OBJECTIVE:Patients with osteoporotic vertebral compression fractures still have residual back pain after vertebral augmentation.The current research is characterized by limited sample size,complex confounding factors,and inconsistent research results.To gain a deeper understanding of this phenomenon,the aim of this study was to identify and evaluate the risk factors for residual back pain after surgery through a systematic review and meta-analysis.METHODS:A comprehensive search was conducted in CNKI,VIP,WanFang,CBMdisc,PubMed,The Cochrane Library,Embase,and Web of Science for case-control studies on residual back pain after vertebral body augmentation for osteoporotic vertebral compression fractures from database inception to July 2024.The search terms were a combination of subject terms and free terms.The basic information,patient characteristics,surgical-related indicators,and risk factors for surgical back pain of the included studies were extracted.After evaluating the bias risk of all included studies,a meta-analysis was conducted using Stata 14.0 software on the relevant indicators.RESULTS:(1)21 case-control studies with a total of 8 043 patients were included.Among them,965 patients developed back pain.The quality score of all 21 studies was ≥7.(2)The meta-analysis results showed that age(WMD=0.98,95％CI:0.40-1.56,P=0.010),bone mineral density(WMD=-0.28,95％CI:-0.34 to-0.21,P=0.000),the number of vertebral fractures(OR=3.50,95％CI:2.65-4.62,P=0.000),thoracolumbar fracture index(OR=3.65,95％CI:2.61-5.11,P=0.000),cement volume(OR=6.89,95％CI:2.62-18.17,P=0.000),and cement distribution(OR=2.38,95％CI:1.93-2.93,P=0.000)were risk factors for the development of back pain after vertebral body augmentation in patients with osteoporotic vertebral compression fractures.CONCLUSION:Current evidence indicates that age,bone mineral density,the number of vertebral fractures,thoracolumbar fracture index,bone cement injection volume,and the distribution of bone cement are risk factors for low back pain.Specifically,bone mineral density,the number of vertebral fractures,thoracolumbar fracture index,and non-uniform distribution of bone cement are identified as independent risk factors for low back pain.Patients exhibiting these high-risk factors require vigilant monitoring and prompt intervention to mitigate the occurrence of clinical low back pain,thereby enhancing patient outcomes and quality of life.

OBJECTIVE:Patients with osteoporotic vertebral compression fractures still have residual back pain after vertebral augmentation.The current research is characterized by limited sample size,complex confounding factors,and inconsistent research results.To gain a deeper understanding of this phenomenon,the aim of this study was to identify and evaluate the risk factors for residual back pain after surgery through a systematic review and meta-analysis.METHODS:A comprehensive search was conducted in CNKI,VIP,WanFang,CBMdisc,PubMed,The Cochrane Library,Embase,and Web of Science for case-control studies on residual back pain after vertebral body augmentation for osteoporotic vertebral compression fractures from database inception to July 2024.The search terms were a combination of subject terms and free terms.The basic information,patient characteristics,surgical-related indicators,and risk factors for surgical back pain of the included studies were extracted.After evaluating the bias risk of all included studies,a meta-analysis was conducted using Stata 14.0 software on the relevant indicators.RESULTS:(1)21 case-control studies with a total of 8 043 patients were included.Among them,965 patients developed back pain.The quality score of all 21 studies was ≥7.(2)The meta-analysis results showed that age(WMD=0.98,95％CI:0.40-1.56,P=0.010),bone mineral density(WMD=-0.28,95％CI:-0.34 to-0.21,P=0.000),the number of vertebral fractures(OR=3.50,95％CI:2.65-4.62,P=0.000),thoracolumbar fracture index(OR=3.65,95％CI:2.61-5.11,P=0.000),cement volume(OR=6.89,95％CI:2.62-18.17,P=0.000),and cement distribution(OR=2.38,95％CI:1.93-2.93,P=0.000)were risk factors for the development of back pain after vertebral body augmentation in patients with osteoporotic vertebral compression fractures.CONCLUSION:Current evidence indicates that age,bone mineral density,the number of vertebral fractures,thoracolumbar fracture index,bone cement injection volume,and the distribution of bone cement are risk factors for low back pain.Specifically,bone mineral density,the number of vertebral fractures,thoracolumbar fracture index,and non-uniform distribution of bone cement are identified as independent risk factors for low back pain.Patients exhibiting these high-risk factors require vigilant monitoring and prompt intervention to mitigate the occurrence of clinical low back pain,thereby enhancing patient outcomes and quality of life.

Objective To explore the prevalence and characteristics of occult hepatitis B virus infection （OBI） among blood donors in Huzhou region. Methods A total of 31 348 blood donors collected from October 2018 to February 2020 were selected for detecting HBV infection markers by serological and nucleic acid detection techniques. According to the detection results， 27 cases of HBsAg double negative （two kinds of reagent detection）， nucleic acid amplification technology （NAT） positive samples were identified as the occult HBV infection group （OBI group）； 25 cases of HBsAg double positive （two kinds of reagent detection）， NAT positive samples were identified as dominant HBV infection group， respectively. HBV nucleic acid quantitative detection， serum hepatitis B three line markers， liver function markers detection， and the results of the two groups were compared and analyzed. Results There were 31 034 HBsAg negative blood donors， 27 of whom were HBV-DNA positive， and the prevalence of OBI was 0.87 ‰. Six kinds of serology were found in 27 OBI patients， among which 25 cases （92.6%） were HBcAb， 17 cases （63.0%） were HBsAb， 17 cases （63.0%） were HBeAb， 15 cases （55.6%） were HBcAb and HBsAb， and 14 cases （51.9%） were HBcAb and HBeAb. There was no significant difference in gender， HBcAb positive rate， TBI， AST and ALT between the two groups （ P >0.05）. There were significant differences in age and HBsAb level （ χ ²=1.201， P <0.001； t =28.336， P <0.001）， and the average viral load was （25.86±19.68） IU/mL， which was significantly lower than the average viral load of the control group （3 254.65±535.98）IU/mL（ t =32.412， P <0.01）. Conclusion There is a certain prevalence of OBI in blood donors in Huzhou area. The main kinds of serology are HBcAb and HBsAb. Serological detection combined with nucleic acid detection can ensure the safety of blood transfusion and reduce the risk of blood borne diseases.

【Objective】 To analyze the characteristics of gene mutation in S region of blood donors with occult hepatitis B virus infection (OBI) in Huzhou area. 【Methods】 A total of 60 107 blood samples in Huzhou between October 2018 and June 2020 were collected by our blood station. Among them, 52 samples were NAT, yield and their epidemiological characteristics were analyzed. Twenty-seven OBI out of the 52 NAT yield samples were included in experimental group. Other eight HBV-infected individuals with positive HBsAg, core antibody (anti-HBc) and HBV-DNA were selected as positive control. Liver function and 5 serological markers of HBV were compared between the two groups, and HBV genotypes and amino acid mutation in S region in the two groups were analyzed. 【Results】 The number of NAT-yield samples were different by gender, age, and educational background (P<0.05). In 18~30 aged donor population, the number of NAT-yield samples were significantly more in males than in females (P<0.05). No significant differences in liver function indicators, e antigen (HBeAg), and anti-HBc were noticed between the two group (P>0.05). Surface antigen (HBsAg) in the experimental group was significantly lower than that in the control group, while surface antibody (anti-HBs) and e antibody (anti-HBe) were significantly higher than those in the control group (P<0.05). Twenty sequences in S region were obtained from the experimental group, including 4 in S region and 16 in preSS region; 16 cases with type C and 4 cases with type B. 【Conclusion】 The follow-up of NAT-yield blood donors in Huzhou area should be conducted. Compared with HBV infected individuals with positive HBsAg, anti-HBc and HBV-DNA, those with OBI have a higher gene mutation rate in S region.

【Objective】 To investigate the prevalence of occult hepatitis B virus infection (OBI) among blood donors in Huzhou, and to analyze the viral load and molecular characteristics of OBI. 【Methods】 45 368 blood samples were screened by enzyme linked immunosorbent assay (ELISA) and nucleic acid testing (NAT) for HBV infection from October 2018 to February 2020 in our center. HBsAg-/NAT+ blood donors were studied as experimental group, contemporary HBsAg+ /NAT+ donors as the control. The serum viral nucleic acids of the two groups were extracted, and HBV DNA copies were detected by real-time PCR, the differences between the two groups were compared. The S region gene of the virus was amplified and sequenced by Nested PCR, then compared with the reference sequence of HBV wild type, in order to confirm the genotyping and molecular mutation characteristics of S region. 【Results】 36 samples were confirmed as OBI (0.08%, 36 / 45 368). The HBV DNA load of 8 samples was lower than the detection limit, and the average HBV DNA load of other 28 samples was (42.3±1.24) IU / mL, which was significantly lower than that of the controls (3.32±1.94) ×10⁴ IU / mL(P<0.05). Among the 28 OBI samples, 20 were type B (71.43%), and 8 were type C (28.57%). The frequency of amino acid variation in HBsAg epitopes was significantly higher in OBI than in MHR(P<0.05). 【Conclusion】 The viral load of OBI blood donors in Huzhou, mainly genotype B, is low, and the variation sites were mainly focused in HBsAg epitope and amino acid region (124~147).

Flavaspidic acid AB is a bicyclic phloroglucinol derivative with various biological activities in Dryopteris fragrans (L.) Schott. The structure of flavaspidic acid AB was analyzed by inverse synthesis techniques, and its synthesis was designed under the principle of association. Using phloroglucinol as raw material, the 2-methyl-4-butyrylphloroglucinol was synthesized by Vilsmeier-Haack reaction, reduction and acylation, and the flavaspidic acid fragment was synthesized by acylation, alkylation and deacylation, after which N, N-dimethylmethyleneammonium iodide was activated and the flavaspidic acid AB was obtained. The structures of intermediates and flavaspidic acid AB were confirmed by MS, 1H NMR and 13C NMR, and the yield of the target product reached 14.7%. Results indicate that the designed synthetic route of flavaspidic acid AB is simple and easy.

Objective To understand the difference of serological characteristic between alloantibodies,'simple'Rhspecific autoantibodies and autoantibodies mimicking alloantibodies by studies of a patient who produces alloantibodies and autoantibodies that to distinguish Serologically them in order to more appropriate RBC component transfusion administration would be performed for patients.Methods Several serological methods were performed to the patient's serum samples for identification of antibodies by using two antibody screening cell reagents from different manufacturers.Using adsorption of the patient's Rh antibodies in the presence of LISS with the antibody was similar to that of the antigen negative cell from a donor who had a ccDEE Rh type and O type,and to detect antibodies in the absorbed serum and the eluting solution.Results The patient had a ccDEE Rh type with a positive direct antiglobulin test (DAT).Serum antibodies were identified as IgM anti-C,anti-e and IgG anti-e;the possibility of anti-Ce antibody is not excluded.After absorption,serum antibodies were identified as IgM anti-C,anti-e and IgG anti-e;anti-Ce antibody is not excluded.The antibody in patient's RBC elution was identified as IgG anti-e antibody.Conclusion Alloantibody and mimicking alloantibody can be distinguished by comprehensive analysis of patient's Rh phenotype,DAT result and antibody specificity in the serum and absorbed serum and elution of RBC.The low affinity antibody can be better absorbed by adding low ionic liquid (LISS).

Objective To investigate the clinical efficacy of recombinant human epidermal growth factor in the treatment of recurrent oral ulcers in elderly patients.Methods 82 cases of elderly patients in our hospital in the treatment of recurrent oral ulcer were selected,41 cases in the control group,the conventional western medicine treatment,41 cases of the study group,recombinant human epidermal growth factor in treatment before and after treatment,blood determination of immune status,clinical efficacy and adverse reactions of comparison were performed at one-year follow-up.Results the effective rate of treatment group is lower than 78.05％of the effective rate of treatment group 95.12％,study group 3,6 and 12 months recurrence rate(4.88％,7.32％,7.32％)than in the control group the recurrence rate(19.51％,24.39％,29.27％),the study group after the treatment of CD3+ and CD4+/CD8+ and NK were higher than the control group,the CD8+ level is lower than the control group(P<0.05),the two groups had no serious adverse reaction.Conclusion recombinant human epidermal growth factor is effective in the treatment of oral ulcer.

Objective to investigate the clinical efficacy of decompression and pedicle screw fixation through posterior approach for complete thoracic spine fracture dislocation.Methods The clinical data of six patients with complete thoracic spine fracture and dislocation treated from September 2002 to June 2016 were analyzed retrospectively by case series study.There were five males and one female,aged 21-67 years old (mean,47.2 years).The injury segments were T3～4 dislocation in one case,T5～6 dislocation in two cases,T6 ～7 dislocation in two cases and T8 ～9 dislocation in one case.There was one case of ASIA grade E and five cases of Grade A,and all of six cases were associated with multiple rib fractures and hemopneumothorax.The companied status was one case of sternal fracture,one case of atlantoaxial complex fractures and three cases of pulmonary contusion.The posterior median incision decompression and pedicle screw system fixation were performed,and the intervertebral bone grafting was conducted after restoration.The surgery time,bleeding volume during surgery,fracture restoration,bone grafting fusion,failure of internal fixation and other complications were recorded.The Visual Analogue Scale (VAS) and American Spinal Injury Association (ASIA) classification were used to assess the pain and neurological function improvement between the preoperative visit and final follow-up visit.Results The surgery time was 150-240 minutes (mean,205 minutes).The bleeding volume during the surgery was 700-2 100 ml (mean,1167 ml).One case was died of pulmonary infection at one week after surgery,the others were followed up for 3-14 months (mean,7.4 months).After operation,five patients were satisfied with the reduction,and the lateral displacement was partially restored in one cases.Five cases of intervertebral bone grafting all had bone fusion.There was no fixation failure.The VAS was (7.4 ± 0.6) points before surgery,(4.5 ± 1.6) points at one week after surgery and (1.8 ± 0.3) points at final visit of follow-up,which had significant difference from the preoperative status (P ＜ 0.05).One case of ASIA grade E had no postoperative aggravation and four cases of grade A had no improvement.Conclusion Posterior decompression and pedicle screw fixation system is optimal choice of treatment for complete thoracic fractures and dislocations for it can attain reduction of fracture and dislocation as well as bone fusion,provide stability for spine and relieve pain.

Objective To compare the impact of propofol and sevoflurane on thermoregulation in children undergoing orheopaedic surgery.Methods Sixty-eight children scheduled to undergo ortho-paedic surgery were randomly allocated to receive propofol (group P)and sevoflurane(group S)anes-thesia,34 cases in each group.Tympanic temperature was recorded 5 minutes before (T0 )and 5 min (T1 ),1 5 min (T2 ),30 min (T3 ),45 min (T4 ),60 min (T5 ),75 min (T6 ),90 min (T7 ),105 min (T8 )and 120 min (T9 )after anesthesia.Total fluid intake,duration of surgery,duration of anesthe-sia,the incidence of hypothermia,and the incidence of shivering were also recorded.Results Com-pared with T0 ,in both groups body temperature declined at T1-T8 .There was no difference between the two groups in total fluid intake,duration of surgery,duration of anesthesia and the incidence of shivering.Compared with group P,children in group S had a higher incidence of hypothermia(8 vs 1). Children in group S had lower temperature,which had statistical significance at T7 and T8 (P <0.05). Conclusion The core temperature of children undergoing orthopaedic surgery showed a trend of in-crease after the first fall in the surgery.Compared with propofol,sevoflurane anesthesia is more likely to lead to the incidence of hypothermia in children undergoing orthopaedic surgery in 90 min after in-duction of anesthesia.