Objective:To evaluate the screw placement guided by C-arm computer navigation in the fixation and fusion of instability of the atlantoaxial joint using atlantoaxial pedicle screws.Methods:A retrospective study was conducted to analyze the clinical data of 30 patients who had been treated for atlantoaxial instability by pedicle screw fixation and fusion at Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University from October 2020 to November 2022. The patients were divided into 2 groups according to whether the C-arm computer navigation system had been used to assist their screw placement. In the observation group, there were 12 patients [9 males and 3 females with an age of (55.6±7.3) years] whose screw placement was assisted by C-arm computer navigation; in the control group, there were 18 patients [13 males and 5 females with an age of (52.4±8.1) years] whose screw placement was assisted by conventional X-ray fluoroscopy. The 2 groups were compared in terms of surgery time, intraoperative bleeding volume, intraoperative fluoroscopy time, incidence of postoperative complications, and neck disability index (NDI) and visual analogue scale (VAS) at 3 months after surgery.Results:The 2 groups were comparable because there were no significant differences in the preoperative general data between them ( P>0.05). All the 30 patients were followed up for (23.8±6.1) months after surgery. The surgery time, intraoperative fluoroscopy time, and intraoperative bleeding volume in the observation group were significantly shorter or smaller, respectively, than those in the control group [(109.5±19.3) min versus (135.6±23.2) min; (43.5±11.7) s versus (68.8±24.5) s; (240.6±65.8) mL versus (320.4±95.6) mL)] ( P<0.05). No vascular or neural injuries or other complications occurred in any of the patients. There was no statistically significant difference between the observation group and the control group in the NDI or VAS pain score at 3 months after surgery [(18.6±7.3) points versus (20.4±9.3) points; (1.6±0.6) points versus (1.4±0.5) points] ( P>0.05). Follow-ups observed no loosening or breakage of implants, no recurrence of instability of the atlantoaxial joint, or no nonunion of the bone grafts. Conclusion:In the treatment of atlantoaxial instability with atlantoaxial pedicle screw fixation and fusion, compared with conventional X-ray fluoroscopy guidance, the screw placement guided by C-arm computer navigation can result in the same therapeutic efficacy but shorter surgery time, less intraoperative blood loss and less radiation exposure.

Objective:To investigate the association between the local renin-angiotensin system (RAS) in human follicular fluid (hFF) and age, ovarian function, in vitro fertilization (IVF) laboratory outcome. Methods:A non-intervention observational study was designed. hFF and medical case history without personal identity of patients who received IVF simply because of male factor infertility in Reproductive Medicine Center, the First Affiliated Hospital of Soochow University during January 2021 and February 2022 were collected. The renin, angiotensin converting enzyme (ACE), ACE2, angiotensin (Ang)Ⅱ and Ang 1-7 levels were detected by enzyme-linked immunosorbent assay kit. The correlation between age and RAS in hFF was analyzed by simple linear regression, and multivariate linear regression was used to further analyze the correlation between the RAS and IVF laboratory outcome.Results:1) A total of 139 samples of analysable hFF were obtained. 2) There was a linear negative correlation between age and renin (Pearson's r=-0.313 3, P<0.001), angiotensin converting enzyme (ACE; Pearson's r=-0.183 6, P=0.031), angiotensinⅡ (AngⅡ; Pearson's r=-0.218 6, P=0.010), ACE/ACE2 (Pearson's r=-0.319 2, P<0.001), AngⅡ/Ang1-7 (Pearson's r=-0.224 3, P=0.008), while the linear relationship with ACE2 and Ang1-7 was not significant (all P>0.05). 3) Basal follicle-stimulating hormone was positively correlated with age ( β=0.636, P<0.001), ACE2 ( β=0.267, P=0.026) and AngⅡ ( β=0.268, P=0.001), while negatively correlated with ACE ( β=-0.320, P<0.001) and Ang1-7 ( β=-0.217, P=0.014). Basal luteinizing hormone was positively correlated with AngⅡ ( β=0.330, P=0.003), while negative correlated with Ang1-7 ( β=-0.395, P=0.002). Antral follicle count was positively correlated with Ang1-7 ( β=0.153, P=0.049), while negatively correlated with age ( β=-0.869, P<0.001) and ACE2 ( β=-0.082, P=0.004). Basal anti-Müllerian hormone was only negatively correlated with age ( β=-0.349, P<0.001). There was no correlation between RAS and basal estradiol, progesterone, prolactin, testosterone (all P>0.05). 4) Oocyte retrieval count was positively correlated with renin ( β=0.146, P=0.014), AngⅡ ( β=0.113, P=0.034) and Ang1-7 ( β=0.185, P=0.002), while negatively correlated with age ( β=-0.717, P<0.001); MⅡ oocyte maturation rate was positively correlated with AngⅡ ( β=0.207, P=0.019) and Ang1-7 ( β=0.217, P=0.026), while negatively correlated with age ( β=-0.518, P<0.001). There was no correlation between RAS and the rates of two pronuclei embryos, transplantable embryos, high-quality embryos (all P>0.05). Conclusion:The local RAS in ovarian follicles is affected by age and correlated with ovarian function and IVF laboratory outcome.

Objective:To investigate the association between the local renin-angiotensin system (RAS) in human follicular fluid (hFF) and age, ovarian function, in vitro fertilization (IVF) laboratory outcome. Methods:A non-intervention observational study was designed. hFF and medical case history without personal identity of patients who received IVF simply because of male factor infertility in Reproductive Medicine Center, the First Affiliated Hospital of Soochow University during January 2021 and February 2022 were collected. The renin, angiotensin converting enzyme (ACE), ACE2, angiotensin (Ang)Ⅱ and Ang 1-7 levels were detected by enzyme-linked immunosorbent assay kit. The correlation between age and RAS in hFF was analyzed by simple linear regression, and multivariate linear regression was used to further analyze the correlation between the RAS and IVF laboratory outcome.Results:1) A total of 139 samples of analysable hFF were obtained. 2) There was a linear negative correlation between age and renin (Pearson's r=-0.313 3, P<0.001), angiotensin converting enzyme (ACE; Pearson's r=-0.183 6, P=0.031), angiotensinⅡ (AngⅡ; Pearson's r=-0.218 6, P=0.010), ACE/ACE2 (Pearson's r=-0.319 2, P<0.001), AngⅡ/Ang1-7 (Pearson's r=-0.224 3, P=0.008), while the linear relationship with ACE2 and Ang1-7 was not significant (all P>0.05). 3) Basal follicle-stimulating hormone was positively correlated with age ( β=0.636, P<0.001), ACE2 ( β=0.267, P=0.026) and AngⅡ ( β=0.268, P=0.001), while negatively correlated with ACE ( β=-0.320, P<0.001) and Ang1-7 ( β=-0.217, P=0.014). Basal luteinizing hormone was positively correlated with AngⅡ ( β=0.330, P=0.003), while negative correlated with Ang1-7 ( β=-0.395, P=0.002). Antral follicle count was positively correlated with Ang1-7 ( β=0.153, P=0.049), while negatively correlated with age ( β=-0.869, P<0.001) and ACE2 ( β=-0.082, P=0.004). Basal anti-Müllerian hormone was only negatively correlated with age ( β=-0.349, P<0.001). There was no correlation between RAS and basal estradiol, progesterone, prolactin, testosterone (all P>0.05). 4) Oocyte retrieval count was positively correlated with renin ( β=0.146, P=0.014), AngⅡ ( β=0.113, P=0.034) and Ang1-7 ( β=0.185, P=0.002), while negatively correlated with age ( β=-0.717, P<0.001); MⅡ oocyte maturation rate was positively correlated with AngⅡ ( β=0.207, P=0.019) and Ang1-7 ( β=0.217, P=0.026), while negatively correlated with age ( β=-0.518, P<0.001). There was no correlation between RAS and the rates of two pronuclei embryos, transplantable embryos, high-quality embryos (all P>0.05). Conclusion:The local RAS in ovarian follicles is affected by age and correlated with ovarian function and IVF laboratory outcome.

Objective:To evaluate the screw placement guided by C-arm computer navigation in the fixation and fusion of instability of the atlantoaxial joint using atlantoaxial pedicle screws.Methods:A retrospective study was conducted to analyze the clinical data of 30 patients who had been treated for atlantoaxial instability by pedicle screw fixation and fusion at Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University from October 2020 to November 2022. The patients were divided into 2 groups according to whether the C-arm computer navigation system had been used to assist their screw placement. In the observation group, there were 12 patients [9 males and 3 females with an age of (55.6±7.3) years] whose screw placement was assisted by C-arm computer navigation; in the control group, there were 18 patients [13 males and 5 females with an age of (52.4±8.1) years] whose screw placement was assisted by conventional X-ray fluoroscopy. The 2 groups were compared in terms of surgery time, intraoperative bleeding volume, intraoperative fluoroscopy time, incidence of postoperative complications, and neck disability index (NDI) and visual analogue scale (VAS) at 3 months after surgery.Results:The 2 groups were comparable because there were no significant differences in the preoperative general data between them ( P>0.05). All the 30 patients were followed up for (23.8±6.1) months after surgery. The surgery time, intraoperative fluoroscopy time, and intraoperative bleeding volume in the observation group were significantly shorter or smaller, respectively, than those in the control group [(109.5±19.3) min versus (135.6±23.2) min; (43.5±11.7) s versus (68.8±24.5) s; (240.6±65.8) mL versus (320.4±95.6) mL)] ( P<0.05). No vascular or neural injuries or other complications occurred in any of the patients. There was no statistically significant difference between the observation group and the control group in the NDI or VAS pain score at 3 months after surgery [(18.6±7.3) points versus (20.4±9.3) points; (1.6±0.6) points versus (1.4±0.5) points] ( P>0.05). Follow-ups observed no loosening or breakage of implants, no recurrence of instability of the atlantoaxial joint, or no nonunion of the bone grafts. Conclusion:In the treatment of atlantoaxial instability with atlantoaxial pedicle screw fixation and fusion, compared with conventional X-ray fluoroscopy guidance, the screw placement guided by C-arm computer navigation can result in the same therapeutic efficacy but shorter surgery time, less intraoperative blood loss and less radiation exposure.

Objective:To investigate the clinical efficacy of oblique intervertebral fusion in the treatment of failed internal fixation of thoracolumbar fractures.Methods:A retrospective study was conducted to analyze the clinical data of 14 patients who had undergone revision surgery for failed internal fixation of thoracolumbar fracture at Department of Orthopedics, The First Hospital Affiliated to Zhengzhou University from January 2014 to December 2021. There were 6 men and 8 women with a mean age of 47.5 (42.0, 54.3) years. Fracture segments: T 12 in 2 cases, L 1 in 3 cases, L 2 in 4 cases, L 3 in 3 cases, and L 4 in 2 cases; AO classification: type A in 1 case, type B in 7 cases, and type C in 6 cases. Their prior surgical method was posterior internal fixation with pedicle screws. The revision surgery consisted of subtotal vertebral resection through the oblique lateral approach, bone column reconstruction and lateral screw-rod internal fixation for intervertebral fusion after posterior internal fixation reset. The operation time, intraoperative bleeding, postoperative hospital stay, and incidence of complications were recorded. Compared were visual analogue scale (VAS) and Oswestry disability index (ODI) scores for low back pain at preoperation, 3 days and 3 months postoperation, and the last follow-up, fusion at the last follow-up, and Frankel grading for neurological function at preoperation and postoperation. Results:All the 14 patients underwent surgery successfully and were followed up for 23 (18, 24) months. The operation time was (175.1±28.2) min, the intraoperative bleeding (300.4±122.6) mL, and the postoperative hospital stay 6 (6, 7) d. One case developed postoperative transient hip flexion weakness but was discharged after restoration of normal muscle strength by conservative treatment. Both VAS and ODI scores for low back pain at all postoperative time points were significantly improved compared with the preoperative values ( P<0.05), with a significant trend of 3 days postoperation >3 months postoperation > the last follow-up ( P<0.05). In the 12 patients with preoperative neurological damage, the Frankel grading rose by at least 1 level postoperatively ( Z=-3.110, P=0.002). The last follow-up revealed no loosening or fracture of the internal fixation. Complete bony fusion was visible in all CT sagittal reconstructions. Conclusion:For patients with thoracolumbar fracture undergoing failed internal fixation, oblique intervertebral fusion is an alternative minimally invasive surgical treatment due to its satisfactory overall outcomes.

Objective:To systematically review the qualitative research on dignity cognition and experience of the elderly in nursing homes.Methods:Qualitative research on the dignity cognition and experience of the elderly in nursing homes was retrieved by computer in PubMed, Web of Science, Cochrane Library, Embase, PsycINFO, CINAHL, China National Knowledge Infrastructure, Wanfang Data, VIP and China Biology Medicine disc. The retrieval time limit was from the establishment of the database to May 31, 2021. The quality of the article was assessed using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center.Results:A total of 10 articles were included, and 30 research results were extracted. The research results were grouped into 8 categories, and 4 integrated results were synthesized, namely, the elderly's cognition of dignity, the impact of impaired dignity on the elderly, the factors affecting the maintenance of dignity, and the elderly's dignity maintenance strategies.Conclusions:Nursing homes should attach importance to the dignity of the elderly, provide dignity care, protect the autonomy of the elderly, and strengthen the social support system to promote the realization of the elderly with dignity.

Cathepsin D (CTSD), the major lysosomal aspartic protease that is widely expressed in different tissues, potentially regulates the biological behaviors of various cells. Follicular granulosa cells are responsive to the increase of ovulation number, hence indirectly influencing litter size. However, the mechanism underlying the effect of CTSD on the behaviors of goat granulosa cells has not been fully elucidated. This study used immunohistochemistry to analyze CTSD localization in goat ovarian tissues. Moreover, western blotting was applied to examine the differential expression of CTSD in the ovarian tissues of monotocous and polytocous goats. Subsequently, the effects of CTSD knockdown on cell proliferation, apoptosis, cell cycle, and the expression of candidate genes of the prolific traits, including bone morphogenetic protein receptor IB (

The aim of this study was to investigate the expression of growth hormone (GH) gene on skeletal muscle cell proliferation of Guizhou cattle. The coding sequence of cattle GH gene was amplified by reverse transcription PCR, cloned into the pUCM-T vector and then used to construct the GH gene overexpression vector pEGFP-N3-GH. The expression of the GH gene in skeletal muscle-related tissues (psoas major and longissimus dorsi) of Guizhou cattle was determined by real-time fluorescent quantitative PCR (RT-qPCR). This was followed by culturing and identification of the bovine primary skeletal muscle cells. Subsequently, we introduced the GH gene overexpression vector into the cells to investigate its effect on the proliferation of bovine skeletal muscle cells and the expression of insulin like growth factor 1 and 2 genes related to skeletal muscle growth and development. RT-qPCR results showed that the expression level of GH gene was higher in the psoas major than in the longissimus dorsi of Guizhou cattle, and the expression level in the psoas major of Guanling cattle and Weining cattle was significantly higher than in the longissimus dorsi (P<0.05). The transfection and proliferation results showed that pEGFP-N3-GH significantly increased the expression of GH, IGF-1, and IGF-2 genes in skeletal muscle cells compared to pEGFP-N3 (PP<0.05), and that overexpression of the GH gene also significantly increased the proliferation rate of skeletal muscle cells at the four periods examined (PP<0.01). Our results suggest that GH gene can promote the proliferation of skeletal muscle cells of Guizhou cattle and exerts a positive regulatory effect. This lays the foundation for further exploring the mechanism by which the GH gene affects the growth and development of Guizhou cattle.
Animals ; Cattle ; Cell Proliferation ; Cloning, Molecular ; Growth Hormone/genetics* ; Insulin-Like Growth Factor I/genetics* ; Muscle, Skeletal

Objective To retrospectively analyze unplanned secondary surgical operations in neurosurgery. Methods The incidence, causes and time interval from the first operation of unplanned secondary operations were systematically reviewed, and the length of stay, hospitalization expenses and conditions of prognosis of the patients were compared with those who did not suffered from unplanned secondary operations.Results In this study,339 unplanned secondary operations were confirmed from 2012 to 2016 in neurosurgery and the incidence of unplanned secondary operations was 0.65%. 80.24% of the unplanned secondary operations were incurred by postoperative bleeding,which was proved to be higher than other causes. Conclusions Unplanned secondary operations had caused more economic burdens, thus deserving close attentions. Reducing perioperative bleeding and implementing hierarchical operation management would be key to preventing and decreasing unplanned secondary operations.

Objective:To perform textual researches on name, origin and distribution of Maidong to clarify the medicinal varieties and history recorded in ancient literatures and provide evidence for clinical use. Methods:Ancient herbal works were performed textual research, and the resource investigation and modern data were analyzed. Results:According to the ancient herbal records and modern researches, Maidong had lots of alias, while only Maimendong and Maidong were used as the medicine common names. According to the records of main origin, original plant morphological and medicinal characteristics of Maimendong, it was preliminarily concluded that Maidong recorded in the ancient herbal records was mainly produced in Jiande of Zhejiang province, Mianyang of Sichuan prov-ince, Xiangyang of Hubei province and the surrounding areas. The chemical compositions and pharmacological activities of Maidong and Shanmaidong were similar;therefore, they both could be used as the medicines. Conclusion:In the light of the ancient and mod-ern medicinal customs, modern chemistry and pharmacology researches and clinical practice of TCM, it deserves further discussion on whether Maidong and Shanmaidong can be used as multi source varieties of traditional Chinese medicines just like Polygonaceae plants palmatum L. , Rheum tanguticum Maxim, ex Balf. and Rheum officinale Baill. , and Ranunculaceae plants Coptis chinensis Franch. , Coptis deltoidea C. Y. Cheng et Hsiao and Coptisteeta Wall.