＜0.05).There was no significant difference in thoracolumbar kyphosis(TLK)and PT(P＞0.05),while there were significant differences in SVA,PI,TPA,LL,SS,and TK(P＜0.05)between the two groups of patients at the same time points.In the non AVCF group,SVA was associated with TPA,TK,TLK,LL,and PT,TPA was associated with TK,TLK,LL,PI,SS,and PT,TK was associated with TLK,PT,and SS,TLK was associated with LL,PI,and PT,LL was associated with PT and SS,and PT was associated with SS at 3 months after surgery(P＜0.05).In the AVCF group,SVA was correlated with TPA,TPA was correlated with LL,PI,PT,and SS,and PT was correlated with PI and SS(P＜0.05).TK,SVA,PI,SS,TPA and LL were significantly correlated with AVCF after PKP in OVCF patients(P＜0.05).After adjustment of age,initial fracture site,vertebral height recovery rate,diabetes,number of fractured vertebrae before operation,bone density,amount of bone cement,and leakage of bone cement into intervertebral disc,SVA(OR=2.633,95％CI:1.857-3.732),TPA(OR=2.497,95％CI:1.684-3.702),TK(OR=3.184,95％CI:2.699-3.755),LL(OR=0.526,95％CI:0.438-0.631),PI(OR=0.478,95％CI:0.320-0.715),and SS(OR=0.592,95％CI:0.500-0.701)were still significantly correlated with AVCF(P＜0.001).SVA,TPA,TK,LL,PI,and SS all had certain predictive values for postoperative AVCF in OVCF patients after PKP[area under the curve(AUC)＞0.750].Among them,SVA had a bigger AUC value(0.826)for predicting AVCF than other parameters,with a sensitivity of 0.827,specificity of 0.757,and accuracy of 0.792.Conclusions:There is a significant correlation between AVCF and spinopelvic sagittal balance in OVCF patients after PKP surgery.SVA,TPA,TK,LL,SS,and PI have certain predictive values for the occurrence of AVCF after PKP;Smaller SVA,TPA,TK and larger LL,SS,PI at 3 months after surgery can reduce the probability of AVCF occurrence in OVCF patients after PKP surgery.

Objectives:To observe the changes in spinopelvic sagittal plane parameters after percutaneous kyphoplasty(PKP)in patients with osteoporotic vertebral compression fracture(OVCF),and to explore their impacts on adjacent vertebral compression fracture(AVCF).Methods:201 patients with OVCF who underwent PKP in our hospital from May 2018 to November 2022 were selected as the study subjects.The patients were followed up for 2 years after PKP surgery,and were divided into AVCF group(n=44)and non AVCF group(n=157)based on whether AVCF occurred during the follow-up period.The spinopelvic sagittal parameters,visual analogue scale(VAS)scores,and Oswestry disability index(ODI)were compared between the two groups of patients before operation and at 1 week,1 month,and 3 months after surgery.Pearson correlation test was used to analyze the correlations between the spinopelvic sagittal parameters in the AVCF group and non AVCF group at 3 months after surgery;Logistic regression analysis was used to evaluate the correlation between spinopelvic sagittal parameters and AVCF after PKP surgery.The receiver operating charactertics(ROC)curve was drawn to analyze the predictive value of various spinopelvic sagittal parameters for AVCF in patients with OVCF after PKP.Results:The baseline VAS score and ODI of patients in the AVCF group were significantly higher than those in the non AVCF group(P＜0.05).3 months after surgery,the VAS score and ODI of both groups were significantly reduced,and the non AVCF group was significantly lower than the AVCF group(P＜0.05).There were significant differences in pelvic tilt(PT),sagittal vertical axis(SVA),T1 pelvic angle(TPA),sacral slope(SS),lumbar lordosis(LL),and pelvic incidence(PI)between the two groups at different time points(P＜0.05).The non AVCF group showed a significant difference in thoracic kyphosis(TK)before and after operation(P＜0.05).There was no significant difference in thoracolumbar kyphosis(TLK)and PT(P＞0.05),while there were significant differences in SVA,PI,TPA,LL,SS,and TK(P＜0.05)between the two groups of patients at the same time points.In the non AVCF group,SVA was associated with TPA,TK,TLK,LL,and PT,TPA was associated with TK,TLK,LL,PI,SS,and PT,TK was associated with TLK,PT,and SS,TLK was associated with LL,PI,and PT,LL was associated with PT and SS,and PT was associated with SS at 3 months after surgery(P＜0.05).In the AVCF group,SVA was correlated with TPA,TPA was correlated with LL,PI,PT,and SS,and PT was correlated with PI and SS(P＜0.05).TK,SVA,PI,SS,TPA and LL were significantly correlated with AVCF after PKP in OVCF patients(P＜0.05).After adjustment of age,initial fracture site,vertebral height recovery rate,diabetes,number of fractured vertebrae before operation,bone density,amount of bone cement,and leakage of bone cement into intervertebral disc,SVA(OR=2.633,95％CI:1.857-3.732),TPA(OR=2.497,95％CI:1.684-3.702),TK(OR=3.184,95％CI:2.699-3.755),LL(OR=0.526,95％CI:0.438-0.631),PI(OR=0.478,95％CI:0.320-0.715),and SS(OR=0.592,95％CI:0.500-0.701)were still significantly correlated with AVCF(P＜0.001).SVA,TPA,TK,LL,PI,and SS all had certain predictive values for postoperative AVCF in OVCF patients after PKP[area under the curve(AUC)＞0.750].Among them,SVA had a bigger AUC value(0.826)for predicting AVCF than other parameters,with a sensitivity of 0.827,specificity of 0.757,and accuracy of 0.792.Conclusions:There is a significant correlation between AVCF and spinopelvic sagittal balance in OVCF patients after PKP surgery.SVA,TPA,TK,LL,SS,and PI have certain predictive values for the occurrence of AVCF after PKP;Smaller SVA,TPA,TK and larger LL,SS,PI at 3 months after surgery can reduce the probability of AVCF occurrence in OVCF patients after PKP surgery.

Objective:To determine the prevalence of Helicobacter pylori (Hp) infection in orthotopic liver transplantation (LT) recipients, and to study the efficacy and safety of Hp eradication therapy.Methods:13C-urea breath test was carried out between July 2018 and October 2019. There were 104 males and 26 females with an average age of 52.1 year for these LT recipients who were regularly followed-up in the Organ Transplant Center, the Affiliated Hospital of Qingdao University. Propensity scoring was used to match age and gender in a ratio of 1∶3. A healthy group of individuals consisting of 299 males and 91 females, with an average age of 51.8 years, were selected as the control group also in a ratio of 1∶3. All patients underwent 13C-urea breath test to evaluate Hp infection and results of quadruple therapy. Results:The prevalence of Hp infection among the LT recipients was 18.5%(24/130) which was significantly lower than the control group 36.4% (142/390) (χ 2=14.400, P<0.001). Among the recipients who received LT and 13C-urea breath test for less than 1 year, 1-3 years and more than 3 years, the prevalences of Hp infection were 14.3% (6/42), 17.8%(8/45) and 23.3%(10/43), respectively. Although the prevalence of Hp showed a gradually increasing trend, no correlation between Hp infection and duration from LT was observed (χ 2=1.321, P=0.517). Seventeen Hp positive recipients underwent Hp eradication therapy. The success rate of Hp eradication was 100.0%(17/17). Immunosuppressant concentration was monitored regularly in 10 patients. During Hp eradication, the blood concentration of immunosuppressant increased from 1.7 to 3.6 times, and the drug dosage was reduced to one half to one third of what it was before Hp eradication. Seven of these 17 recipients suffered from adverse effects caused by increased levels of blood concentration of immunosuppressants, including headache, hypertension, insomnia and irritability. Normal liver and kidney functions were observed during eradication. Conclusion:In this study, the prevalence of Hp infection among liver transplant recipients was 18.5%. The success rate of Hp eradication was 100% using bismuth-containing quadruple therapy. The dosage of immunosuppressant required to be monitored, and if necessary, adjusted during eradication to reduce adverse side effects.