Objective To investigate the relationship between cerebrospinal fluid(CSF)colony stimulating factor 1 receptor(CSF1R)and CSF biomarkers of Alzheimer disease(AD),and to analyze whether CSF1R is associated with mild cognitive impairment patients'cognition.Methods Data from non-demented adults were collected from the Alzheimer Disease Neuroimaging Initiative database,and participants were divided into four groups(A-/TN-,A+/TN-,A+/TN+and A-/TN+),according to the NIA-AA criteria,and the dynamic changes of CSF1R in CSF at different pathological stages of AD were tracked.Multiple linear regression models were used to analyze the relationship between CSF1R and AD biomarkers and cognition,and mediation models were used to investigate the potential association between CSF1R and AD pathology.Results A total of 451 non-demented adults were enrolled in this study,and we found that CSF CSF1R levels were increased in the A-/TN+group(P<0.05)and the A+/TN+group(P<0.05)compared with the A+/TN-group.CSF CSF1R levels were significantly and positively correlated with CSF tau protein(P<0.001)and phosphorylated tau protein(P<0.001)levels but not with amyloid β-protein(P=0.123),and similar results were obtained in the cognitively normal and mild cognitive impairment groups.In the mild cognitive impairment group,higher CSF CSF1R levels were associated with lower cognitive(P<0.05)levels.Furthermore,the relationship between CSF1R and AD pathology was mediated in part by soluble triggering receptor expressed on myeloid cells 2(sTREM2)(percentage:19.3%to 31.4%).Conclusions This study is the first study to discover the association of CSFIR with AD biomarkers and cognition,and CSF1R may influence AD pathology through soluble TREM2(sTREM2).

Objective To investigate the relationship between cerebrospinal fluid(CSF)colony stimulating factor 1 receptor(CSF1R)and CSF biomarkers of Alzheimer disease(AD),and to analyze whether CSF1R is associated with mild cognitive impairment patients'cognition.Methods Data from non-demented adults were collected from the Alzheimer Disease Neuroimaging Initiative database,and participants were divided into four groups(A-/TN-,A+/TN-,A+/TN+and A-/TN+),according to the NIA-AA criteria,and the dynamic changes of CSF1R in CSF at different pathological stages of AD were tracked.Multiple linear regression models were used to analyze the relationship between CSF1R and AD biomarkers and cognition,and mediation models were used to investigate the potential association between CSF1R and AD pathology.Results A total of 451 non-demented adults were enrolled in this study,and we found that CSF CSF1R levels were increased in the A-/TN+group(P<0.05)and the A+/TN+group(P<0.05)compared with the A+/TN-group.CSF CSF1R levels were significantly and positively correlated with CSF tau protein(P<0.001)and phosphorylated tau protein(P<0.001)levels but not with amyloid β-protein(P=0.123),and similar results were obtained in the cognitively normal and mild cognitive impairment groups.In the mild cognitive impairment group,higher CSF CSF1R levels were associated with lower cognitive(P<0.05)levels.Furthermore,the relationship between CSF1R and AD pathology was mediated in part by soluble triggering receptor expressed on myeloid cells 2(sTREM2)(percentage:19.3%to 31.4%).Conclusions This study is the first study to discover the association of CSFIR with AD biomarkers and cognition,and CSF1R may influence AD pathology through soluble TREM2(sTREM2).

Objective: To describe the sickness absenteeism among primary and secondary school students in Jiading District and to analyze its correlation with the incidence of infectious diseases and associated lead or lag times, so as,to provide a scientific basis for the health and education departments to take measures. Methods: The regularity and symptom composition of school sickness absenteeism among primary and secondary school students in Jiading District from the 2010-2017 were described. The Joinpoint model was applied to analyze the changing trend of absenteeism. And the rate of school sickness absenteeism and incidences of 7 acute infectious diseases were compared through visual analysis. The time lagged correlation coefficients and Granger causality tests were applied to quantitatively analyze the correlation and lead/lag patterns. Results: The average rate of school sickness absenteeism among primary and secondary school students in Jiading District, Shanghai was 0.27%. Since the 2012 academic year, the overall rate of sickness absenteeism has been on the rise. Fever was the most common symptom of absenteeism (47.49%). The trend of sickness absenteeism rate was mainly consistent with the incidence of influenza, and showed a one way Granger causality. The maximum time lagged correlation coefficient was obtained in the second semester of the 2017 academic year with a value of 0.43 (95% CI =0.25-0.58). The maximum time lagged correlation coefficient between the rate of sickness absenteeism with fever and other respiratory symptoms and the incidence of influenza was also obtained in the second semester of the 2017 academic year and the maximum correlation coefficient was 0.50(95% CI =0.33-0.65). Conclusion The sickness absenteeism rate in primary and secondary school students is correlated to influenza incidence, and it has potential application value in supplementing early warning of influenza activities in the community.

Objective:To compare and analyze the differences of exercise cardiopulmonary function and the correlation of different cardiopulmonary function indexes among different aircraft types in pilots.Methods:Retrospective study was used. The exercise cardiopulmonary function of 68 Air Force pilots who were qualified for flight in aeromedical identification were tested with the Italian Cosmed exercise cardiopulmonary function tester at a power increasing rate of 25 W/min. The subjects were divided into fighter group and other aircraft group according to aircraft types. The differences of exercise cardiopulmonary function between 2 groups were compared. The correlation between maximal oxygen uptake and age, body mass index, and the correlation between heart rate recovery and exercise endurance were analyzed.Results:There were significant differences in maximal heart rate, respiratory quotient and heart rate recovery value at 1 min after exercise between fighter group (32 cases) and other aircraft group (36 cases) ( t=2.28, 2.50, 2.37, P=0.026, 0.049, 0.021). There was no significant difference in other indexes. The maximal oxygen uptake was negatively correlated with age and body mass index ( r=-0.329, -0.339, both P<0.001). The values of heart rate recovery at 2 min and 3 min after exercise were positively correlated with maximal oxygen uptake and maximal exercise power ( r=0.284, 0.290, 0.306, 0.268, P=0.001, 0.026, 0.002, 0.002). Conclusions:The indexes of exercise cardiopulmonary function have significant differences among pilots in different aircraft types, and there are significant changes with age and weight gain. The heart rate after exercise can monitor the changes of cardiopulmonary function under different training conditions.

Objective:To compare and analyze the differences of exercise cardiopulmonary function and the correlation of different cardiopulmonary function indexes among different aircraft types in pilots.Methods:Retrospective study was used. The exercise cardiopulmonary function of 68 Air Force pilots who were qualified for flight in aeromedical identification were tested with the Italian Cosmed exercise cardiopulmonary function tester at a power increasing rate of 25 W/min. The subjects were divided into fighter group and other aircraft group according to aircraft types. The differences of exercise cardiopulmonary function between 2 groups were compared. The correlation between maximal oxygen uptake and age, body mass index, and the correlation between heart rate recovery and exercise endurance were analyzed.Results:There were significant differences in maximal heart rate, respiratory quotient and heart rate recovery value at 1 min after exercise between fighter group (32 cases) and other aircraft group (36 cases) ( t=2.28, 2.50, 2.37, P=0.026, 0.049, 0.021). There was no significant difference in other indexes. The maximal oxygen uptake was negatively correlated with age and body mass index ( r=-0.329, -0.339, both P<0.001). The values of heart rate recovery at 2 min and 3 min after exercise were positively correlated with maximal oxygen uptake and maximal exercise power ( r=0.284, 0.290, 0.306, 0.268, P=0.001, 0.026, 0.002, 0.002). Conclusions:The indexes of exercise cardiopulmonary function have significant differences among pilots in different aircraft types, and there are significant changes with age and weight gain. The heart rate after exercise can monitor the changes of cardiopulmonary function under different training conditions.

Objective:To investigate the clinical outcome of microdissection testicular sperm extraction (microTESE) combined with intracytoplasmic sperm injection (ICSI) in patients with nonobstructive azoospermia (NOA) associated with mumps orchitis.Methods:The clinical data of NOA patients who underwent microTESE from December 2013 to October 2019 in the ICSI treatment cycle in Assisted Reproduction Center, Northwest Women and Children's Hospital were collected. All the patients who had a history of mumps were divided into two groups according to whether they had mumps orchitis or not. The clinical outcomes after the implementation of microTESE combined with ICSI were compared.Results:A total of 52 NOA patients were finally collected in the present study and 26 patients successfully processed sperm retrieval, the total sperm retrieval rate (SRR) was 50.0% (26/52). The SRR was 94.4% (17/18) in ornitis group, and 26.5% (9/34) in non-ornitis group. The difference between the two groups was statistically significant ( P<0.001). ICSI treatment was tried in sperm patients, and the clinical pregnancy rate was 61.5% (16/26). There was no statistically significant difference in the clinical pregnancy rate and the early pregnancy abortion rate between ornitis group and non-ornitis group [58.5% (10/17) vs. 66.7% (6/9), P=0.696; 20.0% (2/10) vs. 16.7% (1/6), P=0.868]. In the laboratory data, the difference of two pronucleus rate between orchitis group and non-orchitis group was statistically significant (73.9% vs. 57.0%, P=0.006), while the difference of high-quality embryo rate between the two groups was not statistically significant (44.2% vs. 56.8%, P=0.144). Conclusion:The SRR of NOA patients with mumps orchitis was higher that of out ornitis. And good results can be expected when microTESE and ICSI treatment are performed at the same period.

Objective:To investigate the clinical outcome of microdissection testicular sperm extraction (microTESE) combined with intracytoplasmic sperm injection (ICSI) in patients with nonobstructive azoospermia (NOA) associated with mumps orchitis.Methods:The clinical data of NOA patients who underwent microTESE from December 2013 to October 2019 in the ICSI treatment cycle in Assisted Reproduction Center, Northwest Women and Children's Hospital were collected. All the patients who had a history of mumps were divided into two groups according to whether they had mumps orchitis or not. The clinical outcomes after the implementation of microTESE combined with ICSI were compared.Results:A total of 52 NOA patients were finally collected in the present study and 26 patients successfully processed sperm retrieval, the total sperm retrieval rate (SRR) was 50.0% (26/52). The SRR was 94.4% (17/18) in ornitis group, and 26.5% (9/34) in non-ornitis group. The difference between the two groups was statistically significant ( P<0.001). ICSI treatment was tried in sperm patients, and the clinical pregnancy rate was 61.5% (16/26). There was no statistically significant difference in the clinical pregnancy rate and the early pregnancy abortion rate between ornitis group and non-ornitis group [58.5% (10/17) vs. 66.7% (6/9), P=0.696; 20.0% (2/10) vs. 16.7% (1/6), P=0.868]. In the laboratory data, the difference of two pronucleus rate between orchitis group and non-orchitis group was statistically significant (73.9% vs. 57.0%, P=0.006), while the difference of high-quality embryo rate between the two groups was not statistically significant (44.2% vs. 56.8%, P=0.144). Conclusion:The SRR of NOA patients with mumps orchitis was higher that of out ornitis. And good results can be expected when microTESE and ICSI treatment are performed at the same period.

Objective To investigate the clinical efficacy of treating injury to the upper cervical spine with posterior internal fixation without bone graft fusion.Methods Included in this retrospective study were 35 patients with upper cervical injury who had been treated at Department of Orthopedics,The Second Affiliated Hospital to Soochow University from June 2010 to August 2017.They were 21 males and 14 females with an average age of 44.1 years (from 26 to 56 years).They were all treated firstly by posterior occipitocervical internal fixation or internal fixation with atlantoaxial pedicle screws without bone graft fusion.The internal fixation was then removed after a solid bone union was confirmed by X-ray.The scores of Japanese Orthopedic Association (JOA),visual analogue scale (VAS),Neck disability index (NDI) and neck stiffness were used to evaluate the functional recovery of the upper cervical spine.We also observed the rotational range of the upper cervical spine using functional CT scan of C 1-C2.Results All the pedicle screws were successfully implanted after satisfactory intraoperative reduction,leading to no injury to the vertebral artery or spinal cord.All patients were followed up for an average of 18.1 months (from 7 to 28 months).At preoperation,post-implantation and final follow-up,the JOA scores were 6.5 ± 1.4,7.7 ± 1.5 and 16.1 ± 0.8 points,the VAS scores 6.1 ± 1.6,2.8 ± 0.8 and 1.1 ± 0.9 points,and the NDI scores 37.9 ± 2.6,20.3 ± 3.8 and 3.7 ± 1.7 points,showing significant improvements after internal fixation and after removal of internal fixation (P ＜ 0.05).Serious neck stiffness was observed in none of the 35 patients,mild neck stiffness in 12 patients and freedom from neck stiffness in 23 patients.The postoperative radiological analysis revealed fine fracture reduction and bony union in all.After 6 to 12 months the rotation of upper cervical spine was obviously improved and the left-to-right range of rotation of C 1-C2 was 35.4° ± 2.6° as revealed by functional CT scan.Conclusion For the middle aged and young patients with new injury to the upper cervical spine,the posterior occipitocervical internal fixation or internal fixation with atlantoaxial pedicle screws can be performed without bone graft fusion at the first stage and removal of internal fixation can be done at the second stage so that the atlantoaxial rotation can be preserved to ensure satisfactory clinical efficacy while bone union can be also ensured and pain reduced.

Objective:To analyze the operation technique and the methods to avoid early complications on the learning curve for bilateral direct anterior approach (DAA) total hip arthroplasty (THA).Methods: We retrospectively studied a series of continued cases with bilateral avascular necrosis of the femoral head (AVN) or degenerative dysplastic hip and rheumatoid arthritis that were treated by DAA THA in Beijing Jishuitan Hospital.A total of 22 patients with 44 hips were analyzed from June 2014 to August 2016 in this study.There were 17 males and 5 females,and the median age was 48 years(range: 34-67 years).All the surgery was done by DAA method by two senior surgeons.The clinic characters,early surgery treatment results and complications were analyzed.Results: We used the cementless stems in all the cases.The average operating time was (167±23) min;the average blood loss was (775±300) mL;the blood transfusion was in average (327±341) mL;the wound drainage in average was (111±73) mL Most of the patients could move out of the bed by themselves on the first day after operation,5 patients could walk without crutches on the first operating day,and 13 patients could squat on the third days after operation.The patients were discharged averagely 4 days after operation.We followed up all the patients for averagely 16 months (range: 8-24 months).There was no loosening or failure case in the latest follow up.In the study,2 patients had great trochanter fracture,2 patients had thigh pain,4 patients had lateral femoral cutaneous nerve palsy,and 3 patients had muscle damage.The Harris scores were improved from 29±8 preoperatively to 90±3 postoperatively (P<0.01).Conclusion: The DAA THA can achieve faster recovery and flexible hip joint after operation.However it is a kind of surgery with high technique demanding.Carefully selected patients,and skilled technique,can help the surgeon avoid the early complications.It is associated with high complication rate in the learning curve for bilateral DAA THA.

Objective To analyze the characteristics and changes in the disease spectrum of Air Force(AF) servicemen in order to provide reference for the determinatron of the overall level of health of AF and priorities of disease prevention and control.Methods The data of outpatient and inpatient diseases between 2009 and 2013 in AF was collected and analyzed statistically according to the International Classification of Diseases-9(ICD-9),and statistical description was performed with SPSS18.0.Results Between 2009 and 2013,unit B had the highest number of outpatients and inpatients,accounting for 47.74% and 39.64% respectively.The upper respiratory tract infections,gastroenteritis/gastritis,chronic low back pain,skin diseases,nasal sinusitis,training injury,trauma,hemorrhoids,varicocele and stone diseases were the common and frequently occurring diseases in AF,which were the top ten in the disease spectrum.Among them,the incidence and admission rate of skin diseases kept declining.However,the incidence of gastroenteritis/gastritis in unit A,the incidence and admission rate of chronic low back pain in unit B and D,the incidence of injury in unit D,as well as the incidence of neurological headache and hypertension in unit C and D were higher than in other units.Conclusion Respiratory system disease,and occupation-related diseases such as low back pain,training injuries,trauma,skin disease and digestive system disease are the focus of health care in AF.Health education and health promotion for these diseases should be improved,and health intervention for key populations should be enhanced.