Objective To investigate the prognostic value of vertebral CT parameters for early fusion sink after transforaminal lumbar interbody fusion(TLIF).Methods The clinical and imaging data of 178 patients with lumbar degenerative diseases treated by TLIF were retrospectively studied.The patients were divided into the sedimentation group(n=57)and the non-sedimentation(n=57)group according to the patient's fusion device settlement 3 months after surgery.The results of general data and CT image parameters were compared between the two groups.Multivariate Logistic regression was used to analyze risk factors of early fusion subsidence,and the prediction efficiency was analyzed.Results The incidence of the early fusion sink was 32.0%.Compared with the non-sedimentation group,the sedimentation group had a higher proportion of patients aged≥60 years,osteoporosis,L5-S1 and intervertebral space height,larger fusion contact area and segmental lordosis angle and lower lumbar CT value(P＜0.05).Logistic regression analysis showed that age≥60 years old,surgical level L5-S1,high intervertebral height and large segmental lordosis angle were independent risk factors for the early fusion after TLIF,while high lumbar CT value was protective factor(P＜0.05).Subject working characteristic curves showed that the area under the curve(AUC)of lumbar CT value,intervertebral height,segmental lordosis angle combined with AUC were higher than those of patients aged≥60 years,surgical segment L5-S1,lumbar CT value,intervertebral height,segmental lordosis angle applied alone(P＜0.05).Conclusion Vertebral CT parameters of lumbar CT value,intervertebral height and segmental lordosis angle have higher predictive value for the early fusion after TLIF,and the combined prediction value of the three parameters is higher.

The operation assistant work team of public hospitals is an important bridge and link to realize the integration of industry and finance,and an important practitioner to promote the realization of lean operation management.It examines the service model of the operation assistant team engaged in Similar Multi-disciplinary Treatment,focusing on organizational structure,job responsibilities,and service mechanisms.Build a four-tiered lean operational management system and set up an operation assistant work team that combines production,university and research.Based on specific management matters,establish an operation assistant service mechanism such as problem assessment and classification management mechanism,project standardization management mechanism,reward and punishment assessment mechanism,etc.,to promote the optimization and integration of hospital medical education,research,prevention and management and core elements such as human,talent,material and technology resources.Help public hospitals to continuously improve their lean operation management level.

Objective To investigate the prognostic value of vertebral CT parameters for early fusion sink after transforaminal lumbar interbody fusion(TLIF).Methods The clinical and imaging data of 178 patients with lumbar degenerative diseases treated by TLIF were retrospectively studied.The patients were divided into the sedimentation group(n=57)and the non-sedimentation(n=57)group according to the patient's fusion device settlement 3 months after surgery.The results of general data and CT image parameters were compared between the two groups.Multivariate Logistic regression was used to analyze risk factors of early fusion subsidence,and the prediction efficiency was analyzed.Results The incidence of the early fusion sink was 32.0%.Compared with the non-sedimentation group,the sedimentation group had a higher proportion of patients aged≥60 years,osteoporosis,L5-S1 and intervertebral space height,larger fusion contact area and segmental lordosis angle and lower lumbar CT value(P＜0.05).Logistic regression analysis showed that age≥60 years old,surgical level L5-S1,high intervertebral height and large segmental lordosis angle were independent risk factors for the early fusion after TLIF,while high lumbar CT value was protective factor(P＜0.05).Subject working characteristic curves showed that the area under the curve(AUC)of lumbar CT value,intervertebral height,segmental lordosis angle combined with AUC were higher than those of patients aged≥60 years,surgical segment L5-S1,lumbar CT value,intervertebral height,segmental lordosis angle applied alone(P＜0.05).Conclusion Vertebral CT parameters of lumbar CT value,intervertebral height and segmental lordosis angle have higher predictive value for the early fusion after TLIF,and the combined prediction value of the three parameters is higher.

The operation assistant work team of public hospitals is an important bridge and link to realize the integration of industry and finance,and an important practitioner to promote the realization of lean operation management.It examines the service model of the operation assistant team engaged in Similar Multi-disciplinary Treatment,focusing on organizational structure,job responsibilities,and service mechanisms.Build a four-tiered lean operational management system and set up an operation assistant work team that combines production,university and research.Based on specific management matters,establish an operation assistant service mechanism such as problem assessment and classification management mechanism,project standardization management mechanism,reward and punishment assessment mechanism,etc.,to promote the optimization and integration of hospital medical education,research,prevention and management and core elements such as human,talent,material and technology resources.Help public hospitals to continuously improve their lean operation management level.

The study was carried out to understand the changes in the ethical cognition status of laboratory animals and the effectiveness of laboratory animal ethics education among medical students in Xiangya School of Medicine of Central South University (CSU), and provide new enlightenment for further strengthening the ethical education of laboratory animals. In the study, the same self-compiled questionnaire was used to investigate the ethical cognition of experimental animals among medical students in Xiangya School of Medicine of CSU in 2011 and 2021, and 359 and 363 questionnaires were collected respectively. Through comparative analysis of the questionnaire results before and after ten years, it was found that medical students’ animal experiment operation and attitudes towards laboratory animals, cognition of experimental animal ethics knowledge and their attitude to animal experiment ethics education were significantly improved. It showed that the state of experimental animal ethics cognition among medical students in Xiangya School of Medicine of CSU had improved significantly in recent 10 years, but the cognition of experimental animal ethics knowledge was higher than the actual behavior of caring for experimental animals, and there was the phenomenon of "separation of knowledge and action". The ethics education of experimental animals needs to pay more attention to the development of students’ behavior of caring for experimental animals.

Objective:To study the clinical efficacy of surgical resection combined with iodine-131 ( 131I) therapy in elderly patients with differentiated thyroid cancer and its influence on complications. Methods:Totally 82 elderly patients with differentiated thyroid cancer who were admitted to Chengde Central Hospital from March 2019 to March 2021 were selected and divided into observation group (41 cases) and control group (41 cases) according to the random number table. The control group underwent total thyroidectomy + neck lymph node dissection, and the observation group was treated with 131I after the operation on the basis of the control group. The indicators in the two groups were evaluated (postoperative observation time cutoff was 3 months), including perioperative indexes, postoperative complications, Karnofsky (KPS) score, serum levels of lymphocyte activating gene-3 (LAG-3) and recombinant human Dick-kopfx related protein-1 (DKK-1) before and after treatment, and the efficacy. Results:There was no significant difference between the two groups in the amount of intraoperative bleeding and operation time ( P > 0.05); the hospitalization time in the observation group [(6.72 ± 1.39) d] was shorter than that in the control group [(8.78 ± 1.43) d, P < 0.001]. The incidence of complications in the observation group (31.71%, 13/41) was lower than that in the control group (53.66%, 22/41, P = 0.045). After treatment, KPS scores in the two groups were higher than those before treatment ( P < 0.001); after treatment, KPS score in the observation group was higher than that in the control group ( P < 0.001). After treatment, the serum LAG-3 levels in the two groups were higher than those before treatment, while DKK-1 levels were lower than those before treatment ( P < 0.001); after treatment, the serum LAG-3 level in the observation group was higher than that in the control group, while the DKK-1 level was lower than that in the control group ( P < 0.001). The total effective rate of the observation group (95.12%, 39/41) was higher than that of the control group (80.49%, 33/41, P = 0.043). Conclusion:The clinical efficacy of surgical resection combined with 131I therapy in elderly patients with differentiated thyroid cancer is good, and it can reduce postoperative complications, up-regulate the expression of LAG-3 and down-regulate the expression of DKK-1.

The study was carried out to understand the changes in the ethical cognition status of laboratory animals and the effectiveness of laboratory animal ethics education among medical students in Xiangya School of Medicine of Central South University (CSU), and provide new enlightenment for further strengthening the ethical education of laboratory animals. In the study, the same self-compiled questionnaire was used to investigate the ethical cognition of experimental animals among medical students in Xiangya School of Medicine of CSU in 2011 and 2021, and 359 and 363 questionnaires were collected respectively. Through comparative analysis of the questionnaire results before and after ten years, it was found that medical students’ animal experiment operation and attitudes towards laboratory animals, cognition of experimental animal ethics knowledge and their attitude to animal experiment ethics education were significantly improved. It showed that the state of experimental animal ethics cognition among medical students in Xiangya School of Medicine of CSU had improved significantly in recent 10 years, but the cognition of experimental animal ethics knowledge was higher than the actual behavior of caring for experimental animals, and there was the phenomenon of "separation of knowledge and action". The ethics education of experimental animals needs to pay more attention to the development of students’ behavior of caring for experimental animals.

AIM:To investigate the effect of N-[N-(3,5-difluorophenacetyl)-L-alanyl]-S-phenylglycine t-butyl ester (DAPT) on the Notch signaling pathway in a model of oxidized low-density lipoprotein (ox-LDL)-induced human umbilical vein endothelial cell (HUVEC) damage.METHODS:HUVECs were divided into control group, ox-LDL group, DAPT group and ox-LDL+DAPT group.The morphological changes of the HUVECs with different treatments were observed under light microscope.The viability of the HUVECs was measured by CCK-8 assay.The protein expression levels of Notch1, Notch4 and Jagged1 were determined by Western blot.RESULTS:ox-LDL induced great damage to the HUVECs, evidenced by increased cell death and debris in the culture.However, the cell damage was abolished by adding DAPT into the culture.The viability of the HUVECs was increased by co-treatment with DAPT and ox-LDL.ox-LDL treatment significantly decreased the protein expression levels of Notch1 and Jagged1, and elevated Notch4.However, these changes were totally reversed by DAPT.None of these proteins showed significant change in the HUVECs co-treated with DAPT and ox-LDL as compared with control group.CONCLUSION:ox-LDL is able to induce HUVEC damage in vitro.DAPT attenuates ox-LDL-induced damage in the HUVECs by regulating the Notch signaling pathway.