BACKGROUND:Oblique lumber interbody fusion has become a mature lumbar fusion method at present,and its method of assisting lateral screw-rod fixation under the same channel has attracted attention in recent years.However,there is currently no consensus on the optimal intraoperative placement of lateral screw-rod,and there is a lack of relevant biomechanical evidence.OBJECTIVE:To establish various oblique lumber interbody fusion combined with lateral screw-rod fixation models,evaluate their impact on lumbar spine biomechanics,and provide biomechanical foundations for the implantation of lateral screw-rod.METHODS:Using CT images of a healthy adult,the L4-L5 Stand-Alone oblique lumber interbody fusion model and lateral screw-rod fixation models with different screw placement positions were established by using Mimics,Geomagic and SolidWorks software,including nine double screw-rod fixation models and five single screw-rod fixation models.Ansys Workbench software was employed to analyze the range of motion,peak stress of internal fixation and cage under conditions of flexion,lateral bending,and rotation.RESULTS AND CONCLUSION:(1)The range of motion of all internal fixation models was less than Stand-Alone oblique lumber interbody fusion model.Both single screw-rod and double screw-rod showed the least range of motion when placed close to the upper endplates of L4 and L5,and the former had more restrictions on the motion.(2)The peak stress of cage in all internal fixation models was lower than Stand-Alone oblique lumber interbody fusion model.Except for right rotation condition,double screw-rod was minimal cage stress when placed anterior superior and posterior inferior quadrants of L4 and L5,which was similar to that when placed proximaly to L4 lower and L5 upper endplates;screw-rod showed minimal stress when placed proximally to L4 lower and L5 upper endplates.(3)Under flexion-extension condition,double rod-screw exhibited minimal internal fixation stress when positioned close to the upper endplates of L4 and L5;single-rod fixation showed minimal stress when placed proximally to L4 lower and L5 upper endplates.(4)It is indicated that the position of lateral screw-rod is one of the important factors that affect the biomechanical properties of oblique lumber interbody fusion,double screw-rod performs better biomechanical properties than single-rod fixation.The best biomechanical stability can be obtained when double screw-rod is placed close to the upper endplate of the vertebral body.The risk of cage subsidence is greatly reduced when the double screw-rod is placed in the anterior superior and posterior inferior quadrants of the upper and lower vertebrae or adjacent to the upper and lower endplates.

Objective:To understand the characteristics of faculty in high-level public health schools in China, and analyze the differences in age, area and school level.Methods:Based on the internet information, the faculty information of 18 high-level public health schools was collected for a descriptive analysis on faculty characteristics.Results:There were 1 642 faculty members in the schools of public health in China, in whom 51.8% were women, 92.8% had doctorate, 32.4% had postdoctoral experience and 56.8% were former students staying to teach. The average age of the faculty members was (45.6±9.8) years. Meanwhile the top three study subjects were epidemiology and health statistics (31.0%), occupational health and environmental sanitation (16.5%), and health toxicology (16.3%). In the faculty members aged >40 years, 90.2% had doctorate, 62.6% were former students staying to teach, and 24.7% had no educational background of public health. The proportions of faculty members aged ≤40 years in the three groups mentioned above were 98.2%, 45.8% and 39.1% respectively. In terms of study subject, big data study were mainly conducted in the schools with top subject ranking and the schools in developed areas.Conclusions:The public health faculty was characterized by cross education background and high capability. The study subjects and sub-disciplines varied with schools and areas.

Objective: To investigate the correlation of emotional and behavioral problems with sleep problems in children with cerebral palsy, so as to provide reference for intervention of emotional and behavioral problems in children. Methods: A cross sectional survey was conducted, and 402 children aged 6-18 with cerebral palsy who were adopted by social welfare institutions in Guangzhou City from January 2023 to January 2024 were selected to investigate their full time nurses. The Parents Strengths and Difficulties Questionnaire (SDQ) was used to assess the emotional and behavioral problems of children with cerebral palsy, and the Children s Sleep Habits Questionnaire (CSHQ) was used to assess sleep problems. Multiple linear regression analysis was used to analyze the correlation between the sleep problem of children with cerebral palsy and the emotional and behavioral problems. Results: The prevalence of emotional and behavioral difficulties among children with cerebral palsy was 15.7%. The median sleep problem score of children with emotional and behavioral problems [37.0(36.0, 41.0)] was significantly higher than that of children without emotional and behavioral [35.0(34.0, 36.0)] ( Z =-5.74, P <0.01). The results of multiple linear regression analysis showed that after adjusting covariables such as age, gender, cerebral palsy classification, language retardation, visual impairment and epilepsy, the total sleep problem score of children with cerebral palsy was positively correlated with the total difficulty score ( β= 0.28, 95%CI =0.17-0.34, P <0.05). Conclusions Sleep problems in children with cerebral palsy are associated with emotional and behavioral difficulties. Understanding of the management of sleep problems in children with cerebral palsy should be enhanced to reduce the incidence of emotional and behavioral problems in children with cerebral palsy.

Objective:To explore the relationship and underlying mechanisms between servant leadership and satisfaction of medical staff in tertiary hospitals, and to provide references for improving satisfaction of medical personnel.Methods:From January to June 2023, a questionnaire survey was conducted among on-duty medical staff at a tertiary hospital in Guangzhou using a simple random sampling method. Data corresponding to four key variables: servant leadership, hospital management level, affective commitment, and satisfaction of medical staff were collected. SPSS 25.0 software was used to perform independent samples t-tests and one-way analysis of variance (ANOVA) to examine group differences, and Pearson correlation analysis was conducted to explore the relationships among multiple variables. Amos 24.0 software was employed to construct a structural equation model to conduct confirmatory factor analysis of the four key variables, analyze potential mediating effects, and use multi-group analysis to examine differences in path parameters and structure among groups. Results:A total of 632 valid questionnaires were obtained. The satisfaction score of medical staff was (4.50±0.66)(maximum score was 5 points). Age, years of work experience, and job category had statistically significant effects on satisfaction of medical staff ( F = 5.799, 6.483, 7.671; P = 0.001). All four key variables were significantly positively correlated ( P<0.001). Servant leadership, hospital management level, and affective commitment all had direct positive effects on satisfaction of medical staff, with path coefficients of 0.207, 0.386, and 0.345, respectively ( P <0.05, critical ratio>1.96). Hospital management level and affective commitment each had independent partial mediating effects between servant leadership and satisfaction of medical staff (path coefficients of 0.353 and 0.067, respectively; P = 0.007, 0.018). They also jointly exerted a chain mediating effect (path coefficient of 0.243, P = 0.013). Differences in path effects among different job categories (clinical doctors, nurses, and administrative support staff) were statistically significant ( χ2 = 43.344, df = 24, P = 0.009). Conclusions:The servant leadership in tertiary hospitals can directly influence the satisfaction of medical staff, as well as indirectly influence it through emotional commitment and hospital management level. Moreover, the mechanisms of influence vary among medical staff of different professional categories. Tertiary hospitals should introduce and promote servant leadership styles, enhance the servant leadership behaviors of management personnel, and strengthen the synergistic effects of servant leadership, hospital management level, and affective commitment. Differential adjustment mechanisms should be implemented for different job categories.

Objective:To understand the characteristics of faculty in high-level public health schools in China, and analyze the differences in age, area and school level.Methods:Based on the internet information, the faculty information of 18 high-level public health schools was collected for a descriptive analysis on faculty characteristics.Results:There were 1 642 faculty members in the schools of public health in China, in whom 51.8% were women, 92.8% had doctorate, 32.4% had postdoctoral experience and 56.8% were former students staying to teach. The average age of the faculty members was (45.6±9.8) years. Meanwhile the top three study subjects were epidemiology and health statistics (31.0%), occupational health and environmental sanitation (16.5%), and health toxicology (16.3%). In the faculty members aged >40 years, 90.2% had doctorate, 62.6% were former students staying to teach, and 24.7% had no educational background of public health. The proportions of faculty members aged ≤40 years in the three groups mentioned above were 98.2%, 45.8% and 39.1% respectively. In terms of study subject, big data study were mainly conducted in the schools with top subject ranking and the schools in developed areas.Conclusions:The public health faculty was characterized by cross education background and high capability. The study subjects and sub-disciplines varied with schools and areas.

BACKGROUND:Oblique lumber interbody fusion has become a mature lumbar fusion method at present,and its method of assisting lateral screw-rod fixation under the same channel has attracted attention in recent years.However,there is currently no consensus on the optimal intraoperative placement of lateral screw-rod,and there is a lack of relevant biomechanical evidence.OBJECTIVE:To establish various oblique lumber interbody fusion combined with lateral screw-rod fixation models,evaluate their impact on lumbar spine biomechanics,and provide biomechanical foundations for the implantation of lateral screw-rod.METHODS:Using CT images of a healthy adult,the L4-L5 Stand-Alone oblique lumber interbody fusion model and lateral screw-rod fixation models with different screw placement positions were established by using Mimics,Geomagic and SolidWorks software,including nine double screw-rod fixation models and five single screw-rod fixation models.Ansys Workbench software was employed to analyze the range of motion,peak stress of internal fixation and cage under conditions of flexion,lateral bending,and rotation.RESULTS AND CONCLUSION:(1)The range of motion of all internal fixation models was less than Stand-Alone oblique lumber interbody fusion model.Both single screw-rod and double screw-rod showed the least range of motion when placed close to the upper endplates of L4 and L5,and the former had more restrictions on the motion.(2)The peak stress of cage in all internal fixation models was lower than Stand-Alone oblique lumber interbody fusion model.Except for right rotation condition,double screw-rod was minimal cage stress when placed anterior superior and posterior inferior quadrants of L4 and L5,which was similar to that when placed proximaly to L4 lower and L5 upper endplates;screw-rod showed minimal stress when placed proximally to L4 lower and L5 upper endplates.(3)Under flexion-extension condition,double rod-screw exhibited minimal internal fixation stress when positioned close to the upper endplates of L4 and L5;single-rod fixation showed minimal stress when placed proximally to L4 lower and L5 upper endplates.(4)It is indicated that the position of lateral screw-rod is one of the important factors that affect the biomechanical properties of oblique lumber interbody fusion,double screw-rod performs better biomechanical properties than single-rod fixation.The best biomechanical stability can be obtained when double screw-rod is placed close to the upper endplate of the vertebral body.The risk of cage subsidence is greatly reduced when the double screw-rod is placed in the anterior superior and posterior inferior quadrants of the upper and lower vertebrae or adjacent to the upper and lower endplates.

Objective:To explore the relationship and underlying mechanisms between servant leadership and satisfaction of medical staff in tertiary hospitals, and to provide references for improving satisfaction of medical personnel.Methods:From January to June 2023, a questionnaire survey was conducted among on-duty medical staff at a tertiary hospital in Guangzhou using a simple random sampling method. Data corresponding to four key variables: servant leadership, hospital management level, affective commitment, and satisfaction of medical staff were collected. SPSS 25.0 software was used to perform independent samples t-tests and one-way analysis of variance (ANOVA) to examine group differences, and Pearson correlation analysis was conducted to explore the relationships among multiple variables. Amos 24.0 software was employed to construct a structural equation model to conduct confirmatory factor analysis of the four key variables, analyze potential mediating effects, and use multi-group analysis to examine differences in path parameters and structure among groups. Results:A total of 632 valid questionnaires were obtained. The satisfaction score of medical staff was (4.50±0.66)(maximum score was 5 points). Age, years of work experience, and job category had statistically significant effects on satisfaction of medical staff ( F = 5.799, 6.483, 7.671; P = 0.001). All four key variables were significantly positively correlated ( P<0.001). Servant leadership, hospital management level, and affective commitment all had direct positive effects on satisfaction of medical staff, with path coefficients of 0.207, 0.386, and 0.345, respectively ( P <0.05, critical ratio>1.96). Hospital management level and affective commitment each had independent partial mediating effects between servant leadership and satisfaction of medical staff (path coefficients of 0.353 and 0.067, respectively; P = 0.007, 0.018). They also jointly exerted a chain mediating effect (path coefficient of 0.243, P = 0.013). Differences in path effects among different job categories (clinical doctors, nurses, and administrative support staff) were statistically significant ( χ2 = 43.344, df = 24, P = 0.009). Conclusions:The servant leadership in tertiary hospitals can directly influence the satisfaction of medical staff, as well as indirectly influence it through emotional commitment and hospital management level. Moreover, the mechanisms of influence vary among medical staff of different professional categories. Tertiary hospitals should introduce and promote servant leadership styles, enhance the servant leadership behaviors of management personnel, and strengthen the synergistic effects of servant leadership, hospital management level, and affective commitment. Differential adjustment mechanisms should be implemented for different job categories.

AIM:To comprehend the mechanism by which ginsenoside Rc protects against cerebral ischemia-reperfusion injury(CIRI),with a particular emphasis on pyroptosis.METHODS:The C57BL/6 mice were randomly di-vided into 6 groups:sham group,middle cerebral artery occlusion/reperfusion(MCAO/R)group,ginsenoside Rc+MCAO/R group(Rc group),AMP-activated protein kinase(AMPK)agonist acadesine/5-aminoimidazole-4-carboxamide-1-β-D-ribofuranoside(AICAR)+MCAO/R group(agonist group),and ginsenoside Rc+MCAO/R+AMPK inhibitor Compound C group(Rc+inhibitor group).The mice in agonist group were given 500 mg/kg of AICAR intraperitoneally,while those in Rc+inhibitor group were given 20 mg/kg of Compound C intraperitoneally.Ginsenoside Rc was gavaged into the mice in Rc and Rc+inhibitor groups at a dose of 40 mg/kg once per day for 7 d after modeling,while the mice in sham and MCAO/R groups got the same volume of purified water.With the use of the Zea-Longa score,we determined which mice had neu-rological abnormalities.TTC staining was employed for assessing the cerebral infarct amount in mice,and the dry wet weight technique was utilized for determining the degree of cerebral edema.Moreover,HE staining was used to observe pathological alterations in the brain,and Western blot and RT-qPCR were applied for detecting the expression of AMPK,nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3),caspase-1 and gasdermin-D(GSDMD)in the brains of mice.Lastly,ELISA was employed for measuring the levels of inflammatory factors,interleukin-1β(IL-1β)and IL-18.RESULTS:Brain edema,infarct volume and neurological impairments were all diminished in agonist and Rc groups.Additionally,they demonstrated neuronal damage inhibition.The ratio of p-AMPK/AMPK and AMPK mRNA ex-pression in mouse brain tissues was elevated in both Rc and agonist groups.They showed decreased mRNA and protein levels of NLRP3,caspase-1 and GSDMD,as well as the levels of IL-1β and IL-18.Compared with Rc group,there were remarkable decreases in p-AMPK/AMPK ratio and AMPK mRNA expression in the brain tissue of mice in Rc+inhibitor group(P<0.05).The mRNA and protein levels of NLRP3,caspase-1 and GSDMD,and the IL-1β and IL-18 expression levels were significantly increased(P<0.05).Moreover,the neurological deficiency scores and infarct volume were in-creased,and the degrees of cerebral edema and neuronal pathological damage were enhanced(P<0.05).CONCLU-SION:Ginsenoside Rc may inhibit NLRP3/caspase-1/GSDMD-mediated pyroptosis by activating AMPK pathway,thereby reducing CIRI in mice.

Objective: To investigate the association between cysteine level and lumbar spine (LS) bone mineral density (BMD) among children with cerebral palsy, so as to provide a basis for bone health enhancement among children with cerebral palsy. Methods: A total of 149 children aged 10-18 with cerebral palsy who were admitted to the G city Social Welfare Institute (Luogang District) from January 2023 to January 2024. Basic demographic characteristics of children with cerebral palsy were extracted from medical records system. Cysteine levels were measured using the enzyme cycling method. LS BMD of the children was determined by specialized rehabilitation physicians using dual energy X ray absorptiometry, and the corrected BMD Z -scores for LS were calculated. Non restrictive cubic splines and segmented multiple linear regression were employed to analyze the correlation between cysteine levels and age specific height Z -scores (HAZ scores) for LS BMD in children with cerebral palsy. Results: The median cysteine concentration in children with cerebral palsy was 9.13(8.42, 10.30)μmol/L, with significantly higher levels in spastic type children [9.28(8.53，10.49)μmol/L] compared to non spastic types [8.64(7.89，9.66)μmol/L]( Z=-2.46，P <0.05). The median LS BMD HAZ score was -1.07( -2.10 , -0.16), and the detection rate of decreased bone mass was 29.5%. There was an "L" shaped association between serum homocysteine concentration and LS BMD HAZ score in children with cerebral palsy. When serum homocysteine concentration was below 8.7 μmol/L, a significant negative correlation was observed between LS BMD HAZ score and serum homocysteine concentration ( B=-0.32, 95%CI =-1.06 to -0.15, P <0.05). Conclusions The significant negative correlation between cysteine levels and LS BMD in children with cerebral palsy at lower cysteine concentrations, which suggests a potentially higher sensitivity to the influence of homocysteine than healthy children and adolescents, warranting attention even if not reaching the standard of hyperhomocysteinemia.

Due to the virtues of no stutter peaks, low rates of mutation, and short amplicon sizes, insertion/deletion (InDel) polymorphism is an indispensable tool for analyzing degraded DNA samples from crime scenes for human identifications (Wang et al., 2021). Herein, a self-developed panel of 43 InDel loci constructed previously by our group was utilized to evaluate the genetic diversities and explore the genetic background of the Han Chinese from Beijing (HCB) including 301 random healthy individuals. The lengths of amplicons at 43 InDel loci in this panel ranged from 87 to 199 bp, which indicated that the panel could be used as an effective tool to utilize highly degraded DNA samples for human identity testing. The loci in this panel were validated and performed well for forensic degraded DNA samples (Jin et al., 2021). The combined discrimination power (PD) and combined probability of exclusion (PE) values in this panel indicated that the 43 InDel loci could be used as the candidate markers in personal identification and parentage testing of HCB. In addition, population genetic relationships between the HCB and 26 reference populations from five continents based on 19 overlapped InDel loci were displayed by constructing a phylogenetic tree, principal component analysis (PCA), and population genetic structure analysis. The results illustrated that the HCB had closer genetic relationships with the Han populations from Chinese different regions.
Beijing ; China ; Forensic Genetics/methods* ; Gene Frequency ; Genetics, Population ; Humans ; INDEL Mutation ; Phylogeny