Objective: To improve the efficiency and standardization of preoperative anemia diagnosis and treatment by establishing a systematic intelligent management platform for preoperative anemia. Methods: A multidisciplinary collaborative model was adopted to develop a preoperative anemia management system that integrates intelligent early warning, standardized treatment pathways, and quality control. The system utilizes natural language processing technology to automatically capture laboratory data and establish evidence-based medical decision support functions. A pre-post study design was employed to compare changes in preoperative anemia screening rates, preoperative anemia intervention rates, reasonable use of iron supplements, and perioperative red blood cell transfusion rates before and after system implementation. Results: After system implementation, the standardization of anemia diagnosis and treatment significantly improved: 1) Screening effectiveness: The anemia screening rate increased to 50.00% (an increase of 27.24%); 2) Intervention effectiveness: The anemia treatment rate rose to 56.30% (an increase of 14.02%); 3) Treatment standardization: The reasonable use rate of iron supplements increased to 55.33% (an increase of 21.02%); the red blood cell transfusion rate decreased to 18.29% (a decrease of 4.07%), and the amount of red blood cell transfusions was reduced by 291 units. Conclusion: This system achieves full-process management of preoperative anemia through information technology, significantly enhancing the standardization of diagnosis and treatment as well as intervention effectiveness, providing an effective solution for perioperative anemia management.

OBJECTIVE: To compare clinical efficacy between side-opening and front-opening bone cement injectors in percutaneous kyphoplasty(PKP) for the management of thoracolumbar osteoporotic vertebral compression fractures(OVCFs). METHODS: A retrospective cohort study was conducted, comprising 62 patients with single-segment thoracolumbar OVCFs (T₁₁-L₂), who underwent bilateral PKP at our department during the period from June 2020 to October 2021. Patients were categorized into two groups based on the specific bone cement injector employed during the surgical procedure: the side-opening group (n=29) and the front-opening group (n=33). Among them, the side-opening group consisted of 6 male and 23 female patients, with a mean age of (73.32±9.11) years. The front-opening group included 7 male and 26 female patients, with a mean age of (71.29±10.39) years. The variables encompassed essential patient characteristics were recorded, such as gender, age, bone mineral density (BMD), and fracture level (T₁₁-L₂), as well as procedural aspects, including operation duration, cement injection volume, cement distribution type (lobular or diffuse), occurrence of cement leakage, pre-and post-operative visual analogue scale (VAS) pain scores, and vertebral compression ratio. RESULTS: All patients underwent successful surgery, with a mean follow-up duration of (15.37±3.03) months. There were no statistically significant differences in gender, age, BMD, fracture level, preoperative vertebral compression degree, and VAS scores between the side-opening group and the front-opening group (P>0.05). The operation time, the mean cement injection volumes, the distribution of bone cement within the vertebrae has no statistically significant difference between two groups(P>0.05). Both the side-opening and front-opening groups showed significant improvements in VAS scores at 3 days and 6 months after operation (P<0.05). However, there was no significant difference in VAS scores between the two groups at both 3 days and 6 months after the operation (P>0.05). CONCLUSION Side-opening bone cement injectors in bilateral PKP surgery for single-segment thoracolumbar OVCF achieve similar clinical efficacy as front-opening injectors, without significant improvement in cement distribution and containment.
Humans ; Female ; Male ; Kyphoplasty/instrumentation* ; Aged ; Bone Cements ; Fractures, Compression/surgery* ; Retrospective Studies ; Spinal Fractures/surgery* ; Thoracic Vertebrae/injuries* ; Lumbar Vertebrae/injuries* ; Osteoporotic Fractures/surgery* ; Middle Aged ; Aged, 80 and over

This study was aimed at performing epidemiologic investigation of the first psittacosis death case in Hangzhou City,to provide a reference for the investigation and disposal of psittacosis cases,as well as prevention and control.Epidemio-logic data were collected through field epidemiologic investigation,and close contacts and environmental samples were collected for pathogenicity testing.The first symptom in the patient was cough,which did not raise concerns at the time.Several days later,the patient developed abdominal distension and black stools,and visited two medical institutions for treatment and hospi-talization.The patient's sputum and peripheral blood were tested for Chlamydia psittaci infection by metagenomic analysis via next-generation sequencing.Samples collected from the patient's family members,close contacts,and home environment test-ed negative with real-time quantitative polymerase chain reaction.The patient later died of gastrointestinal bleeding.This article is the first report of a case of psittacosis contracted from exposure to a sick parrot in Hangzhou City,in a patient who died be-cause of an underlying disease.Operational training should be provided for medical personnel,and early diagnosis with mNGS and treatment of patients with underlying diseases should be performed as early as possible to avoid fatality.In addition,health education should be carried out to raise public awareness of the disease.

Objective·To study the alterations in vestibular hair cell morphology and function of ATPase plasma membrane Ca2+transporting 2 oblivion(Atp2b2 Oblivion)heterozygous mice at different ages.Methods·Atp2b2 Oblivion heterozygous male mice aged 2 months and 8 months were selected with ten in each kind and C57BL/6J wild-type mice with the same gender,age and number were selected as the control group.Expression patterns of ATP2B2 in vestibular hair cells and numbers of hair cells in the striola zone and the extra striola zone in the two groups of mice at different ages were observed and calculated respectively through immunofluorescence assay.Hair bundle structures were detected by scanning electron microscopy(SEM),and mitochondria and ribbon synapse structures were observed by transmission electron microscopy(TEM).Vestibular evoked potential(VsEP),vestibular evoked myogenic potential(VEMP),rotarod rod test,and balance beam test were adopted for the evaluation of vestibular functions.Results·ATP2B2 was mainly expressed in the hair bundle of vestibular hair cells in the two groups of mice.Hair cell numbers in the striola zone and the extra-striola zone did not exhibit any differences between Atp2b2 Oblivion heterozygous mutant mice and wild-type mice of 2-month-old and 8-month-old.No visible structural abnormality in the hair bundle could be seen through SEM.TEM results implied no morphological abnormality in mitochondria or ribbon synapses in the 2-month-old heterozygous mutant mice,while vacuolar degeneration was discovered in the mitochondria under the cuticular plate in the 8-month-old heterozygous mutant mice with the normal ribbon synapses and the normal mitochondria near the innervation site.VsEP and VEMP thresholds of 2-month-old and 8-month-old Atp2b2 Oblivion heterozygous mutant mice were significantly elevated compared with the wild-type mice.Analysis of VsEP waveform manifested prolonged P1 latency and declined P1N1 amplitude in heterozygous mutant mice(P＜0.05).Results of rotarod rod test and balance beam test acquired from 2-month-old Atp2b2 Oblivion heterozygous mutant mice were not significantly different from the wild-type mice,while the ability of the mutant mice to accomplish the tests descended significantly at 8 months of age compared with the wild-type mice(P＜0.05).Conclusion·Atp2b2 Oblivion heterozygous mutant mice showed defective vestibular electrophysiological function at 2 months old,and abnormalities in vestibule-related behaviors can be detected at 8 months old.The vestibular function ofAtp2b2 Oblivion heterozygous mutant mice deteriorate progressively.

Irreducible anteromedial radial head dislocation (IARHD) caused by transposed biceps tendon is rare. Delayed diagnosis and surgical failure often occur. A 46-year-old fisherman presented with 10 days history of painful swelling and restricted movement of his right elbow due to strangulation injury by a fishing boat cable. On examination, the images of the right elbow reveals in a "semi-extended and pronated" elastic fixation position. Radiography and 3-dimensional reconstruction CT reveals an isolated anteromedial radial head dislocation with extreme protonation of the radius and the bicipital tuberosity towards the posterior aspect of the elbow joint, and MRI shows biceps tendon wrapping around the radial neck, similar to umbilical cord wrapping seen in newborns. The Henry approach was applied for the first time to reduce the biceps tendon. The patient achieved a good functional recovery at 26 months, which represents the first reported case of IARHD without fracture caused by biceps tendon in an adult. In treatment of IARHD, attention should be paid to the phenomenon of biceps tendon transposition. Careful clinical examination, comprehensive imaging modalities, and appropriate surgical approach are the keys to successful management.

The aim of this study was to establish a laboratory research model for the desiccation tolerance of Coxiella bur-netii(C.burnetii),based on an axenic culture system.The conditions for osmotic pressure in the axenic culture system of C.burnetii were set via a gradient.Quantitative PCR was used to determine the C.burnetii genome equivalents during the culture cycle under different osmotic pressures,and the growth curves were recorded.In addition,the bacterial manifestations of C.burnetii obtained from eukaryotic cell cultures or cell-free cultures were analyzed with phase contrast microscopy and transmis-sion electron microscopy(TEM).The bacterial infection levels and vacuole forming units(VFU)were measured by infection of BGMK cells.C.burnetii showed as many as 7 days of adaptive survival in osmotic axenic medium under high osmotic condi-tions.The bacteria shrank by dehydration under extremely high osmotic pressure and appeared primarily as hypo-hydrated small cell variants(SCVs).The VFUs were significantly diminished 24 hours after infection,as compared with the parallel contrasts.The method for researching desiccation tolerance was thus successfully established.This method provides a basis for further investigation of the genetic mechanisms of the anti-desiccation properties of C.burnetii in the natural environment,through proteomics and other methods.

Objective:Xanthohumol is a kind of isoamyl olefinic flavonoid natural compounds,which have antitumor activity and impact on a variety of cell signaling pathways,The objective of this study was to explore the effects of xanthohumol on proliferation and apoptosis of thyroid cancer cells B-CPAP through the Notch signaling pathway.Methods:B-CPAP cells were cultivated in vitro,Xanthohumol was divided into control group(0 μ mol/L),low dose group(10 μ mol/L),middle dose group(20 μ mol/L),high dose group(40 μ mol/L)according to the different concentrations,The logarithmic growth cells were cultivated with different concentrations of xanthohumol intervention,application of MTT colorimetry in the detection of proliferation inhibition rates of B-CPAP cells.B-CPAP cells morphological changes were observed by using fluorescence microscope after appli-cation of Hoechst 33258 dyeing.B-CPAP cells apoptosis were detected by Annexin V-FITC/PI flow cytometry.Notch signaling pathway related proteins were determined?by?Western blotting.Re-sults:MTT showed that low dose group,middle dose group and high dose group,respectively pro-cessing after 24h,48h,72h,proliferation inhibition rates of the three groups were statistical?signifi-cance(F=189.34,131.73,124.51,P＜0.05);Respectively treated after 24h,48h,72h,proliferation in-hibition rates of xanthohumol increased over time in the same group,The differences were statisti-cally significant(F=204.51,169.64,183.15,P＜0.05).B-CPAP cells of high dose group appeared ob-viously apoptosis morphological changes compared with the control group through Hoechst33258 dying.Flow cytometry showed apoptosis rates of concrol group,low dose group and high dose group compared were statistical?significance(F=1235.54,P＜0.05).Apoptosis rate was higher in the high-dose group.Western blotting showed that Notch1,Treatment was performed for 72h,Hes1,Bcl-2 expression were significantly decreased in low dose group,middle dose group and high dose group compared with the control group(F=203.22,161.52,224.78),while cleaved caspase-3 ex-pression significantly increased(F=463.27),the differences were statistically significant(P＜0.05).Conclusions:Xanthohumol inhibits B-CPAP cells proliferation and induces cells apoptosis maybe through the Notch signaling pathway.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

This study aims to investigate the effects of Bushen Huoxue Decoction regulating adipose-derived stem cells(ADSCs)-exosomes(Exos) on the apoptosis of intervertebral disc nucleus pulposus cells(NPCs) and extracellular signal-regulated kinase(ERK) signaling pathway. Tert-butyl hydrogen peroxide(TBHP)-induced NPCs were divided into control, model, drug-containing serum, blank Exos, normal serum Exos, and drug-containing serum Exos groups. Cell viability and proliferation were examined by the CCK-8 assay and EdU staining, respectively. The cell cycle and apoptosis were evaluated by flow cytometry. Enzyme-linked immunosorbent assay was employed to measure the levels of interleukin(IL)-1β, tumor necrosis factor(TNF)-α, and IL-6. The mRNA levels of aggrecan, collagen type Ⅱ alpha 1 chain(COL2A1), and ERK were determined by qRT-PCR, and the protein levels of aggrecan, COL2A1, and p-ERK were determined by Western blot. The results showed that compared with the model group, the treatments with drug-containing serum, blank Exos, and normal serum Exos enhanced the viability and proliferation of NPCs, decreased the proportion of cells in the G_0/G_1 phase, increased the proportion of cells in the S phase, reduced apoptosis, lowered the levels of IL-1β, TNF-α, and IL-6, up-regulated the mRNA and protein levels of aggrecan and COL2A1, and down-regulated the mRNA level of ERK and the protein level of p-ERK. Compared with the drug-containing serum, blank Exos, and normal serum Exos groups, the treatment with drug-containing serum Exos enhanced the viability and proliferation of NPCs, decreased the proportion of cells in the G_0/G_1 phase, increased the cells in the S phase, reduced apoptosis, lowered the levels of IL-1β, TNF-α, and IL-6, up-regulated the mRNA and protein levels of aggrecan and COL2A1, and down-regulated the mRNA level of ERK and the protein level of p-ERK. The results confirmed that the Exos secreted by ADSCs after treatment with Bushen Huoxue Decoction-containing serum promoted the proliferation of degenerated NPCs, inhibited apoptosis and the expression of inflammatory mediators, and promoted the production of proteoglycans and collagen, thus delaying the progression of intervertebral disc degeneration, the mechanism of which was related to the regulation of the ERK signaling pathway.
Intervertebral Disc Degeneration/drug therapy* ; Apoptosis/drug effects* ; Nucleus Pulposus/cytology* ; Drugs, Chinese Herbal/pharmacology* ; Animals ; Rats ; MAP Kinase Signaling System/drug effects* ; Rats, Sprague-Dawley ; Collagen Type II/metabolism* ; Humans ; Cell Proliferation/drug effects* ; Stem Cells/metabolism* ; Aggrecans/metabolism* ; Cell Survival/drug effects* ; Male ; Cells, Cultured ; Tumor Necrosis Factor-alpha/metabolism*

OBJECTIVE: To explore clinical effect of Zero-profile intervertebral fusion with cage-titanium plate in treating multilevel cervical spondylotic myelopathy. METHODS: From January 2016 to January 2020, 107 patients with multisegmental cervical spondylotic myelopathy treated by surgery were retrospectively analyzed and divided into Hybrid group and control group according to different surgical methods. There were 54 patients in Hybrid group, including 42 males and 12 females, aged from 33 to 77 years old with an average of (57.3±9.5) years old;20 patients with C₃-C₆, 27 patients with C₄-C₇ and 7 patients with C₃-C₇;Zero-profile intervertebral fusion with cage-titanium plate internal fixation was performed. There were 53 patients in control group, including 34 males and 19 females;aged from 36 to 79 years old with an average of (57.8±8.9) years old;17 patients with C₃-C₆, 27 patients with C₄-C₇, and 9 patients with C₃-C₇;titanium plate interbody fusion fixation was performed. Operation time, blood loss and complications between two groups were compared, visual analogue scale (VAS), Japanese Orthopedic Association (JOA) scores and neck disability index (NDI) were used to assess recovery of clinical symptoms;cervical lordosis (CL), cervical sagittal vertical axis (C-SVA), and T₁ slope (T₁S) were measured and compared to evaluate cervical sagittal plane parameters. RESULTS: All patients were followed up, Hybrid group was followed up for 24 to 64 months with an average of (31.7±18.4) months, and control group was followed up for 24 to 65 months with an average of (32.6±15.8) months. There was no significant difference in follow-up time between two groups (P>0.05). Operation time and blood loss in Hybrid group were less than those in control group (P<0.05). VAS, JOA score and NDI were significantly improved between two groups at the lastest follow-up (P<0.05). There were no significant difference in VAS, JOA and NDI scores between two groups before and after operation (P>0.05). CL in both two groups at 3 months and the latest follow-up after operation were significantly improved than those before operation (P<0.05), there were no significant difference between two groups in T1S and C-SVA before and after operation (P>0.05). Postoperative dysphagia occurred in 2 patients in Hybrid group and 9 patients in control group, and had statistically difference in the incidence of dysphagia between two groups (χ²=5.112, P=0.024). During the follow-up, there were no complications such as loosening, displacement or fracture of internal fixation between two groups. CONCLUSION Compared with titanium plate interbody fusion, Zero-profile intervertebral fusion combined with cage-titanium plate for the treatment of multilevel cervical spondylotic myelopathy could shorten surgical time and blood loss, reduce surgical trauma and postoperative swallowing difficulties, and is conducive to early and rapid recovery.
Humans ; Male ; Female ; Middle Aged ; Spinal Fusion/instrumentation* ; Bone Plates ; Titanium ; Aged ; Spondylosis/surgery* ; Adult ; Cervical Vertebrae/surgery* ; Retrospective Studies ; Spinal Cord Diseases/surgery*