Objectives:To compare the short-term effectiveness and safety between robot-assisted cortical bone trajectory screw(CBTS)and traditional pedicle screw(TPS)fixations in posterior lumbar interbody fusion(PLIF)for lumbar spinal stenosis with osteoporosis.Methods:We retrospectively analyzed the clinical data of 113 patients who underwent robot-assisted PLIF and internal fixation in our hospital between September,2018 and June,2021.The patients were divided into two groups according to the internal fixation method.55 pa-tients fixed with CBTS were included in the CBTS group,and 58 patients fixed with TPS were included in the TPS group.The general data[age,sex ratio,height,weight,body mass index(BMI),hip bone mineral densi-ty(BMD)],surgical related data(operative time,incision length,intraoperative blood loss),perioperative indicators(postoperative length of hospital stay,surgical complications,screw loosening rate,adjacent facet joint violation rate,preoperative and postoperative blood glucose),and visual analogue scale(VAS)score of pain and Oswestry disability index(ODI)before and after surgery were recorded and compared.Results:There was no significant difference in age,sex ratio,height,weight,BMI and hip BMD between the two groups(P＞0.05).There was no significant difference in operative time,postoperative length of hospital stay,surgical complications,preoperative VAS score and ODI,and ODI at 1 month and 6 months after operation between the two groups(P＞0.05).The intraoperative blood loss,length of incision and VAS score at 6 months after operation in the CBTS group were significantly lower than those in the TPS group(500mL vs 600mL,P=0.007;8cm vs 10cm,P=0.006;2 vs 3,P＜0.001).There was no significant difference in blood glucose before operation and 1 day after operation between the two groups(P＞0.05),while at 1 week after operation,the CBTS group was significantly lower than the TPS group(4.75mmol/L vs 5.57mmol/L,P=0.041).At the final follow-up,the rates of screw loosening and adjacent facet joint violation in CBTS group were significantly lower than those in TPS group(1.68％vs 4.52％,P=0.044 and 13.83％vs 26.53％,P=0.029).Conclusions:For patients with lumbar spinal stenosis combined with osteoporosis,PLIF with robot-assisted CBTS fixation is less in surgical trauma,faster in early postoperative recovery,and fewer in screw-related complications than with TPS fixation.

Objectives:To compare the short-term effectiveness and safety between robot-assisted cortical bone trajectory screw(CBTS)and traditional pedicle screw(TPS)fixations in posterior lumbar interbody fusion(PLIF)for lumbar spinal stenosis with osteoporosis.Methods:We retrospectively analyzed the clinical data of 113 patients who underwent robot-assisted PLIF and internal fixation in our hospital between September,2018 and June,2021.The patients were divided into two groups according to the internal fixation method.55 pa-tients fixed with CBTS were included in the CBTS group,and 58 patients fixed with TPS were included in the TPS group.The general data[age,sex ratio,height,weight,body mass index(BMI),hip bone mineral densi-ty(BMD)],surgical related data(operative time,incision length,intraoperative blood loss),perioperative indicators(postoperative length of hospital stay,surgical complications,screw loosening rate,adjacent facet joint violation rate,preoperative and postoperative blood glucose),and visual analogue scale(VAS)score of pain and Oswestry disability index(ODI)before and after surgery were recorded and compared.Results:There was no significant difference in age,sex ratio,height,weight,BMI and hip BMD between the two groups(P＞0.05).There was no significant difference in operative time,postoperative length of hospital stay,surgical complications,preoperative VAS score and ODI,and ODI at 1 month and 6 months after operation between the two groups(P＞0.05).The intraoperative blood loss,length of incision and VAS score at 6 months after operation in the CBTS group were significantly lower than those in the TPS group(500mL vs 600mL,P=0.007;8cm vs 10cm,P=0.006;2 vs 3,P＜0.001).There was no significant difference in blood glucose before operation and 1 day after operation between the two groups(P＞0.05),while at 1 week after operation,the CBTS group was significantly lower than the TPS group(4.75mmol/L vs 5.57mmol/L,P=0.041).At the final follow-up,the rates of screw loosening and adjacent facet joint violation in CBTS group were significantly lower than those in TPS group(1.68％vs 4.52％,P=0.044 and 13.83％vs 26.53％,P=0.029).Conclusions:For patients with lumbar spinal stenosis combined with osteoporosis,PLIF with robot-assisted CBTS fixation is less in surgical trauma,faster in early postoperative recovery,and fewer in screw-related complications than with TPS fixation.

Objective To analyze the relationship between follow-up service, personal characteristics, lifestyle and blood sugar management of diabetic patients in Gansu Province, and put forward scientific suggestions on influencing blood sugar management of diabetic patients. Methods Based on the data of the 6th National Health Service Questionnaire, 273 subjects were included. Chi-square test and unconditional logistic regression were used to analyze the blood glucose control and its influencing factors of diabetic patients. Results A total of 39.56% patients' blood sugar status was well controlled. 76.92% patients signed up for family doctor service, and 77.66% patients took hypoglycemic drugs according to the law of doctor's advice. There were significant differences in blood sugar control among patients in different regions, educational levels and occupational types (P <0.05) , logistic regression analysis showed that Hui patients (OR=0.21), doctors without family contract (OR=2.86) and patients taking hypoglycemic drugs intermittently (OR = 6.58). Conclusion The blood sugar control rate of diabetic patients in Gansu is low, and the nationality, contracted family doctors and medication plan affect the blood sugar control level of patients. In order to ensure the high efficiency of follow-up treatment, the related follow-up services provided by primary medical institutions, it is necessary to provide self-management programs that meet the individual characteristics and meet the needs of the disease.

Objective:To evaluate the relationship between inflammatory bowel disease (IBD) and diabetes mellitus.Methods:The database of PubMed, EMBASE and Cochrane were searched by computer, and the related studies on the relationship between IBD and diabetes were collected. The retrieval time was from the database establishment to November 2, 2019. The heterogeneity analysis was conducted by Cochran Q test and I2 value. The relative risk ( RR) and 95% confidence interval ( CI) were used as the research indexes to conduct Meta analysis. Sensitivity analysis and publication bias test were also carried out. Results:Twelve observational studies were included in the study, and 216 024 IBD patients were included. Meta analysis showed that there was a significant correlation between IBD and diabetes ( RR = 1.27, 95% CI 1.09 - 1.49), and the risk of diabetes in IBD patients was 1.27 times higher than that of the general population. The results of subgroup analysis showed that: compared with the general population, the risk of type 2 diabetes mellitus (T2DM) in patients with ulcerative colitis (UC) increased ( RR = 1.44, 95% CI 1.25 -1.66), while the risk of type 1 diabetes mellitus (T1DM) had no significant difference. Compared with the general population, the risk of T1DM and T2DM in patients with Crohn′s disease (CD) both increased (T1DM: RR = 1.34, 95% CI 1.05 - 1.71; T2DM: RR = 1.44, 95% CI 1.01 - 2.07). Conclusions:There is a relationship between IBD and diabetes mellitus, and the risk of diabetes is increased in IBD patients.

In 2020, the European Society for Parenteral and Enteral Nutrition (ESPEN) published ESPEN practical guideline: Clinical nutrition in inflammatory bowel disease. The main contents of the guideline are discussed and compared with expert consensus: Nutrition support therapy in inflammatory bowel disease ( the second edition) , which published in 2018 by Chinese Society of Gastroenterology (CSGE) and Chinese Society for Parenteral and Enteral Nutrition (CSPEN) .

The nutritional status of patients with inflammatory bowel disease (IBD) is closely related to their clinical outcomes. As the widespread application of enteral nutrition in IBD patients, nutrition-related adverse reactions happen frequently and are getting more and more attention. Based on current domestic and overseas literature reports and clinical practice, this article expounds the possible adverse reactions and solutions in the implementation of enteral nutrition in patients with IBD.

Objective:To explore the relationship between the phase angle (PhA) and nutritional status in patient with Crohn′s disease (CD) .Methods:CD patients treated in West China Hospital of Sichuan University from May 2019 to June 2020 were enrolled retrospectively. The general data and routine nutritional indexes of patients were collected. Routine nutritional indexes included physical measurement, human composition, nutritional risk screening 2002 (NRS2002) and patient-generated subjective global assessment (PG-SGA) . The PhA value of patients was measured and the diagnostic efficacy was calculated. According to Kyle standard, low PhA is defined as male PhA less than 5° and female PhA less than 4.6° under bioelectrical impedance 50 kHz. The patients were divided into normal PhA group and low PhA group. The differences in nutritional indexes between the two groups were compared, and the correlation between PhA and routine nutritional indexes was analyzed.Results:A total of 112 CD patients were enrolled in the study, including 71 males (63.4%) and 41 females (36.6%) with the age range of 15-60 years old, and 56 patients in low PhA group and 56 in normal PhA group. Taking NRS2002 score as the gold standard, the area under curve (AUC) of CD diagnosis with PhA was 0.720 (95% CI: 0.547-0.893) in men and 0.799 (95% CI: 0.647-0.950) in women. When PhA<5.5° was defined as cut-off value for men, the sensitivity was 0.80 and the specificity was 0.73. When PhA<5.1° was defined as cut-off value for women, the sensitivity was 0.81 and the specificity was 0.78. The proportion of patients with nutritional risk, PG-SGA score and edema index in low PhA group were higher than those in normal PhA group (all P<0.05) , while body mass index (BMI) , arm circumference, arm muscle circumference, waist circumference, fat mass, fat-free mass, appendicular skeletal muscle mass index, intracellular water, extracellular water, and basal metabolic rate were lower than those in normal PhA group (all P<0.05) . PhA was negatively correlated with NRS2002 score, PG-SGA score and edema index ( r = -0.26, -0.35, -0.82, all P<0.05) , while it was positively correlated with BMI, arm circumference, arm muscle circumference, waist circumference, fat-free mass, appendicular skeletal muscle mass index, intracellular water, extracellular water, and basal metabolic rate ( r = 0.38, 0.59, 0.57, 0.31, 0.36, 0.49, 0.46, 0.25, 0.39, all P<0.05) . Conclusion:There is a strong correlation between PhA value and routine nutritional indexes in CD patients, suggesting that PhA can be used as a nutritional index to evaluate the nutritional status of CD patients.

In 2020, the European Society for Parenteral and Enteral Nutrition (ESPEN) published ESPEN practical guideline: Clinical nutrition in inflammatory bowel disease. The main contents of the guideline are discussed and compared with expert consensus: Nutrition support therapy in inflammatory bowel disease ( the second edition) , which published in 2018 by Chinese Society of Gastroenterology (CSGE) and Chinese Society for Parenteral and Enteral Nutrition (CSPEN) .

The nutritional status of patients with inflammatory bowel disease (IBD) is closely related to their clinical outcomes. As the widespread application of enteral nutrition in IBD patients, nutrition-related adverse reactions happen frequently and are getting more and more attention. Based on current domestic and overseas literature reports and clinical practice, this article expounds the possible adverse reactions and solutions in the implementation of enteral nutrition in patients with IBD.

Objective:To explore the relationship between the phase angle (PhA) and nutritional status in patient with Crohn′s disease (CD) .Methods:CD patients treated in West China Hospital of Sichuan University from May 2019 to June 2020 were enrolled retrospectively. The general data and routine nutritional indexes of patients were collected. Routine nutritional indexes included physical measurement, human composition, nutritional risk screening 2002 (NRS2002) and patient-generated subjective global assessment (PG-SGA) . The PhA value of patients was measured and the diagnostic efficacy was calculated. According to Kyle standard, low PhA is defined as male PhA less than 5° and female PhA less than 4.6° under bioelectrical impedance 50 kHz. The patients were divided into normal PhA group and low PhA group. The differences in nutritional indexes between the two groups were compared, and the correlation between PhA and routine nutritional indexes was analyzed.Results:A total of 112 CD patients were enrolled in the study, including 71 males (63.4%) and 41 females (36.6%) with the age range of 15-60 years old, and 56 patients in low PhA group and 56 in normal PhA group. Taking NRS2002 score as the gold standard, the area under curve (AUC) of CD diagnosis with PhA was 0.720 (95% CI: 0.547-0.893) in men and 0.799 (95% CI: 0.647-0.950) in women. When PhA<5.5° was defined as cut-off value for men, the sensitivity was 0.80 and the specificity was 0.73. When PhA<5.1° was defined as cut-off value for women, the sensitivity was 0.81 and the specificity was 0.78. The proportion of patients with nutritional risk, PG-SGA score and edema index in low PhA group were higher than those in normal PhA group (all P<0.05) , while body mass index (BMI) , arm circumference, arm muscle circumference, waist circumference, fat mass, fat-free mass, appendicular skeletal muscle mass index, intracellular water, extracellular water, and basal metabolic rate were lower than those in normal PhA group (all P<0.05) . PhA was negatively correlated with NRS2002 score, PG-SGA score and edema index ( r = -0.26, -0.35, -0.82, all P<0.05) , while it was positively correlated with BMI, arm circumference, arm muscle circumference, waist circumference, fat-free mass, appendicular skeletal muscle mass index, intracellular water, extracellular water, and basal metabolic rate ( r = 0.38, 0.59, 0.57, 0.31, 0.36, 0.49, 0.46, 0.25, 0.39, all P<0.05) . Conclusion:There is a strong correlation between PhA value and routine nutritional indexes in CD patients, suggesting that PhA can be used as a nutritional index to evaluate the nutritional status of CD patients.