Spinal Fusion Versus Repeat Discectomy for Recurrent Lumbar Disc Herniation: A Systematic Review and Meta-Analysis.

OBJECTIVE: Recurrent lumbar disc herniation (RLDH) is one of the major causes of failure for primary surgery. Repeat discectomy (RD) and spinal fusion (SF) are 2 surgical options for RLDH. The objective of our study is to compare the effectiveness of SF compared with RD in the treatment of RLDH. METHODS: We systematically searched PubMed, Embase, Cochrane Library, Web of Science, and Ovid Medline for studies (published between Jan 1, 1959 and July 8, 2022; no language restriction) comparing SF and RD for the RLDH. Odds ratio and weighted mean difference were calculated for binary outcomes and continuous outcomes. The quality of each outcome was graded using the Grading of Recommendations, Assessment, Development and Evaluations criteria. RESULTS: We identified 5029 studies, of which 11 studies were included. There were 2 randomized controlled trials and the remaining were observational studies. Comparing SF and RD groups, no differences were found in visual analog scales for leg and back and Oswestry Disability Index. Furthermore, the Japanese Orthopaedic Association scores of SF were significantly higher than the RD group. In terms of complications, the incidence of neurological deficit, segmental instability, and re-recurrence is significantly lower with SF than with the RD group. Lastly, the SF group was associated with longer hospital stays and operation time, and more blood loss. CONCLUSIONS: The pooled evidence suggests that fusion achieves better results than RD for RLDH. The results of this review should be further confirmed by future high-quality randomized controlled trials.

Analysis of the effect of home quarantine on blood lipid and glucose of healthy adults during the COVID-19 epidemic times based on the data of physical examination / 中华健康管理学杂志

Objective:To analyze the effect of home quarantine on blood glucose and lipids in healthy adults during the COVID-19 epidemic times.Method:From April 7, 2020 to May 1, 2020, 512 adults wereexamined in Beijing physical examination center, of which 87 adults aged olderthan 18, received community closed management or home quarantine from January 23, 2020 to March 30, 2020, and theadultshad physical examination in Beijing physical examination center in the same month of 2018 and 2019 were selected as controls. The change trend of blood glucose and blood lipid acrossthe three years was analyzed by one-way repeated measurement of variance, and the difference of blood lipid and blood glucose between two years of physical examination was further analyzed by Bonferroni method. Datawereanalyzed by gender.Result:Among the 87 subjects, 36 (41.4%) were male and 51(58.6%) were female. The average age was (46.3±13.2) years and ranged from 24 to 74. The difference of high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC) and fasting blood glucose (FBG) among 2018, 2019 and 2020 was statistically significant (all P<0.05), while differences in LDL-C, TC and FBG were statistically significant for males (all P<0.05) and HDL-C, LDL-C, TC and FBG were statistically significant for females (all P<0.05). HDL-C in 2018and 2020were significantly lower than that in 2019 [(1.27±0.29), (1.30±0.31) vs. (1.36±0.34) mmol/L], LDL-C in 2020was significantly higher than that in 2018and 2019 [(3.11±0.88) vs. (2.81±0.77), (2.84±0.71) mmol/L], TG in 2020 was significantly higher than that in 2019[(1.54±1.17) vs. (1.32±0.80) mmol/L], TC in 2019and 2020were significantly higher than that in 2018 [(4.88±0.94), (5.10±0.99) vs. (4.63±0.90) mmol/L], and the FBG in 2019and 2020were significantly lower than that in 2018 [(5.34±1.17), (5.44±1.58) vs. (5.84±1.70) mmol/L] (all P<0.05). The comparative analysis of men and women showed that the means of LDL-C, TG, TC and FBG of men were higher than those of women while the mean of HDL-C was lower than that of women in each year; compared with 2019, the increase of LDL-C and TC of men was obvious while the decrease of HDL-C of women was obvious (all P<0.05) in 2020. Conclusion:During the epidemic period of COVID-19, the home quarantine has adverse effects on blood glucose and lipid.

Analysis of influencing factors of nonalcoholic fatty liver disease in healthy people: Based on nested case control study / 中国综合临床

Objective:Based on the occupational cohort of Beijing Medical Examination Center, to explored the relevant factors of nonalcoholic fatty liver disease (NAFLD), and to provide scientific basis for screening and early diagnosis of NAFLD in high-risk population.Methods:Based on the cohort of occupational population who underwent physical examination in Beijing physical examination center from January to December 2009, the physical examination indexes were collected, and a retrospective survival cohort with a follow-up period of 3 years was established.According to the idea of nested case-control study, each case was randomly matched with the same gender, age and physical examination time in the same month by using the method of random sampling without putting back.Conditional logistic regression model was established by using the matched data.The diagnostic value of related indicators for NAFLD was analyzed by receiver operating characteristic curve (ROC).Results:A total of 1 194 subjects were included, including 684 males (57.3%, 684/1 194) and 510 females (42.7%, 510/1 194). The age was (50.8±11.6) years.The age ranged from 24.0 to 88.0 years.There were 597 patients with NAFLD, including 342 males and 255 females.Logistic regression analysis showed that body mass index, high density lipoprotein cholesterol, hemoglobin, platelet count, uric acid and urea nitrogen were statistically significant in male model (all P<0.05). Body mass index( OR=1.242, 95% CI 1.143-1.349, P<0.001), hemoglobin( OR=1.034, 95% CI 1.015-1.053, P<0.001), platelet( OR=1.005, 95% CI 1.002-1.009, P=0.005), uric acid( OR=1.004, 95% CI 1.001-1.006, P=0.004), high density lipoprotein cholesterol( OR=0.377, 95% CI 0.184-0.775, P=0.008) and urea nitrogen( OR=0.807, 95% CI 0.693-0.938, P=0.005) were protective factors for NAFLD in male patients..Body mass index( OR=1.552, 95% CI 1.366-1.762, P<0.001), triglyceride ( OR=2.606, 95% CI 1.616-4.204, P<0.001), blood glucose( OR=2.199, 95% CI 1.332-3.631, P=0.002), uric acid( OR=1.005, 95% CI 1.001-1.010, P=0.024) in female model were statistically significant ( P<0.05), and were risk factors for NAFLD in female patients. Conclusion:The incidence rate of NAFLD was different among different gender and age, body mass index, high density lipoprotein cholesterol, hemoglobin, platelet count, uric acid, urea nitrogen, triglyceride and blood glucose were closely related to the incidence of NAFLD.

Effects of maternal passive smoking during pregnancy and girls’ overweight / 中国学校卫生

Objective@#To investigate the effect of maternal passive smoking during pregnancy and girls’ overweight /obesity on the age at menarche(AAM), and to provide a reference for improving healthy development of children and adolescents.@*Methods@#Based on the school entrance physical examination in 2016, a cross-section study was conducted by convenient sampling method, in a total of 2 722 students of 7th grade, from 26 middle schools in urban areas of Guangzhou. Multivariate logistic regression model was used to investigate the relationship between maternal passive smoking during pregnancy and girls’ overweight /obesity and AAM. A four-way decomposition method was used to explore the mediated effect of girls’ overweight/obesity on the relationship between maternal passive smoking during pregnancy and AAM.@*Results@#The proportion of girls who had menstruate was 90.82%(2 472/2 722). The median AAM was 12.00 years old, with an early menarche rate of 34.91%(863/2 472). Compared with girls whose mother hadn’t passive smoking during pregnancy, the risk of early AAM in girls with mother passive smoking during pregnancy≤3 days/week increased by 32%(OR=1.32, 95%CI=1.06-1.65), the risk in girls with maternal passive smoking during pregnancy>3 days/week increased by 58%(OR=1.58, 95%CI=1.21-2.07). Multivariate Logistic regression analysis showed that, overweight or obesity girls had a 77% higher risk of early AAM than non-overweight/obesity girls(OR=1.77, 95%CI=1.36-2.31). The four-way decomposition analysis showed 79.60% of early AAM risk could be accounted by maternal passive smoking during pregnancy(P<0.01).@*Conclusion@#Girls’ overweight/obesity and maternal passive smoking during pregnancy were associated with early menarche. The effect on daughters’ age at menarche is mainly in a direct effect manner of maternal passive smoking during pregnancy.

Research on Effect Factors to Function of Human-machine System as Displaying with LCD / 航天医学与医学工程

Objective To provide the experimental data for standard establishment and ergonomics research on manned spaceflight displays basing on relation of six effect factors to function of human-machine system as displaying with LCD,and the best factor-level-composition is chosen.Methods An experimental system was developed.The orhoganal experiment means was adopted.Twenty subjects were asked to finish three tasks: to view parameters of the whole screen interface,to seek local parameters,to identify the fault events quickly.Three indices: reaction time,error times and times of unable to recognize were analyzed.Results The indices were much different for different factors at different levels.According to the indices of mean reaction time,extreme difference of view-angle was the lowest and view-distance the highest.Conclusion The order of the display effects of different factors on human-machine system is successively: viewdistance,illuminant level,character height,color of character/background and viewangle.