Aortic aneurysm(AA)and aortic dissection(AD)are critical cardiovascular disease emergencies that seriously threaten human life and health.Due to various factors,the progressive reduction of various types of cells,such as smooth muscle cells and endothelial cells in the aortic wall,is an essential mechanism for developing AA and AD.On this basis,AD is induced by mechanical stresses such as hypertension,leading to damaged endothelial rupture or hemor-rhage within the aortic wall.However,AA causes the aortic wall to thin and expand outward in response to stimuli such as prolonged blood flow impingement.At present,increasing evidence shows that various programmed cell death,such as apoptosis,necroptosis,pyroptosis,ferroptosis,copper death,poly ADP-ribose polymerase 1(PARP-1)-dependent cell death,and immunogenic cell death,play essential roles in the pathogenesis of AA and AD.Therefore,understanding the key molecules and pathways in the pathogenesis of AA and AD from the perspective of programmed cell death and searching for inhibitors of various types of programmed death is essential to prevent aortic destruction and disease progression.The review summarizes the roles and research progress of different types of programmed cell death modalities in the development of AA and AD,clarifies the central position of programmed cell death in forming AA and AD,and searches for new thera-peutic methods for the clinic.

Objective To explore the changes in cervical curvature and their influencing factors after percutaneous posterior cervical endoscopic treatment for single segment cervical spondylotic radiculopathy.Methods 200 patients with single segment cervical spondylotic radiculopathy from January 2021 to March 2024 was selected,then divide them into control group and study group according to the random number table method.The control group received traditional open anterior cervical surgery,while the study group received percutaneous posterior cervical endoscopic treatment.Compare the treatment outcomes,surgical related conditions,cervical curvature and other sagittal parameters,pain levels,and cervical function between the two groups of patients.Using the generalized estimation equation(GEE)model to analyze the improvement degree of cervical curvature and other cervical sagittal parameters by two methods,and analyze the risk factors affecting changes in cervical curvature.Results The study group had significantly shorter surgical time,incision length,and hospitalization time compared to the control group.The intraoperative blood loss and hospitalization costs were also significantly lower than those of the control group,and the differences were statistically significant(P<0.05).The excellent rate of the study group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).The C2-7 Cobb angle and T1 tilt angle in the study group were significantly higher than those in the control group,the intervertebral height was significantly higher than that in the control group,and the C2-7 sagittal vertical axis(C2-7 SVA)was significantly smaller than that in the control group,with statistically significant differences(P<0.05).At three months after surgery and the last follow-up,the visual analogue scale(VAS)scores and neck disability index(NDI)of the two groups of patients were significantly lower than those before treatment,and the study group was significantly lower than the control group.At three months after surgery and the last follow-up,the Japanese Orthopaedic Association(JOA)scores of the two groups of patients were significantly higher than those before treatment,and the study group was significantly higher than the control group,with statistically significant differences(P<0.05).Intervertebral height≤8 mm(OR＾=1.627,95%CI:1.401～1.938,P=0.020),T1 tilt angle≤25°(OR＾=1.598,95%CI:1.381～1.934,P=0.027),and no percutaneous cervical endoscopic treatment(OR＾=2.591,95%CI:1.673～3.998,P=0.000)were independent risk factors affecting changes in cervical curvature.C2-7 SVA≤20 cm(OR＾=0.748,95%CI:0.601～0.928,P=0.007)was a protective factor for changes in cervical curvature.According to GEE,the improvement of C2-7 Cobb angle,intervertebral height,T1 tilt angle,and C2-7 SVA in the study group was significantly better than that in the control group,and the differences were statistically significant(P<0.05).Conclusion Percutaneous posterior cervical endoscopic treatment can significantly improve the cervical cervical curvature and cervical sagittal plane parameters of patients with single segment cervical spondylotic radiculopathy,and the treatment effect is better than traditional open anterior cervical surgery.The surgical trauma is smaller,the cost is lower,the hospital stay is shorter,and the postoperative recovery is faster.It is worthy for clinical application.

Aortic aneurysm(AA)and aortic dissection(AD)are critical cardiovascular disease emergencies that seriously threaten human life and health.Due to various factors,the progressive reduction of various types of cells,such as smooth muscle cells and endothelial cells in the aortic wall,is an essential mechanism for developing AA and AD.On this basis,AD is induced by mechanical stresses such as hypertension,leading to damaged endothelial rupture or hemor-rhage within the aortic wall.However,AA causes the aortic wall to thin and expand outward in response to stimuli such as prolonged blood flow impingement.At present,increasing evidence shows that various programmed cell death,such as apoptosis,necroptosis,pyroptosis,ferroptosis,copper death,poly ADP-ribose polymerase 1(PARP-1)-dependent cell death,and immunogenic cell death,play essential roles in the pathogenesis of AA and AD.Therefore,understanding the key molecules and pathways in the pathogenesis of AA and AD from the perspective of programmed cell death and searching for inhibitors of various types of programmed death is essential to prevent aortic destruction and disease progression.The review summarizes the roles and research progress of different types of programmed cell death modalities in the development of AA and AD,clarifies the central position of programmed cell death in forming AA and AD,and searches for new thera-peutic methods for the clinic.

Objective To explore the changes in cervical curvature and their influencing factors after percutaneous posterior cervical endoscopic treatment for single segment cervical spondylotic radiculopathy.Methods 200 patients with single segment cervical spondylotic radiculopathy from January 2021 to March 2024 was selected,then divide them into control group and study group according to the random number table method.The control group received traditional open anterior cervical surgery,while the study group received percutaneous posterior cervical endoscopic treatment.Compare the treatment outcomes,surgical related conditions,cervical curvature and other sagittal parameters,pain levels,and cervical function between the two groups of patients.Using the generalized estimation equation(GEE)model to analyze the improvement degree of cervical curvature and other cervical sagittal parameters by two methods,and analyze the risk factors affecting changes in cervical curvature.Results The study group had significantly shorter surgical time,incision length,and hospitalization time compared to the control group.The intraoperative blood loss and hospitalization costs were also significantly lower than those of the control group,and the differences were statistically significant(P<0.05).The excellent rate of the study group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).The C2-7 Cobb angle and T1 tilt angle in the study group were significantly higher than those in the control group,the intervertebral height was significantly higher than that in the control group,and the C2-7 sagittal vertical axis(C2-7 SVA)was significantly smaller than that in the control group,with statistically significant differences(P<0.05).At three months after surgery and the last follow-up,the visual analogue scale(VAS)scores and neck disability index(NDI)of the two groups of patients were significantly lower than those before treatment,and the study group was significantly lower than the control group.At three months after surgery and the last follow-up,the Japanese Orthopaedic Association(JOA)scores of the two groups of patients were significantly higher than those before treatment,and the study group was significantly higher than the control group,with statistically significant differences(P<0.05).Intervertebral height≤8 mm(OR＾=1.627,95%CI:1.401～1.938,P=0.020),T1 tilt angle≤25°(OR＾=1.598,95%CI:1.381～1.934,P=0.027),and no percutaneous cervical endoscopic treatment(OR＾=2.591,95%CI:1.673～3.998,P=0.000)were independent risk factors affecting changes in cervical curvature.C2-7 SVA≤20 cm(OR＾=0.748,95%CI:0.601～0.928,P=0.007)was a protective factor for changes in cervical curvature.According to GEE,the improvement of C2-7 Cobb angle,intervertebral height,T1 tilt angle,and C2-7 SVA in the study group was significantly better than that in the control group,and the differences were statistically significant(P<0.05).Conclusion Percutaneous posterior cervical endoscopic treatment can significantly improve the cervical cervical curvature and cervical sagittal plane parameters of patients with single segment cervical spondylotic radiculopathy,and the treatment effect is better than traditional open anterior cervical surgery.The surgical trauma is smaller,the cost is lower,the hospital stay is shorter,and the postoperative recovery is faster.It is worthy for clinical application.

Objective: To analyze the diagnostic value of skeletal muscle biopsy in patients with rhabdomyolysis. Methods: Clinical and pathological data of 26 patients with rhabdomyolysis from January 2002 to December 2018 undergoing muscle biopsy were collected. Results: Eighteen males and 8 females were finally recruited with median age of 6-73 (37.3±19.6) years. The average time from onset to biopsy was 44 days (median course was 30 days). All patients had acute manifestations with muscle pain and/or weakness. Serum creatine kinase was between 1 648-92 660 U/L. Muscle biopsies showed nonspecific changes in 12 cases (a few with type 2 muscle fiber atrophy, slight deposition of lipid droplets), 10 cases with necrotizing myopathy (muscle fiber necrosis and regeneration). Toxic neurogenic damages were seen in 2 cases (type 1 and type 2 angular atrophic muscle fibers with group change), lipid storage disease in 1 case (lipid droplets deposit significantly) and idiopathic inflammatory myopathy in 1 case (muscle fiber necrosis and regeneration, with lymphocyte infiltration). The etiology of non-specific pathological changes included short-term strenuous exercise in 6 patients, poisoning in two, chronic kidney disease in one, viral infection in one, hypothyroidism in one and unknown reason in one. As to patients with necrotizing myopathy, seven were poisoning or drug-related, one with hyperthyroidism, two with unknown reason. Conclusions Among the numerous causes of rhabdomyolysis, exercise usually links nonspecific skeletal muscle changes and poisoning or drug-related disorders are commonly associated with necrotic myopathy. Rhabdomyolysis induced by primary myopathy is rare.

Objective: To explore drug resistance of different viral loads, and investigate the relationship between drug resistance and CD4⁺T cell counts in patients with HIV antiretroviral therapy (ART) in China from 2003 to 2015. Methods: Data were extracted from the Chinese National HIVDR Surveillance database from 2003 to 2015. For this study, the data collected were as follows: having received ART for ≥12 months; 18 years or older; demographic characteristics, information of ART, CD4⁺T cell counts, viral load (VL) and HIV drug resistance of a total of 8 362 patients were collected. Multi-variables non-conditional logistic regression model was used to study the relationship between viral load, HIV drug resistance and CD4⁺T cell counts. Results: Participants with age of (41.8±10.5) years were enrolled in this study. Among them, 59.9% (5 009 cases) were men. The percentage of CD4⁺T cell counts <200 cells/μl in the total population was 17.9% (1 496 cases), the highest was in VL ≥1 000 copies/ml with drug resistance, which was 43.0% (397/923) , followed by VL 50-999 copies/ml with drug resistance, which was 31.1% (69/222), and the lowest was in VL 50-999 copies/ml without drug resistance 13.2% (273/2 068). Compared to VL 50-999 copies/ml without drug resistance, VL<50 copies/ml, VL 50-999 with drug resistance, VL≥1 000 copies/ml without drug resistance, and VL ≥1 000 copies/ml with drug resistance, the OR (95%CI) of CD4 <200 cells/μl were 0.9 (0.7-1.0), 3.2 (2.3-4.4), 2.6 (2.1-3.2), and 4.9 (4.0-5.9), respectively. Among 222 patients with VL 50-999 and HIVDR, the most frequent antiretroviral drugs were EFV and NVP, both of which were NNRTI, and whose percentage both were 94.1% (209 cases). The most frequent mutations were M184V/I (NNRTI), and the percentage was 26.1% (58 cases). The second one was K103N (NNRTI), and the percentage was 22.5% (50 cases). The percentage of V32L/E (PI) and V82A (PI) were lower, they were 0.9% (2 cases) and 0.5% (1 case) respectively. Conclusion Decreased CD4⁺T cell counts were associated with HIV drug resistance at low viraemia. In the case of low viral load, the most vulnerable were the NNRTI antiviral drugs such as EFV and NVP.

BACKGROUND: During spinal orthopedic repair, the main difficulty is to maximize the correction of the deformity, simultaneously, to reduce the incidence of trauma and complications, especial y to avoid the corresponding spinal nerve injury. OBJECTIVE: To evaluate the curative effect of one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation in the treatment of rigid angular kyphosis of thoracolumbar spine. METHODS: We retrospectively analyzed the data of 42 cases of rigid angular kyphosis of thoracolumbar spine that were treated by one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation. Al patients received detailed imaging examination before and after operation. Kyphosis angle, Frankel grading and perioperative complications were recorded in al patients. X-ray films or CT films showed the bone graft fusion during fol ow-up. RESULTS AND CONCLUSION: Patients were fol owed up for 10-36 months after treatment. The average time of bone graft fusion was 5.1 months. Cobb’s angle of kyphosis was corrected from 78.4° (38°-110°) preoperatively to 7°(-8°-24°) at 10 days after treatment. The correction rate was 90%. The average angle during final fol ow-up was 7.9°, with an average loss of 0.9°. In 16 paresis patients, Frankel grading results showed grade B in 0 case, grade C in 3 cases, grade D in 5 cases, and grade E in 8 cases during final fol ow-up, showing significant improvement as compared with that pre-treatment (P < 0.05). Among 42 patients, 5 cases had complications. At 7 months after treatment, there were screw and titanium rod loosening at the distal end of the fusion segment in 1 case, cerebrospinal fluid leakage in 2 cases, transient double lower limb weakness in 1 case, pain in one side of lower limb in 1 case, and no severe complications appeared. These results verified that one-stage posterior pedicle subtraction osteotomy of apical vertebra with transpedicular instrumentation could achieve satisfactory clinical outcomes in rigid angular kyphosis of thoracolumbar spine. The internal fixation was stable and with a high fusion rate and few complications. The medium-term effect was satisfactory.