Objective:To explore the effect of midline approach minimally invasive posterior transforaminal lumbar interbody fusion (MIS-PTLIF) on lumbar function recovery and complications in patients with lumbar degenerative diseases.Methods:A total of 84 patients with lumbar degenerative diseases admitted to the First Hospital of Qinhuangdao from December 2021 to June 2023 were selected and divided into two groups according to the random number table method: 42 cases in the control group were treated with traditional open posterior lumbar interbody fusion (PLIF), and 42 cases in the observation group were treated with midline approach MIS-PTLIF. Perioperative related indicators, Visual Analogue Scale (VAS) scores, creatine phosphokinase (CPK) levels, Oswestry Disability Index (ODI) scores at different time points, and the incidence of postoperative complications were compared between the two groups.Results:The observation group was superior to the control group in operation time, incision length, intraoperative blood loss, time to get out of bed, and hospital stay (all P<0.05). There were no significant differences in preoperative VAS and ODI scores between the two groups (all P>0.05). At 1 week and 3 months after surgery, the VAS and ODI scores of both groups were significantly lower than those before surgery (all P<0.05). The VAS and ODI scores of the observation group at 1 week after surgery were significantly lower than those of the control group (all P<0.05). There was no significant difference in serum CPK level between the two groups 1 day before surgery ( P>0.05). The serum CPK levels of the observation group on the 1st, 3rd, and 5th days after surgery were significantly lower than those of the control group (all P<0.05). The serum CPK level of the observation group on the 5th day after surgery was comparable to that 1 day before surgery ( P>0.05), while that of the control group on the 5th day after surgery was still higher than that 1 day before surgery ( P<0.05). There were no significant differences in the incidence of postoperative complications and fusion rate between the two groups (all P>0.05). Conclusions:MIS-PTLIF has a good short-term effect in the treatment of lumbar degenerative diseases, which can effectively relieve postoperative pain, help the recovery of lumbar function, and its safety and fusion rate are comparable to traditional PLIF, which is worthy of clinical promotion.

Objective To compare the clinical efficacy of the transforaminal endoscopic lumbar discectomy(TELD)approach with that of the interlaminar endoscopic lumbar discectomy(IELD)approach,both performed using a single-channel spinal endoscope,in the treatment of L4-L5 degenerative lumbar lateral recess stenosis(DLLRS).Methods A retrospective analysis was conducted on 78 patients with L4-L5 DLLRS who underwent single-channel endoscopic spinal surgery at our institution between March 2020 and March 2024.Patients were classified into the TELD group(lateral transforaminal approach,n=34)and the IELD group(interlaminar approach,n=44).Propensity score matching(PSM)was performed in a 1∶1 ratio using age,sex,body mass index(BMI),and duration of symptoms as covariates,yielding 25 matched pairs for final comparative analysis.Perioperative outcomes were systematically compared between groups.Visual analog scale(VAS)scores for low back pain and leg pain,as well as the Oswestry Disability Index(ODI),were evaluated preoperatively and at 3 days,3 months,6 months,and 1 year postoperatively.Lumbar computed tomography(CT)scans obtained 3 days after surgery were used to measure the lateral recess angle(LRA)and assess the extent of decompression.Spinal stability was evaluated using dynamic lumbar radiographs at 3 months postoperatively.Clinical outcomes were assessed 1 year after surgery based on the modified MacNab criteria.Results Both groups showed significant reductions in VAS scores for low back and leg pain,as well as in ODI scores,at all postoperative time points compared to baseline values(P<0.05).However,no statistically significant differences were observed between the two groups(P>0.05).Lumbar CT scans performed on postoperative day 3 demonstrated a significant increase in LRA in both groups relative to preoperative measurements(P<0.05).Although the magnitude of increase was greater in the IELD group,the intergroup difference did not reach statistical significance(P>0.05).At 3 months postoperatively,dynamic lumbar radiographs revealed no deterioration in spinal stability in either group compared to preoperative conditions,with no significant difference between groups(P>0.05).According to the modified MacNab criteria at 1 year postoperatively,the excellent and good outcome rate was 88.0%in the TELD group and 92.0%in the IELD group,with no statistically significant difference between the groups(P>0.05).Conclusions Both the TELD and IELD techniques are safe and effective for managing L4-L5 DLLRS,yielding comparable clini-cal outcomes.The selection of surgical approach should be guided by the anatomical location of ventral disc protru-sions,as well as the degree of facet joint hypertrophy and neural compression.

Objective To compare the clinical efficacy of the transforaminal endoscopic lumbar discectomy(TELD)approach with that of the interlaminar endoscopic lumbar discectomy(IELD)approach,both performed using a single-channel spinal endoscope,in the treatment of L4-L5 degenerative lumbar lateral recess stenosis(DLLRS).Methods A retrospective analysis was conducted on 78 patients with L4-L5 DLLRS who underwent single-channel endoscopic spinal surgery at our institution between March 2020 and March 2024.Patients were classified into the TELD group(lateral transforaminal approach,n=34)and the IELD group(interlaminar approach,n=44).Propensity score matching(PSM)was performed in a 1∶1 ratio using age,sex,body mass index(BMI),and duration of symptoms as covariates,yielding 25 matched pairs for final comparative analysis.Perioperative outcomes were systematically compared between groups.Visual analog scale(VAS)scores for low back pain and leg pain,as well as the Oswestry Disability Index(ODI),were evaluated preoperatively and at 3 days,3 months,6 months,and 1 year postoperatively.Lumbar computed tomography(CT)scans obtained 3 days after surgery were used to measure the lateral recess angle(LRA)and assess the extent of decompression.Spinal stability was evaluated using dynamic lumbar radiographs at 3 months postoperatively.Clinical outcomes were assessed 1 year after surgery based on the modified MacNab criteria.Results Both groups showed significant reductions in VAS scores for low back and leg pain,as well as in ODI scores,at all postoperative time points compared to baseline values(P<0.05).However,no statistically significant differences were observed between the two groups(P>0.05).Lumbar CT scans performed on postoperative day 3 demonstrated a significant increase in LRA in both groups relative to preoperative measurements(P<0.05).Although the magnitude of increase was greater in the IELD group,the intergroup difference did not reach statistical significance(P>0.05).At 3 months postoperatively,dynamic lumbar radiographs revealed no deterioration in spinal stability in either group compared to preoperative conditions,with no significant difference between groups(P>0.05).According to the modified MacNab criteria at 1 year postoperatively,the excellent and good outcome rate was 88.0%in the TELD group and 92.0%in the IELD group,with no statistically significant difference between the groups(P>0.05).Conclusions Both the TELD and IELD techniques are safe and effective for managing L4-L5 DLLRS,yielding comparable clini-cal outcomes.The selection of surgical approach should be guided by the anatomical location of ventral disc protru-sions,as well as the degree of facet joint hypertrophy and neural compression.

Objective:To explore the effect of midline approach minimally invasive posterior transforaminal lumbar interbody fusion (MIS-PTLIF) on lumbar function recovery and complications in patients with lumbar degenerative diseases.Methods:A total of 84 patients with lumbar degenerative diseases admitted to the First Hospital of Qinhuangdao from December 2021 to June 2023 were selected and divided into two groups according to the random number table method: 42 cases in the control group were treated with traditional open posterior lumbar interbody fusion (PLIF), and 42 cases in the observation group were treated with midline approach MIS-PTLIF. Perioperative related indicators, Visual Analogue Scale (VAS) scores, creatine phosphokinase (CPK) levels, Oswestry Disability Index (ODI) scores at different time points, and the incidence of postoperative complications were compared between the two groups.Results:The observation group was superior to the control group in operation time, incision length, intraoperative blood loss, time to get out of bed, and hospital stay (all P<0.05). There were no significant differences in preoperative VAS and ODI scores between the two groups (all P>0.05). At 1 week and 3 months after surgery, the VAS and ODI scores of both groups were significantly lower than those before surgery (all P<0.05). The VAS and ODI scores of the observation group at 1 week after surgery were significantly lower than those of the control group (all P<0.05). There was no significant difference in serum CPK level between the two groups 1 day before surgery ( P>0.05). The serum CPK levels of the observation group on the 1st, 3rd, and 5th days after surgery were significantly lower than those of the control group (all P<0.05). The serum CPK level of the observation group on the 5th day after surgery was comparable to that 1 day before surgery ( P>0.05), while that of the control group on the 5th day after surgery was still higher than that 1 day before surgery ( P<0.05). There were no significant differences in the incidence of postoperative complications and fusion rate between the two groups (all P>0.05). Conclusions:MIS-PTLIF has a good short-term effect in the treatment of lumbar degenerative diseases, which can effectively relieve postoperative pain, help the recovery of lumbar function, and its safety and fusion rate are comparable to traditional PLIF, which is worthy of clinical promotion.

Objective:To explore the effect of mild hearing loss on cognitive function by evaluating the Montreal Cognitive Assessment（MoCA） in idiopathic tinnitus patients with mild hearing loss. Methods:102 patients with idiopathic tinnitus（68 patients with normal hearing and 34 patients with mild hearing loss） whose first complaint is tinnitus and 34 healthy volunteers（control group） were included. All subjects were asked to fill the MoCA, Tinnitus Handicap Inventory（THI）, Self-rating Anxiety Scale（SAS）, Self-rating Depression Scale（SDS）, and Pittsburgh Sleep Index（PQSI） after collecting medical history, pure tone audiometry, tinnitus matching and masking test. The clinical characteristics and scores of each scale were compared among the groups. Results:The score and each dimension score of MoCA in idiopathic tinnitus patients with normal hearing were significantly lower than the normal population（P<0.05）; compared with patients with idiopathic tinnitus with normal hearing, patients with mild hearing loss were older（P<0.01） and had lower MoCA scores（P<0.05）. There was no significant difference in MoCA scores（P>0.05） between tinnitus patients with normal hearing and mild hearing loss after correcting confounding factors（age, gender, years of education, duration of tinnitus, frequency of tinnitus tones, side of tinnitus, THI score, SAS score, SDS score, and PQSI score）; idiopathic tinnitus patients with mild hearing loss scored significantly lower in attention and working memory dimensions than idiopathic tinnitus patients with normal hearing（P<0.01）. Conclusion:Patients with idiopathic tinnitus may have cognitive dysfunction, and mild hearing loss may not be a factor that promotes the further aggravation of cognitive dysfunction in patients with idiopathic tinnitus. The role of hearing loss in cognitive dysfunction in patients with idiopathic tinnitus needs further research.
Humans ; Tinnitus/psychology* ; Male ; Female ; Hearing Loss/complications* ; Middle Aged ; Mental Status and Dementia Tests ; Cognition ; Audiometry, Pure-Tone ; Case-Control Studies ; Adult

Objective To explore the origin of ovarian high grade serous carcinoma(HGSC) through analysing the expression and significance of PAX8,PAX2,p53 and RAS in the ovary and fallopian tube of different types and grades of serous carcinoma. Methods A total of 44 cases tissue samples of ovarian tumor including 34 malignant ovarian tumor and 10 normal normal tissue (as control group) were collected from the admitted patients in Affiliated Tumor Hospital of Guangxi Medical University from January 2015 to January 2016. Fallopian tube tissues were segmented in accordance with the fimbria, ampulla, isthmus and the corresponding ovarian tissues were by the side. There were 34 cases of patients with ovarian cancer including 29 cases of epithelial ovarian cancer (27 serous carcinoma, 1 mucinous carcinoma,1 endometrioid adenocarcinoma)and 5 non-epithelial ovarian cancer(sex cord-interstitial tumor). Among 27 cases of patients with ovarian serous cancer,there were 23 HGSC and 4 low-grade ovarian serous cancer (LGSC). One hundred fifty-three cases of samples were diagnosed as ovarian serous cancer by Shandong University Affiliated Qilu Hospital from 2005 to 2013 and these samples were made tissue microarray.(1)To analyze the expression and differences of PAX8,PAX2,p53 and RAS in the above tissues and tissue microarray from ovarian and tubal of HGSC and control women by immunohistochemistry methods.(2)To compare the expression levels of PAX8,PAX2,p53 and RAS in ovarian and fallopian tubes of ovarian cancer patients with different pathological types. (3) To analyze the correlations of tubal and ovarian tissue in PAX8,PAX2,p53 and RAS expression of HGSC.(4)To analyze the factors of the prognosis of ovarian serous cancer in tissue microarray by single factor analysis method. Results (1)PAX8,PAX2, p53 and RAS expression was negative in normal ovarian epithelium of control group,but the expression of PAX8, PAX2, p53 and RAS were strongly positive brown in secrete cells of normal fallopian tube epithelium.(2)p53 and RAS expression of fallopian tube epithelium in the epithelial ovarian cancer group were significantly higher than those in the non-epithelial ovarian cancer groups(P<0.05),but the expression of PAX8 and PAX2 in fallopian tube and the expression of PAX8,PAX2,p53 and RAS in ovarian tissue was not statistically significant in the groups(P>0.05).PAX8,PAX2 and p53 expression of the ovarian in HGSC group were significantly higher than those in LGSC group(P<0.05),while the expression of RAS was lower in the ovarian of the high-grade group (P<0.05), while the expression of PAX8, PAX2, p53 and RAS in fallopian tube was not statistically significant in the groups(P>0.05).(3)There was a significantly positive correlation between fallopian tube and the corresponding ovary of HGSC in PAX8 and PAX2 expression(r=0.422, P=0.045; r=0.693, P=0.000), but not correlation in p53 and RAS expression (r=0.058, P=0.793; r=-0.190,P=0.384).(4)Univariate survival analysis showed that the progression free survival time in patients with ovarian serous cancer group was significantly correlated with the protein expression of PAX8, PAX2 and RAS(P<0.05),but there were not correlated with age,surgical staging,cell differentiation,lymph node metastasis and preoperative chemotherapy and p53 protein expression (P>0.05). The total survival time in patients with ovarian serous cancer group was significantly correlated with the protein expression of PAX8 (P<0.05),but there were not correlated with age,surgical staging,cell differentiation,lymph node metastasis and preoperative chemotherapy and the protein expression of PAX2, RAS and p53 (P>0.05). Conclusions PAX8, PAX2, p53, RAS are of great significance for the study of origin of HGSC. HGSC may be derived from fallopian tube, but further investigation would be necessary to confirm this. PAX8, PAX2, p53, RAS could be expected to be used as predictors of survival prognosis in patients with ovarian serous cancer.

Objective To investigate the status of the humanistic caring ability in the secondary vocational nursing school students,and analyze its influencing factors to provide reference for humanistic education. Methods A total of 468 nursing students from 13 classes of 4 secondary vocational schools were selected as research subjects from March 2017 to May 2017 by random sampling method. All the research subjects were investigated by Caring Ability Inventory(CAI), Charles F. Kettering (CFK) School Climate Inventory, Peer Caring Measurement (PCM), Parent Bonding Instrument-Mother (PBI-M) and Parent Bonding Instrument-Father (PBI-F). Results The total score of secondary vocational nursing students' CAI was (175.47±18.77).The scores of humanistic care ability of nursing students were significantly correlated with school care climate score, mother caring score, class care atmosphere,degree of family harmony, feeling the love of other family members, frequency of contact with family and father caring score, according to Pearson correlation analysis (r=0.315,0.159,0.165,0.186,0.179,0.128,0.134;P<0.05). Conclusions In general, the humanistic caring ability of the secondary nursing school students is at low level. The school care environment score, class care atmosphere, degree of family harmony have great influence on the humanistic care ability of nursing students.

Objective To study effects of polo-like kinase-1(PLK1)small interfering RNA(siRNA)on proliferation and apoptosis of undifferentiated human thyroid cancer cells.Methods 5 PLK1 siRNA(S1,S2,S3,S4 and S5)were constructed and used to transfect human thyroid cancer cell line ARO.RT-PCR was employed to pick out the most effective siRNA,which was then used to transfect ARO cell.RT-PCR and western blot were used to detect PLK1 expression in thyroid cancer cells,which were divided into different groups.MTT assay was performed to examine the effects of PLK1 siRNA on thyroid cancer cells in all groups.Apoptosis of thyroid cancer cells was observed by caspase-3 activity and TUNEL.Results All the 5 siRNA down-regulated PLK1 mRNA expression.among which S4 showed the best effect.S4 transfection could obviously inhibit proliferation of thyroid cancer cells in dose and time dependent manner.Compared with control groups,caspase-3 activity of cancer cells in s4 transfeeted group increased significantly.The effect of S4 transfection was dose and time dependent.TUNEL results showed apoptosis of cancer cells transfected by S4 siRNA was obvious and apoptosis of cells was dose-dependent.Conclusions PLK1 may play an important role in proliferation of undifferentiated thyroid carcinoma.PLK1 siRNA transfection can inhibit proliferation of throid cancer cell through apoptosis induction.

Objective To explore the effect of melatonin on mitochondria in streptozotocin (STZ)-induced diabetic rats and its potential mechanism. Methods The diabetic rat models were induced by intraperitoneal injection of STZ, and the diabetic rats were randomly divided into two groups: diabetes mellitus group (DM group) and melatonin-treated group (DM± MT group). The normal non-diabetic rats were served as control group. Mitochondrial membrane potential and mitochondrial swelling were measured, the expression of voltage-dependent anion channel (VDAC)was assayed by immunohistochemistry in the heart, liver and kidney among the different groups after 8 weeks. Results (1)Compared with DM group, mitochondrial membrane potential in the heart,liver and kidney were significantly elevated in DM± MT group (553.6± 193.5 vs. 311.4 ± 133.7;745.7±115.8 vs. 358.9±158.7; 951.6±246.1 vs. 425.8±177.9, all P＜0.05). (2)Compared with DM group, mitochondrial swelling in the heart, liver and kidney was reinforced in DM ± MT group. (3)Compared with DM group, the expressions of VDAC in the heart, liver and kidney were significantly up-regulated in DM± MT group (76.93 ± 8.263 vs. 58.59 ± 7.62, 50.69 ± 6.33 vs.40.11±6.30, 77.86±8.59 vs. 61.44± 12.86, all P＜0.05). Conclusions Melatonin has protective effect on the activity of mitochondria in the heart, liver and kidney in diabetic rats possibly by up-regulating the expression of VDAC.

Objective To investigate the antimicrobial susceptibility of Pseudomonas aeruginosa (P. aeruginosa) isolated from Zhenjiang area to 13 routinely used antibiotics and identify the structure and dissemination of class Ⅰ integron. Methods K-B test was used to determine the resistant rate of 71 strains of P. aeruginosa. DNA template was extracted by boiling method, PCR method was utilized to detect class Ⅰintegron, and subsequently gene cassettes were analyzed by sequencing. Results The resistant rates to 13 routinely used antibiotics were quite different from 18. 3 to 77.5% among 71 strains of P. aeruginosa. The prevalence of class Ⅰ integron was 38%. These integrons include 5 gene cassettes ( aadB, aac (6) - Ⅱ , PSE-Ⅰ , dfrA17 and aadAS), in which dfrA17 and aadA5 gene cassette were frequently found. Comparing with the negative strains of integron, the positive strains of integron has obviously higher resistance to ten the antibiotics including piporacillin, piperacillin-tazobactam, ceftriaxone, cefepime, ceftazidime, gentamicin,amikacin, tobmmycin, levofloxacin, and ciprofloxacin. Conclusions The resistant rates of P. aeruginosa to 13 drugs were different, and the resistant rates of integron positive strains were obviously higher than integron negative strains, which indicates that integron may play an important role in multidrug reisistance of P. aeruginoosa.