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ObjectiveTo investigate the mediating role of loneliness and social anxiety in the relationship between basic psychological needs satisfaction and smartphone addiction among high school students， and to provide references for the intervention to smartphone addiction for high school students. MethodsIn April 2022， a total of 14 666 high school students from 5 middle schools in a county of Sichuan Province were included by random sampling method. Basic Psychological Needs Scales （BPNS）， the UCLA Loneliness Scale-3 edition （UCLA-3）， Interaction Anxiousness Scale （IAS） and the Mobile Phone Addiction Index （MPAI） were used for cross-sectional investigation. Bootstrap method was used to analyze the mediating role of loneliness and social anxiety in the relationship between the basic psychological needs satisfaction and smartphone addiction. Results① In this study， 14 036 valid questionnaires were returned， and 1 752 （12.48%， 95% CI： 0.114~0.136） high school students were found to be addicted to smartphone phone. The BPNS score was negatively correlated with UCLA-3， IAS and MPAI scores （r=-0.771， -0.486， -0.417， P<0.01）. And MPAI score was positively correlated with IAS and UCLA-3 scores （r=0.403， 0.424， P<0.01）. IAS score was positively correlated with UCLA-3 score （r=0.458， P<0.01）. ②The degree of basic psychological needs satisfaction in high school students can directly negatively predict smartphone addiction （β=-0.383， P<0.05）， and can also indirectly affect smartphone addiction through loneliness and social anxiety （β=-0.130， P<0.05）. ③Loneliness （indirect effect value was -0.145） and social anxiety （indirect effect value was -0.074） partially mediate between the basic psychological needs satisfaction and smartphone addiction. Loneliness-social anxiety also has significant chain mediating effect （indirect effect value was -0.034）， which accounted for 8.88%. ConclusionThe basic psychological needs satisfaction can not only directly affect the occurrence of smartphone addiction， but also indirectly affect the occurrence of smartphone addiction through the chain mediation of loneliness and social anxiety.
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The neural stimulator is a core component of animal robots. While the control effect of animal robots is influenced by various factors, the performance of the neural stimulator plays a decisive role in regulating animal robots. In order to optimize animal robots, embedded neural stimulators had been developed using flexible printed circuit board technology. This innovation not only enabled the stimulator to generate parameter-adjustable biphasic current pulses through control signals, but also optimized its carrying mode, material, and size, overcoming the disadvantages of traditional backpack or head-inserted stimulators, which have poor concealment and are prone to infection. Static, in vitro, and in vivo performance tests of the stimulator demonstrated that it not only had precise pulse waveform output capability, but also was lightweight and small in size. It had excellent in vivo performance in both laboratory and outdoor environments. Our study has high practical significance for the application of animal robots.
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Animals , RoboticsABSTRACT
Autoimmune diseases of the nervous system are a group of diseases caused by the body′s immune system attacking its own nervous system, resulting in structural damage and functional impairment of the corresponding tissues. Interventional clearance of pathogenic auto-antibodies has been shown to be effective in reducing immune damage, inhibiting disease progression and improving prognosis through extensive basic research and long-term clinical practice. The neonatal Fc receptor (FcRn)-mediated circulating protection mechanism of IgG contributes to the long half-life and high plasma levels of IgG. FcRn inhibitors are able to target and block the binding of FcRn to IgG, accelerating IgG clearance and reducing IgG levels. Therefore, the use of FcRn inhibitors in the treatment of autoimmune diseases of the nervous system could theoretically help to accelerate the clearance of pathogenic IgG, achieve good clinical efficacy and have promising applications. Research in this area has made considerable progress in recent years and this article will review this.
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The Fukushima Daiichi Nuclear Power Plant accident in Japan resulted in the release of large amounts of radioactive substances into the surrounding environment and caused contamination. In the accident recovery process, Japan had made great efforts in public communication, including the government’s promotion of organization and planning the popularization and publicity of scientific knowledge in various forms, multi-channel information disclosure, and all-round communication and exchange, which can provide a reference for the development of relevant work in China. The nuclear-related public communication work in China can get four enlightenments. Firstly, the public communication system should be improved, and corresponding policies and mechanisms should be clarified. Secondly the popularization of nuclear science knowledge should be taken as the foundation for early and long-term development. Thirdly, the operators of nuclear facilities shall disclose relevant information according to the law and confront the curiosity or doubts of the public. Finally, multi-channel, multi-level and multi-frequency exchanges and interactions should be conducted to seek unity of understanding and balance of interests between the two sides.
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Objective:To simulate the placement of percutaneous cortical bone trajectory (CBT) screws on reconstructed CT images and three-dimensional lumbar model and to measure the morphometric parameters for guiding the placement of percutaneous CBT screws.Methods:The CT images of 100 adult patients with lumbar spine diseases were studied. The CT images were reconstructed using Mimics software. Taking the projection point on the lamina at the junction of the inner and lower edge of the smallest coronal section of lumbar pedicle as the entry point, the cephalad angle, lateral angle, maximum screw length, maximum screw diameter, distance between trajectory and spinous process were measured. At the same time, the relationship between the trajectory and spinous process was observed by using the reconstructed three-dimensional image.Results:The lateral angle of the trajectory from L 1 to L 5 were 9.3° (8.9°, 9.8°), 9.6° (8.9°, 9.8°), 10.4° (9.5°, 11.3°), 11.81°±1.24° and 13.6° (12.5°, 14.5°), respectively. The cephalad angle from L 1 to L 5 were 26.6° (26.0°, 27.0°), 26.2° (25.7°, 26.5°), 26.9° (26.5°, 27.4°), 25.94°±0.92° and 24.3° (22.7°, 25.4°), respectively. Significant statistic differences were found among all levels in the cephalad angles and lateral angles. The mean diameters of the trajectory from L 1 to L 5 were 5.65±0.49 mm, 6.38±0.60 mm, 6.91±0.67 mm, 7.42±0.76 mm and 8.33 (7.59, 9.01) mm, respectively. Except L 1 and L 5, there were significant differences among all levels in the maximum screw diameters. The mean length of the trajectory from L 1 to L 5 were 36.4 (35.4, 37.0) mm, 36.7 (35.8, 37.3) mm, 37.6 (37.1, 38.1) mm, 37.8 (37.3, 38.1) mm and 36.2 (35.2, 36.9) mm, respectively, and there were also significant differences among all levels. The ration in superior endplate for each segment were 41.08% (34.36%, 45.60%), 37.94% (32.97%, 43.63%), 40.18% (34.56%, 44.49%), 38.61% (34.80%, 46.24%) and 40.9% (35.32%, 46.02%), respectively and statistical differences were significant between L 1 and L 2 and L 2 and L 5. The mean distance between the trajectory and the spinous process from L 1 to L 5 were 7.27±1.23 mm, 7.19 (5.97, 8.28) mm, 7.32 (6.01, 8.28) mm, 7.31±1.36 mm and 7.45 (6.32, 8.23) mm, respectively. In the sagittal CT image, the tip of the trajectory located near the posterior two-fifths of the superior end plate, and the extended line of the trajectory located at the inferior edge of spinous process. In the three-dimensional reconstruction model, no obstruction was found between the simulated screws and the spinous process. Conclusion:Lumbar CBT screw can be implanted percutaneously, and spinous process will not hinder the implantation process. Spinous process and upper endplate can be used as a sign to guide the percutaneous CBT screw implantation. Digital analog screw placement can offer a useful reference for the clinical application of percutaneous cortical bone trajectory screw.
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Objective:To investigate CT classification of diffuse idiopathic skeletal hyperostosis (DISH), and to analyze the correlation between the position of ossification in the anterolateral spine and the sagittal configuration of the spine.Methods:The medical records of 109 patients (70 male and 39 female) who underwent whole spine computerized tomography (CT) from October 2018 to October 2020 were retrospectively analyzed. The average age was 68.4±6.9 years old, ranging from 60 to 88 years old. High resolution CT volume rendering technique images were used to assess the degree of anterolateral spinal ossification in each vertebral space, and a CT grading system was established. Sagittal parameters such as thoracic kyphosis (TK), lumbar lordosis(LL), cervical lordosis (CL), sacral slope (SS), and thoracolumbar junction angle (TLJ) of the patients were measured. The sagittal morphology of the spine was divided into four types using the modified Abelin-Genevois (AG) sagittal classification. In AG type 1 patients, the kyphotic vertex was located in the middle of the thoracic spine (T 4-T 11). In AG type 2 patients, there was no significant kyphotic vertex. In AG type 3 patients, the kyphotic vertex was located in the thoracolumbar segment (T 12-L 2). In AG type 4 patients, the kyphotic vertex was located in the upper thoracic segment (T 1-T 3). Inter-observer and intra-observer reliability were calculated by intra-group correlation coefficient ( ICC). Statistical analysis was conducted to investigate the correlation between different AG types and ossification location and severity. Results:The new DISH grading system classifies the severity of anterolateral spinal ossification in each intervertebral space into grades 0 to 3 with an intra-observer ICC value of 0.871 and inter-observer ICC value of 0.874. Combined with Resnick's DISH diagnostic criteria, 97 patients (89.0%) in this study had four consecutive intervertebral spaces with ossification grade 1 or above. For these patients, in T 4-T 11, the standardized ossification grade of AG type 1 was 1.24±0.69, greater than that of AG type 2 (0.84±0.71) and AG type 3 (1.00±0.70), and the differences were statistically significant ( F=23.101, P<0.001). In T 12-L 2, the standardized ossification grade of AG type 3 was 1.44±0.87, which was higher than AG type 1 (1.06±0.84) and AG type 2 (0.72±0.63), the differences were statistically significant ( F=14.008, P<0.001). In this study, no patients with kyphosis apex in the cervicothoracic region (AG type4) were found. In T 1-T 3, there was no statistical difference between the three groups ( F=0.303, P=0.738); in the whole thoracic and lumbar spine (T 1-L 5), there was statistically significant difference in the total ossification grade ( F=14.374, P<0.001), there was no statistical difference between AG type 1 and AG type 3 ( P=0.254), both of which were higher than AG type 2 ( P<0.001). Conclusion:The new DISH ossification grading system proposed in this study has high credibility, which can be used in DISH's study. This study confirmed that the region where the apex of kyphosis is located is prone to anterolateral ossification of the spine.
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Posterior lumbar fusion is one of the effective methods for the treatment of lumbar degenerative diseases, which have been recognized by the majority of spine surgeons. However, it is found that lumbar fusion brings some problems with application, research and understanding move on. Adjacent segments degeneration (ASD) is one of the main reasons for reoperation after lumbar fixation and fusion. Therefore, dynamic stabilization system used in lumbar diseases has become a research hotspot in spinal surgery. Regarded as an alternative instead of rigid fusion, lumbar transpedicular dynamic stabilization system is gradually applied in clinical practice. It has become one of the most widely used non-fusion methods due to its advantages on maintaining the stability of surgical segments and on retaining intervertebral mobility. However, an emergence of new technique often meets conflicts from traditional concepts. Scholars have explored and evaluated the lumbar dynamic fixation technology in the aspects of biomechanics, clinical efficacy and prognosis. Some studies have explored the application and its related complications of lumbar transpedicular dynamic stabilization in common lumbar degenerative diseases. Comprehensively, the clinical effects of this technology have been confirmed by many studies. It can be used as an alternative instead of rigid fusion in the treatment of unstable segments after nerve decompression. There are still some limitations of this technique. It is necessary to conduct more multi-center randomized controlled trials according to the indications, contraindications, advantages, disadvantages and related risks. Further studies could improve the device in line with the anatomical characteristics of Chinese people and serve patients better.
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In order to provide scientific basis for health education and patient timely seeking behavior, this article summarizes the definition, the status quo and influencing factors of delayed on health seeking behavior of patients with obstructive sleep apnea hypopnea syndrome. Influencing factors mainly include clinical character, individual and environment.
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Objective:To explore the impact of emotional valences on the risk decision performance in college students with or without early life stress.Methods:The child psychological abuse and neglect scale was used to select 30 subjects with early life stress and 30 subjects without early life stress from college students.Iowa game task was conducted under different emotional valences(positive, negative, neutral). Data were analyzed by SPSS 23.0 in the manner of MANOVA of repeated measuring, and the posthoc tests were carried out by the way of Sidak or Dunnett T3.Results:(1)The main effect of early life stress was statistically significant( F(1, 58)=4.35, P=0.04, partial η2=0.07), which meant the early life stressors tended to be more risk-averse than the non-early life stressors ((27.20±6.95) vs (23.53±9.18)). (2)The main effect of emotional valence was statistically significant( F(2, 116)=3.45, P=0.04, partial η2=0.06)), which meant all participants developed a greater risk preference in negative emotions than positive emotions ((26.38±9.09) vs (23.88±7.58)). (3)The interaction between early life stress and emotional valence was not statistically significant( F(2, 116)=0.72, P=0.49, partial η2=0.01), and the influence trend and degree of emotion valence on early life stressors and non-early life stressors were basically same. Conclusion:Both emotion and early life stress have an impact on individual risk decision, but the effect of emotion with different emotional valence on risk decision-making performance of the early life stressors and the non-early life stressors has no significant difference.
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As an interface between external electronic devices and internal neural nuclei, microelectrodes play an important role in many fields, such as animal robots, deep brain stimulation and neural prostheses. Aiming at the problem of high price and complicated fabrication process of microelectrode, a microelectrode twisting machine based on open source electronic prototyping platform (Arduino) and three-dimensional printing technology was proposed, and its microelectrode fabrication performance and neural stimulation performance were verified. The results show that during the fabrication of microelectrodes, the number of positive twisting turns of the electrode wire should generally be set to about 1.8 times of its length, and the number of reverse twisting rings is independent of the length, generally about 5. Moreover, compared with the traditional instrument, the device is not only inexpensive and simple to manufacture, but also has good expandability. It has a positive significance for both the personalization and popularization of microelectrode fabrication and the reduction of experimental cost.
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Equipment Design , Microelectrodes , Printing, Three-DimensionalABSTRACT
With the rapid improvement of the perception and computing capacity of mobile devices such as smart phones, human activity recognition using mobile devices as the carrier has been a new research hot-spot. The inertial information collected by the acceleration sensor in the smart mobile device is used for human activity recognition. Compared with the common computer vision recognition, it has the following advantages: convenience, low cost, and better reflection of the essence of human motion. Based on the WISDM data set collected by smart phones, the inertial navigation information and the deep learning algorithm-convolutional neural network (CNN) were adopted to build a human activity recognition model in this paper. The K nearest neighbor algorithm (KNN) and the random forest algorithm were compared with the CNN network in the recognition accuracy to evaluate the performance of the CNN network. The classification accuracy of CNN model reached 92.73%, which was much higher than KNN and random forest. Experimental results show that the CNN algorithm model can achieve more accurate human activity recognition and has broad application prospects in predicting and promoting human health.
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Humans , Algorithms , Cluster Analysis , Human Activities , Motion , Neural Networks, ComputerABSTRACT
The study showed a case of missed diagnosis of Leriche syndrome. Patients with intermittent claudication were diagnosed as lumbar spinal stenosis by local hospital with lumbar MRI. When conservative treatment was ineffective, the patients were treated in our spine clinic. However, the lumbar MRI showed no significant stenosis, and arteriovenous ultrasound also showed no abnormality. Vascular surgeons believed that patient’s symptoms had little correlation with vascular lesions. After careful reading of lumbar spine MRI, we found that the signal intensity of abdominal aorta increased unevenly below L2 vertebral level. CTA examination of abdominal aorta revealed sclerosis of abdominal aorta and common iliac artery, stenosis and occlusion of abdominal aorta and common iliac artery lumen below the level of renal artery orifice. The patient was finally diagnosed as Leriche syndrome.
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Objective:To measure and compare the length and angle parameters of the screw paths of paravertebral foramen screws (PVFS), pedicle screws (PS) and lateral mass screws (LMS) of subaxial cervical spine.Methods:This study included the cervical computerized tomography (CT) scans of 50 healthy volunteers (25 males and 25 females) in our hospitalfrom January 2018 to June 2018. The average age of the volunteers was 56.00±15.90 years (range, 29-89 years). After three-dimensional reconstruction of CT data, the screw starting points, length of screw paths,optimal medial angles, maximum medial angles and minimum medial angles of PVFS, PS and LMS (Magerl technique) on C 3-C 7 segments were designed and measured on the reconstructed 3D model, and the pedicle widths at various segments of cervical vertebrae were measured. All parameters were measured twice in an interval of two weeks by one orthopaedic surgeons with experience in spine surgery, and the average values of the two measurements were used. Results:In general, the optimum length and medial angle of the PVFS in Chinese population were 10.65 mm and 21.12° at C 3; 10.12 mm, 22.62° at C 4; 9.82 mm, 23.66° at C 5; 9.19 mm, 24.13° at C 6; and 9.10 mm, 27.54° at C 7. The C 3 segment had the longest general optimal length, and the C 7 segment had the shortest general optimal length of PVFS ( F=19.287, P<0.001). However, there was no significant difference in optimal length of PVFS between C 6 and C 7 vertebrae ( P=0.674). The C 7 vertebra had the largest general medial angle, meanwhile the C 3 vertebra had the smallest general medial angle ( F=19.752, P<0.001). The optimum lengths of screw path of PVFS in males at the segments of C 4, C 6 and C 7 vertebrae were longer than those in females (C 4t=2.912, C 6t=3.884, C 7t=5.468, P<0.05), and the optimal medial angle at C 4, C 6 and C 7 segments were smaller than those in females (C 4t=3.560, C 6t=4.370, C 7t=4.738, P<0.05). The optimum length and medial angle of PS in Chinese population were 30.94 mm, 33.92° at C 3; 30.50 mm, 34.95° at C 4; 31.92 mm, 33.42° at C 5; 30.50 mm, 31.94° at C 6; and 29.87 mm, 31.01° at C 7. The general pedicle widths were 5.35 mm at C 3; 5.56 mm at C 4; 5.99 mm at C 5; 6.34 mm at C 6; and 6.86 mm at C 7. The optimum lengths of LMS paths in Chinese population were C 3, 14.84 mm; C 4, 15.33 mm; C 5, 15.44 mm; C 6, 14.74 mm; and C 7, 14.06 mm. In Chinese population, the optimal length of PVFS was 9.10-10.65 mm, and the optimal medial angle was 21.12°-27.54°. The general optimal length of PVFS path were shorter than those of LMS and PS at C 3-C 7 segments ( P<0.05), and the general optimal medial angles were smaller than those of PS at C 3-C 7 segments ( P<0.05). Conclusion:Because of the length of screw path of PVFS is limited, it does not have the risk of direct vertebral artery injury. The insert angle of PVFS is steeper and safer than that of PS. In summary, cervical PVFS can be used as an effective supplement to PS and LMS.
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Objective:To investigate and compare the biomechanical strength of paravertebral foramen screws (PVFS), lateral mass screws (LMS) and pedicle screws (PS).Methods:A total of 30 human cervical spine vertebrae (C 3-C 6) were harvested from 8 fresh-frozen cadaver specimens whose mean age was 45.3±11.2 years at death. The vertebrae were randomly divided into three groups for specific screws. For each vertebra, one side was randomly chosen for direct pullout strength test (speed 5 mm/s), and the other side for fatigue test (displacement ±1.0 mm, frequency 1 Hz, 500 cycles) and residual pullout strength test. 4.5 mm × 12 mm screws were used for PVFS, 3.5 mm × 14 mm screws for LMS, and 3.5 mm × 24 mm screws for PS. Results:The direct pullout strength was 327.10±17.07 N for PVFS, 305.71 ± 11.63 N for LMS, and 635.67 ± 22.82 N for PS. The residual pullout strength was 265.62 ±18.19 N for PVFS, 192.80 ±17.10 N for LMS, and 494.89 ±41.79 N for PS. The residual pullout strength of PVFS, LMS and PS respectively, compared with the direct pullout strength, decreased by 18.8%, 36.93% and 22.15% ( tPVFS=7.795 , tLMS=17.267 , tPS=9.349 , P<0.001). The direct pullout strength of PS was higher than that of PVFS and LMS( t=34.245, t=40.741, P< 0.001), as well as PVFS was slightly higher than LMS ( t=3.275, P=0.004). The residual pullout strength of PS was the highest, PVFS was the second, and LMS was the smallest ( F=314.619, P<0.001). For the fatigue test, the load at the first cycle and the first time when the set position was reached of PVFS were higher than those of LMS ( t=3.625, P=0.002; t=5.388, P<0.001) and PS ( t=2.575, P=0.019; t=2.680, P=0.015), but there was no difference between those of LMS and PS ( t=0.609 , P=0.550; t=1.953 , P=0.067). The load at the last cycle of PVFS and PS was higher than that of LMS ( t=5.341 , P<0.001 ; t=3.439 , P=0.003), while there was no difference between PVFS and PS ( t=1.606, P=0.126). Conclusion:The direct pullout strength of PVFS was slightly higher than that of LMS, and the residual pullout strength was significantly higher than LMS. The property of fatigue resistance of PVFS was similar to PS and obviously better than LMS. In summary, PVFS can be used as an effective substitute for LMS and PS.
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The study showed a case of missed diagnosis of Leriche syndrome.Patients with intermittent claudication were diagnosed as lumbar spinal stenosis by local hospital with lumbar MRI.When conservative treatment was ineffective,the patients were treated in our spine clinic.However,the lumbar MRI showed no significant stenosis,and arteriovenous ultrasound also showed no abnormality.Vascular surgeons believed that patient's symptoms had little correlation with vascular lesions.After careful reading of lumbar spine MRI,we found that the signal intensity of abdominal aorta increased unevenly below L2 vertebral level.CTA examination of abdominal aorta revealed sclerosis of abdominal aorta and common iliac artery,stenosis and occlusion of abdominal aorta and common iliac artery lumen below the level of renal artery orifice.The patient was finally diagnosed as Leriche syndrome.
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Objective@#To analyze the necessity of routinely performing foraminoplasty during percutaneous transforaminal endoscopic discectomy (PETD).@*Methods@#A total of 412 patients including 231 males and 181 females with an average age of 39.1±13 (20-80) years were enrolled in the present study. All patients were preoperatively diagnosed with single-segment lumbar disc herniation and underwent PETD by the same surgical group. The affected segments were at L3-4 in 32 cases, L4-5 in 289 cases, and L5S1 in 91 cases. Among them, 306 cases had no prolapse, 89 had mild up/down prolapse, and 17 had severe prolapse. MRI sagittal imaging was used to measure the height and width of the intervertebral foramen of L3, 4, L4, 5 and L5S1 segments, the distance between the lower edge of vertebral pedicle and the upper edge of the lower vertebral pedicle and the distance between the point 3 mm to the ventral side of the intervertebral space to the superior articular process. The necessity of performing foraminoplasty was evaluated by measuring the change of intervertebral foramen width using dynamic X-ray and verified during operation.@*Results@#The height of the intervertebral foramen of L3,4, L4,5 and L5S1 segments were 1.99±0.25, 1.89±0.15 and 1.52±0.26 cm, respectively. The width of the intervertebral foramen was 0.78±0.14, 0.75±0.13 and 0.64±0.13 cm, respectively. The distance between the lower edge of vertebral pedicle and the upper edge of the lower vertebral pedicle were 1.14±0.17, 1.05±0.16, and 0.98±0.19 cm, respectively. The distance between the point 3 mm to the ventral side of the intervertebral space to the superior articular process were 1.11±0.31, 1.17±0.20, and 0.95±0.14 cm, respectively. The width of the intervertebral foramen of the L3, 4 and L4,5 segments was significantly greater at the over-flexion position than at the over-extension position (P<0.05). Intraoperative verification showed that 347 cases (group A) did not need foraminoplasty. However, the other 65 patients (group B) needed foraminoplasty, including 31 at L4, 5 segment and 34 at L5S1 segment. One patient in group A and one in group B underwent revision operation due to residual intervertebral disc. At 2 years of follow-up, recurrence occurred in 4 patients in group A and 2 patients in group B. The ODI score and JOA score in group A and B were 18%±9%, 24.2±1.3 and 16%±7%, 23.9±1.3, respectively. There were not significantly different between patients in group A and B (t=1.70, P=0.090; t=1.71, P=0.088). The VAS score of lumbar pain of patients in group A was better than that of patients in group B (P<0.05).@*Conclusion@#Most of PETD of L3-S1 segments can reach the therapeutic target without performing foraminoplasty with half-half technique combined with far lateral access technique. Due to the special anatomical position of L5-S1 segment, the probability of performing foraminoplasty during operation is much higher. Performing foraminoplasty or not depends on the preoperative measurement of foramina and verification during the operation.
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Objective@#To compare the incidence of adjacent segment degeneration (ASDeg) and clinical outcomes of minimally invasive versus traditional transforaminal lumbar interbody fusion (TLIF) in the treatment of L 4,5 single-segment lumbar spinal stenosis (LSS) and explore the risk factors of ASDeg.@*Methods@#All of 115 patients with LSS who were treated by the same group of doctors from 2009 to 2013, with a minimum follow-up of 5 years. Thirty-eight patients underwent minimally invasive trans-foraminal lumbar interbody fusion (MIS-TLIF) and 77 patients underwent traditional TLIF. Standing radiographs at the preopera-tive period and the final follow-up were assessed. Radiological parameters included lumbar lordosis (LL), fused segment angle (FSA), disc height (DH) and range of motion (ROM). Babu classification was used to identify facet joint violation (FJV) in patients at 5-year follow-up. Clinical outcomes were assessed according to visual analog scale (VAS) score, Japanese Orthopaedic Associa-tion (JOA) score and Oswestry Disability Index (ODI). Student's t-test, Chi-square test, and non-parametric test were used as the main statistical methods.@*Results@#The mean age of MIS-TLIF group was 58.2±8.8 years, and that of TLIF group was 54.7±11.2 years, and there was no significant difference between the two groups. The mean follow-up time was 64.5±3.8 months in the MIS-TLIF group and 63.9±3.3 months in the TLIF group, and there was no significant difference between the two groups. There were 17 cases of degenerative spondylolisthesis in MIS-TLIF group (44.7%) and 35 cases of degenerative spondylolisthesis in TLIF group (45.5%), and there was no significant difference between the two groups. There was no significant difference in DH and ROM of L3,4, L4,5, L5S1 between the two groups before operation. There was no significant difference in VAS, JOA and ODI scores between the two groups before operation. The VAS, JOA and ODI scores were significantly improved at the last follow-up compared with those before operation. After 5-year follow-up, 56 cases (48.7%) had ASDeg. The incidence of ASDeg was 31.6% in MIS-TLIF group and 57.1% in TLIF group, and there was statistical differences between the two groups (χ2=6.656, P <0.01). Among them, 32 cases only had upper segment ASDeg (6 cases in MIS-TLIF group, 26 cases in TLIF group), 19 cases only had lower segment ASDeg (6 cases in MIS-TLIF group, 13 cases in TLIF group), and 5 cases had both upper and lower ASDeg (5 cases in the TLIF group). The DH of adjacent segments decreased after operation, but the loss of DH in MIS-TLIF group was smaller than that in TLIF group, including L3,4 segments (-4.9%±6.4% vs-8.7%±7.2%, t=-2.761, P <0.01), L5S1 segment (-4.7%±9.8% vs-10.5%±11.7%, t=-2.623, P <0.01). The ROM of adjacent segments increased in both groups, but the increase of ROM in MIS-TLIF group was smaller than that in TLIF group, including L 3,4 segments (1.1°±1.8° vs 2.3°±2.5°, t=-3.122, P <0.01), L5S1 segment (0.9°± 1.9 ° vs 1.8°±1.9 °, t=-2.353, P <0.01). The incidence of FJV was 54.2% in patients with ASDeg in MIS-TLIF group and 47.7% in patients with ASDeg in TLIF group. Chi-square analysis showed that FJV was related to ASDeg in both groups (χ2=3.869, P < 0.05).@*Conclusion@#Both of the two surgical methods have good clinical effects on L 4,5 single-segment LSS. The incidence of AS-Deg after MIS-TLIF is lower than that of TLIF. FJV is a risk factor for ASDeg.
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Objective@#To investigate the association of within-day drinking occasions with average amount consumed per drinking occasion during spring among college students in Hebei Province and to provide the basic data for the revision of quantity of consumption among Chinese residents.@*Methods@#A total of 156 college students in Hebei Province were selected by using simple random sampling method. Information on daily amount and types of water consumption was recorded using the 7-day 24-hour recording method. The daily amount and type of drinking water by sex and BMI were analyzed and compared.@*Results@#The daily median drinking water intake was 1 135 mL; the daily median number of drinking occasion was 6, with 34.6% of participants less than 6 drinking occasions; the median amount consumed per drinking occasion was 177 mL. The daily number of water and plain water drinking occasion of females were higher than males(χ2/Z=8.34, -2.03, P<0.05); the amount consumed per drinking occasion, the amount of plain water and beverages consumed per drinking occasion of males were higher than females(χ2/Z=23.86, -5.48, 3.70, P<0.01); The differences of the amount of plain water consumed per day among students and their BMI were of statistical significance(χ2=9.17, P=0.03), the amount of drinking water each time was positively correlated with body surface area(r=0.18, P=0.03), and frequency of drinking water was positively correlated with the amount of drinking water, negatively correlated with the amount of drinking water each time. The amount of drinking water was positively correlated with the amount of drinking water each time(r=0.30, -0.47, 0.61, P<0.01).@*Conclusion@#There is a certain proportion of unhealthy drinking behavior among college students; drinking behavior is different by sex and BMI. With the increase of drinking occasions, the amount consumed in each drinking occasion decreases, but total amount of drinking water increases.
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Objective To investigate the feasibility,safety and surgical technique of treating type Ⅲ and Ⅳ hilar cholangiocarcinoma by laparoscopy.Methods Clinical data and surgical process of 6 patients who underwent laparoscopic radical resection of hilar cholangiocarcinoma in the Hunan Provincial People's Hospital between April 2015 and October 2018 were retrospectively analyzed.The operations were performed by total laparoscopy in all the patients.Surgical procedure included the basic operation type (gallbladder,hilar and common bile duct resection,lymph node dissection of hepatoduodenal ligament),combined with the resectionof liver,caudate lobe,and portal vein resection and reconstruction.The follow-up time ranged from 1 to 42 months.Results The operation time was 540 ～ 660 min,the blood loss was 300 ～ 500 ml.One case of biliary leakage occurred after operation and healed within 2 weeks after drainage.The patients were all discharged succesfully and still alive.Conclusions Laparoscopic radical resection of type Ⅲ and Ⅳ hilar cholangiocarcinoma is safe and feasible under adequate preoperative evaluation,reasonable case selection and rigorous surgical planning.The short-term efficacy of the patients was good.
ABSTRACT
Objective The single nucleotide polymorphisms (SNPs) of APOE and SLCO1B1 were examined to explore their association with the risk and severity of coronary heart disease(CAD). Methods A total of 1267 cases of consecutive coronary heart disease (CAD)-suspected inpatients visiting department of Cardiology in Peking University Peoples' Hospital from March 2017 to november were recruited into this case-control study, and then 391 CAD cases and 223 non-CAD controls were enrolled for final analysis after screening by coronary angiography and exclusion criteria. The severity of the CAD cases were evaluated according to Gensini scores. The SNPs of APOE(388T>C, 526C>T) and SLCO1B1(388A>G, 521T>C) were detected using Real-time PCR and further verified using Sanger sequencing. Environmental risk factors were collected, and the correlations between SNPs of APOE and SLCO1B1 and the risk and severity of CAD were performed by SPSS version 16.0. Results The SNPs of all the subjects included in CAD group and non-CAD group were successfully detected, with an accordance of 100％ to Sanger sequencing. The distribution of APOE and SLCO1B1 gene were subjected to Hardy-Weinberg. The distributions of APOE gene ε3/ε3 genotypes and ε3 allele were most commonly found in both CAD group and non-CAD group (ε3/ε3: 70.8％,73.1％;ε3: 83.5％,85.2％;respectively). APOE genotypes and alleles were comparable between the CAD cases and non-CAD controls (P>0.05). The frequencies of APOE gene ε4+genotype were more likely to be found in the subgroup of CAD with Gensini score≥72 (P<0.05). The distributions of SLCO1B1 gene *1b/*1b genotypes and *1b allele were most commonly found in both CAD group and non-CAD group (*1b/*1b: 37.3％, 36.8％; *1b: 60.1％, 61.7％; respectively). There was no significant difference in genotype and allele frequencies of SLCO1B1 between the two groups and among subgroups with different severity of CAD (P>0.05). Conclusion This study observed no association between SNPs of APOE, SLCO1B1 and the risk of CAD in this population. However, APOE gene ε4 +genotype may increase the severity of CAD.