Background In Kummell's Disease (KD), stage II patients frequently present with vertebral pseudarthrosis. The associated sclerotic changes at the margins of the pseudarthrosis can hinder the restoration of vertebral height and adversely affect cement distribution and therapeutic outcomes. To evaluate the efficacy of the cement anchoring technique (CAT) in the treatment of stage II KD. Methods A total of 71 patients (CAT group: 33 cases, PVP group: 38 cases) were enrolled between January 2020 and June 2024. The following parameters were compared between two groups: gender, age, BMI, lumbar BMD, duration of disease, fracture type, compression ratio, operative time, volume of cement injected, incidence of cement leakage, cement distribution and pattern, VAS, anterior vertebral height (AVH), middle vertebral height (MVH), posterior vertebral height (PVH), Cobb angle preoperatively and at 1 month and 1 year postoperatively, and ODI preoperatively and at 3 months and 1 year postoperatively. Results All procedures were completed successfully without serious complications. CAT group had more cement injected (5.73 ± 1.32ml / 4.92 ± 0.91ml, P < 0.05) and lower cement leakage (27.27% / 52.63%, P < 0.05) than PVP group. The spongy distribution pattern (63.63% / 28.95%, P < 0.05) and satisfactory cement distribution (57.57% / 36.84%, P < 0.05) was higher in the CAT group. Postoperative VAS and ODI scores improved significantly in two groups. Nevertheless, the postoperative improvement in CAT group was better (P < 0.05). For AVH, MVH, and Cobb angle, the CAT group exhibited significantly greater improvements at 1 month and 1 year postoperatively(P < 0.05). PVP group showed significant deterioration in these parameters at 1 year compared with the 1-month assessment (P < 0.05). Conclusion Cement anchoring technique is a safer and more effective alternative for treating stage II KD. It effectively alleviates pain symptom, promotes better cement diffusion, prevents cement leakage, and effectively improve and maintain vertebral height and reduced kyphotic deformity.

Immune regulation plays an important role in the pathogenesis of intervertebral disc degeneration (IDD). However, the mechanism of immune regulation in IDD is still unclear. All IDD data were downloaded from a public database. The differentially expressed (DE) immune-related genes in IDD were identified by the limma package in R. Functional enrichment analyses were performed to explore potential immune-related biological pathways in IDD. We also identified differentially expressed microRNAs (miRNAs) and long non-coding RNAs (lncRNAs) and constructed an mRNA-miRNA-lncRNA network. ROC analysis was performed to reveal potential diagnostic biomarkers for IDD. To understand the potential role of immune cells in IDD, xCell and Pearson correlation analyses were performed. Finally, expression validation was performed using real-time PCR. C5AR2, NFATC2, FCGR3A, hsa-miR-302d-3p, and MIR17HG were identified in IDD. ROC analysis results suggested that C5AR2 had good diagnostic accuracy, and FCGR3A and NFATC2 had sufficient diagnostic accuracy, which implied that they may be potential diagnostic markers of IDD. We also found that a large number of immune-related signaling pathways, such as cytokine-cytokine receptor interaction, chemokine signaling pathway, toll-like receptor signaling pathway, and Nod-like receptor signaling pathway, were significantly enriched. C5AR2, hsa-miR-302d-3p, and MIR17HG were significantly correlated with multiple immune cell types, such as cDC, CD8+ Tem, macrophage M1, neutrophils, and plasma cells. The C5AR2-hsa-miR-302d-3p-MIR17HG axis may play a role in immune regulation by regulating the infiltration level of related immune cells in the IDD microenvironment. The identification of key immune-related molecules, cells, and signaling pathways in IDD is of great significance to reveal the pathogenesis of IDD.

BACKGROUND:A deeper understanding of individual differences in symptom experiences among middle-aged and older ischemic stroke survivors could enable healthcare professionals to identify previously unknown associations among complex symptoms. This study employs latent class analysis to characterize psychosocial symptom clusters in this population. By identifying distinct subgroups based on these clusters, we compare differences in their quality of life and identify key factors associated with this classification. The findings aim to establish a foundation for developing targeted symptom management models and tailored intervention strategies for stroke survivors. METHODS:A total of 350 middle-aged and older adult ischemic stroke survivors were recruited between September 2022 and September 2023. Psychosomatic symptom clusters, depressive symptoms, fatigue, pain, sleep quality, risk factors, and functional impairment were assessed using validated scales, including the Numerical Rating Scale, the Hospital Anxiety and Depression Scale, the Fatigue Severity Scale, the Self-Rating Scale of Sleep, the Self-Efficacy for Managing Chronic Disease Scale, the Perceived Social Support Scale, and the Stroke Impact Scale. RESULTS:The sample was classified into three subgroups: a "low symptom group" (71.4%, n=250), a "high anxiety-fatigue group" (12.6%, n=44), and a "high symptom group" (16.0%, n=56). Gender, age, post-stroke self-care ability, and NIHSS scores were significant predictors differentiating the latent classes of psychosomatic symptom clusters in this population of middle-aged and older ischemic stroke survivors. CONCLUSION:This study identified three distinct clusters of psychosomatic symptoms among middle-aged and older ischemic stroke survivors in China, the group with the highest symptoms had the poorest quality of life. The findings may assist clinical nurses in classifying high-risk patients for targeted psychosocial interventions, thereby offering a foundation for developing tailored clinical strategies.

BACKGROUND:Few studies have been focused on rehabilitation after an acute intracerebral hemorrhage (ICH) or subarachnoid hemorrhage (SAH), and the benefits remain unclear since mixed results have been reported. The objective of this systematic review was to determine whether early rehabilitation, started within 7 days of stroke onset after ICH or SAH improves recovery (e.g. the proportion of independent survivors) compared with usual care. METHODS:Searches of PubMed and CINAHL for terms including hemorrhage stroke, ICH, SAH, stroke, Randomized Controlled Trial (RCT), early rehabilitation. And contacted authors as required between 1 January 2005 to 31 October 2021. Selection criteria included only RCTs of people in China with acute ICH or SAH, comparing an intervention group that started early rehabilitation (i.e. within 7 days of admission) with usual care. The primary outcome was activities of daily living (Barthel Index Score). The secondary outcome was stroke severity (National Institute of Health Stroke Scale [NIHSS] or Fugl-Meyer motor assessment scale). Two review authors independently selected the eligible publications, extracted the data, assessed the risk of bias, and applied the GRADE approach to assess the quality of the evidence. RESULTS:From 1777 retrieved references, 211 citations included potentially appropriate RCTs, 11 articles were eligible (approximately 44% female; the ages across the trials ranged from 28 to 82 years). We found that timing of rehabilitation interventions after hemorrhagic stroke varied (from 1 to 7 days after admission). Average hospital lengths of stay were 14 days to 1 month. Compared with controls, at 6 months patients who received early rehabilitation showed improvements in the Barthel Index (standardized mean difference: 2.11, 95% confidence interval (CI): 0.87,3.43, P<0.001, I2=100%), the NIHSS, (standardized mean difference: -1.26, 95%CI: -2.53,0.01, P<0.001, I2=99%), or Fugl-Meyer Score (standardized mean difference: 2.72, 95%CI: 1.12, 4.32, P<0.001, I2=100%). CONCLUSION:Early rehabilitation after hemorrhagic stroke may improve patients' quality of life compared with usual care. However, implementation is hampered by fragmented resources and lack of standardized protocols in China. Future research should focus on developing culturally adapted protocols and addressing resource shortages and systemic barriers. PROSPERO REGISTRATION NUMBER:CRD 42022342653.

BACKGROUND:Intervertebral disc degeneration (IDD) is an important cause of low back pain. The aim of this study is to identify the potential molecular mechanism of abnormal methylation-modified DNA in the progression of IDD, hoping to contribute to the diagnosis and management of IDD. METHODS:Low-grade IDD (grade I-II) and high-grade IDD (grade III-V) data were downloaded from GSE70362 and GSE129789 datasets. The abnormally methylated modified differentially expressed mRNAs (DEmRNAs) were identified by differential expression analysis (screening criteria were p < .05 and |logFC| > 1) and differential methylation analysis (screening criteria were p < .05 and |δβ| > 0.1). The classification models were constructed, and the receiver operating characteristic analysis was also carried out. In addition, functional enrichment analysis and immune correlation analysis were performed and the miRNAs targeted for the abnormally methylated DEmRNAs were predicted. Finally, expression validation was performed using real-time PCR. RESULTS:Compared with low-grade IDD, seven abnormal methylation-modified DEmRNAs (AOX1, IBSP, QDPR, ABLIM1, CRISPLD2, ACTC1 and EMILIN1) were identified in high-grade IDD, and the classification models of random forests (RF) and support vector machine (SVM) were constructed. Moreover, seven abnormal methylation-modified DEmRNAs and classification models have high diagnostic accuracy (area under the curve [AUC] > 0.8). We also found that AUC values of single abnormal methylation-modified DEmRNA were all lower than those of RF and SVM classification models. Pearson correlation analysis found that macrophages M2 and EMILIN1 had significant negative correlation, while macrophages M2 and IBSP had significant positive correlation. In addition, four targeted relationship pairs (hsa-miR-4728-5p-QDPR, hsa-miR-4533-ABLIM1, hsa-miR-4728-5p-ABLIM1 and hsa-miR-4534-CRISPLD2) and multiple signalling pathways (for example, PI3K-AKT signalling pathway, osteoclast differentiation and calcium signalling pathway) were also identified that may be involved in the progression of IDD. CONCLUSION:The identification of abnormal methylation-modified DEmRNAs and the construction of classification models in this study were helpful for the diagnosis and management of IDD progression.

Importance: Colorectal cancer (CRC) represents a significant portion of the global cancer burden, underscoring the need for a detailed epidemiological assessment. This analysis is essential for informing targeted public health interventions and guiding strategic resource allocation. Objective The present study aims to conduct a comprehensive analysis of the global, regional, and national burden of CRC and its associated risk factors from 1990 to 2021, utilizing data from the Global Burden of Disease (GBD) 2021 study. Methods A comprehensive analysis was conducted to assess the distribution of CRC across 204 countries and territories, focusing on the burden in relation to age, gender, and geographic location. The study also evaluated the impact of key risk factors on disability-adjusted life years (DALYs) across 21 GBD regions. A Bayesian age-period-cohort (BAPC) model was employed to project the future trajectory of CRC over the next three decades. Findings: The 2021 global incidence of CRC is projected to be approximately 2,194,143 cases (95% uncertainty interval [UI], 2,001,272 to 2,359,390), with a prevalence of 11,679,120 (95% UI, 10,774,527 to 12,538,400) and 24,401,100 DALYs (95% UI, 22,689,369 to 26,161,518) worldwide. Significant regional variations in the burden of CRC were observed, with Central Europe experiencing the highest impact. The burden of CRC increases with age, peaking among the elderly population aged 84 to 94 years. From 1990 to 2021, the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life years rate (ASDR) for CRC showed an upward trend, with a more pronounced burden observed in males compared to females. Future projections suggest a potential decrease in burden of CRC, with a more substantial reduction expected among females. Conclusion The study reveals regional disparities in the burden of CRC, with Central Europe being the most significantly affected region. Dietary risk factors were identified as primary contributing factor. These findings enhance our understanding of the global distribution and variation in CRC prevalence, providing valuable insights for cancer control planning.

Object: This study aimed to explore the relationship between the aggressiveness and immune cell infiltration in pituitary adenoma (PA) and to provide the basis for immuno-targeting therapies. Methods: One hundred and three patients with PA who underwent surgery at a single institution were retrospectively identified. The infiltration of macrophages and T-lymphocytes was quantitatively assessed. Results: The number of CD68+ macrophages was positively correlated with Knosp (p = 0.003) and MMP-9 expression grades (p = 0.00). The infiltration of CD163+ macrophages differed among Knosp (p = 0.022) and MMP-9 grades (p = 0.04). CD8+ tumor-infiltrating lymphocytes (TILs) were also positively associated with Knosp (p = 0.002) and MMP-9 grades (p = 0.01). Interestingly, MGMT expression was positively correlated with MMP-9 staining extent (p = 0.000). The quantities of CD8+ TILs (p = 0.016), CD68+ macrophages (p = 0.000), and CD163+ macrophages (p = 0.043) were negatively associated with MGMT expression levels. The number of CD68+ macrophages in the PD-L1 negative group was significantly more than that in the PD-L1 positive group (p = 0.01). The rate of PD-L1 positivity was positively correlated with the Ki-67 index (p = 0.046) and p53 expression (p = 0.029). Conclusion: Targeted therapy for macrophages and CD8+ TILs could be a helpful treatment in the future for aggressive PA. Anti-PD-L1 therapy may better respond to PAs with higher Ki-67 and p53 expression and more infiltrating CD68+ macrophages. Multiple treatment modalities, especially combined with immunotherapy could become a novel therapeutic strategy for aggressive PA.

目的 检索、筛选、总结并分析系统性红斑狼疮(systemic lupus erythematosus,SLE)患者生育期保健的相关证据并形成最佳证据总结,为SLE患者生育期的护理及管理提供循证依据.方法 系统检索美国指南网、英国国家卫生和临床优化研究所网站、UpToDate、PubMed、Web of Science、Cochrane Library、BMJ Best Practice、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、医脉通、中国生物医学文献数据库、中国知网和万方数据库中与SLE患者生育期保健有关的所有证据,包括指南、专家共识、证据总结、临床决策和Meta分析.检索时限为2011年1月1日—2021年11月18日.由2名研究者对纳入的文献进行质量评价和资料提取,并对符合要求的文献进行证据总结和归纳.结果 共纳入10篇文献,包括临床决策1篇、指南4篇、专家共识3篇和Meta分析2篇.最终形成包括计划妊娠、孕期监测及随访、孕期用药管理、哺乳及新生儿管理4个方面,共21条的最佳证据.结论 护理人员应结合临床特点和工作环境,考虑SLE患者个体情况后对其进行持续、动态的评估,制订治疗和护理方案,改善母婴结局,提高患者生活质量.

Background: Constipation is a functional gastrointestinal disorder that presents with signs and symptoms, which are typically assessed subjectively. Various measurement scales, such as the Constipation Assessment Scale (CAS), are commonly used to evaluate constipation among the general population. However, the instruments should be culturally and contextually relevant in adult psychiatric patients to generate valid and reliable evidence. Purpose: This study aimed to cross-culturally adapt and psychometrically validate the traditional Chinese version of the CAS among adult psychiatric patients in Hong Kong. Method: Using the Brislin protocol and Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines, the CAS was translated into traditional Chinese and tested for internal consistency, test–retest reliability, content validity, and construct validity among psychiatric patients in Hong Kong. Results: The CAS was successfully translated into CAS-TC. The CAS-TC version demonstrated good content validity (scale level CVI = 97%), internal consistency (Cronbach’s alpha = 0.79), and test–retest reliability (ICC = 0.722 [95% CI, 0.587–0.812]). The CAS-TC showed a two-factor loading for the construct validity, which explained 54% of the total variance. Conclusions: The CAS-TC is valid and reliable and can be employed to assess constipation among adult psychiatric patients.

目的 总结成人造血干细胞移植患者口腔并发症预防及管理的最佳证据,为临床护理工作提供参考.方法 检索BMJ、UpToDate、JBI、NGC、NICE、医脉通、Cochrane Library、PubMed、Embase、CINAHL、Web of Science、中国知网、万方数据库,选取符合标准的文献.由2名研究员对文献进行质量评价,证据提取及整合.结果 共纳入证据19篇,包括指南8篇,临床决策1篇、证据总结4篇、专家共识4篇、随机对照试验2篇,从8个维度即评估、基础口腔护理、物理干预、营养干预、药物干预、症状管理、出院指导和人员支持,共总结16条最佳证据.结论 该研究总结造血干细胞移植患者口腔护理管理最佳证据,为临床医护人员开展口腔护理提供循证依据.医务人员应根据临床实际情况及患者意愿选择并应用最佳证据.

目的 探讨血浆蛋白C(protein C,PC)、血浆蛋白S(protein S,PS)、血浆抗凝血酶(antithrombin,AT)、血浆凝血因子Ⅷ(coagulation factor Ⅷ,F Ⅷ)在不同Child-Pugh肝功能分级的慢性肝硬化患者中的应用意义.方法 选取2020年12月至2021年12月首都医科大学附属北京佑安医院进行诊治的96例慢性肝硬化患者作为研究对象,另选择同期体检正常的15例正常人作为对照组,分别采用发色底物法和凝固法测定不同Child-Pugh肝功能分级患者的PC、PS、AT、FⅧ等水平并进行比较,并分析相关性.结果 蛋白C、蛋白S、AT、FⅧ在不同Child-Pugh肝功能分级的分组间有显著差异.随着Child-Pugh肝功能分级变差,患者的蛋白C、蛋白S和AT的活性明显降低,FⅧ活性增加.结论 慢性肝硬化有高凝风险,建议检测和评估血栓形成的可能.

目的 分析总结原发中枢神经系统(central nervous system,CNS)恶性黑色素瘤的临床、影像、治疗及预后特点.方法 对首都医科大学三博脑科医院神经外科 2011 年 5 月至 2021 年 5 月收治并经病理证实的 17 例原发性CNS恶性黑色素瘤患者的临床资料进行回顾性分析,将其分为 4 种类型,分析不同类型患者的年龄、影像特点及治疗和预后情况.结果 17 例患者中 6 例为A型(脑表型),5 例为B型(脑池型),4 例为C型(深部孤立型),2 例为D型(椎管及其他型).表现为颅高压症状者 11 例、局部神经功能障碍者9 例、癫痫者3 例.磁共振(magnetic resonance imaging,MRI)平扫出现T1 高信号者12 例.播散转移 13 例,其中 11 例呈线片状.手术切除 14 例、活检 3 例,6 例术后进行了抗肿瘤治疗.总体中位生存期 7 个月,综合治疗的患者较单纯手术治疗的患者生存期明显延长[(20.6±7.9)个月vs(3.3±0.9)个月].各分型间症状、影像及治疗方式均有明显差别.结论 原发CNS恶性黑色素瘤发病率低,多具有较明显的影像特点,临床可分为 4 种类型.该病需手术联合放射治疗等进行综合治疗,但其恶性程度高,预后差.

Introduction:Poststroke depression (PSD) is common but insufficiently addressed by health professionals, and management is not always evidence-based.Objectives:This evidence implementation project aimed to improve adherence to evidence-based practice for screening, prevention, and management of patients with PSD in the neurology ward of the Fifth Affiliated Hospital of Zunyi Medical University, China.Methods:This project was based on the JBI methodological approach and was conducted in three phases, from January to June 2021: a baseline audit, implementation of strategies, and a follow-up audit. We utilized the JBI Practical Application of Clinical Evidence System software and the Getting Research into Practice tools. Fourteen nurses, 162 stroke patients, and their caregivers participated in this study.Results:The results of the baseline audit showed that compliance with evidence-based practice was poor, with 3/6 criteria showing 0% adherence and the other three audit criteria showing 5.7, 10.3, and 49.4% adherence, respectively. Through feedback to nurses regarding the baseline audit results, the project team identified five barriers and adopted a battery of strategies to overcome these barriers. The follow-up audit revealed significantly enhanced outcomes across all the best practice criteria, and the compliance of each criterion reached at least 80%.Conclusion:The implementation program designed to screen, prevent, and manage PSD in a tertiary hospital in China improved nurses' knowledge and compliance with evidence-based management of PSD. Further testing of this program in more hospitals is needed.

Objective:We conducted a real-world multi-center clinical study with a large sample size to comprehensively evaluate the performance of three commercial hepatitis C virus (HCV) core antigen assays. The study aimed to evaluate the performance for their use in HCV infection screening, and to provide clues for further improving the sensitivity and specificity of the assays.Methods:Key performance indicators including the lower limit of detection (LOD), diagnostic sensitivity, and specificity of three HCV antigen assays (the Architect, Laibo, and ChemClin HCV core antigen assays) were evaluated using commercial seroconversion panels reflecting early HCV infection and clinical routine serum samples of outpatients and inpatients from 3 tertiary hospitals from January 2018 to April 2022. Factors that affect the performance indicators were further investigated.Results:The window period for detecting HCV infection with the three antigen assays was equal to or slightly longer than that of the RNA assay, but all are shorter than that of the anti-HCV assay. There was a good linear positive correlation between HCV core antigen and HCV RNA levels in treatment naive patients with hepatitis C ( r=0.90, P<0.01). For the most common genotype 1b strain in China, the LOD of the three HCV assays were equivalent to 531 IU/ml (Architect), 3,698 IU/mL (Laibo), and 4,624 IU/mL (ChemClin) HCV RNA, respectively. Due to the skewed distribution of HCV RNA levels in treatment-naive hepatitis C patients, more than 95% of the patients had viral loads higher than 6 166 IU/ml. Therefore, the three HCV antigens assays still maintained a satisfactory diagnostic sensitivity (94.33%-99.40%). Among 54 immunodeficient patients (leukemia patients) with HCV infection, 9% (5/54) had negative anti-HCV results, while the HCV antigen assays found all these infectors. Through further experiments, we revealed the amino acid polymorphism in the core region of genotype 3 strain impaired the sensitivity of all three HCV antigen assays. In addition, the sensitivity of the two domestic assays was impaired by anti-HCV antibodies in the serum. The specificity of HCV antigen assays for diagnosing hepatitis C is 99.94% to 99.98%. The rheumatoid factors, autoantibodies, and other unknown interference substances can lead to a small number of low level, "false positive" antigen results. Conclusions:HCV core antigen assay may be used as a satisfactory approach of infection screening, especially for the immunodeficient patents. However, the sensitivity and specificity of the assays are influenced by multiple factors, which should be further improved.

目的 分析合并巨细胞病毒性视网膜炎(CMVR)与非巨细胞病毒性视网膜炎(nonCMVR)AIDS患者的一般临床检测指标的差异和相关性,为CMVR患者的早期、及时诊断与治疗提供帮助.方法 回顾性分析就诊于首都医科大学附属北京佑安医院33例AIDS合并视网膜病变患者入院时的一般资料和常规临床检测指标,依据房水中CMV病毒载量检测(AH-CMV)结果分为CMVR(n=20,≥500 copies/mL)和nonCMVR组(n=13,<500 copies/mL),对比分析两组T淋巴细胞、血常规检测指标之间的差异,以及各检测指标与AH-CMV的相关性.结果 CMVR和nonCMVR两组患者的年龄、性别组成差异均无统计学意义;对T淋巴细胞常规检测分析显示,两组之间CD3+、CD4+、CD8+T淋巴细胞的比例和数量差异均无统计学意义,CD4/8比值在两组之间差异无统计学意义(P>0.05);CMVR组患者中CD4+T<100个/μL的患者15例(75.0％),多于nonCMVR组中CD4+T<100个/μL的患者8例(61.5％),但差异无统计学意义(P>0.05);对血常规检测分析显示,两组之间WBC、LYM、MON、PLT检测值差异均无统计学意义,CMVR组患者的NEU、NLR水平显著低于nonCMVR组患者(P<0.05);AH-CMV与临床常规检测指标的相关性分析显示,AH-CMV与外周血CMV病毒载量、T淋巴细胞、WBC、NEU、LYM、MON、PLT之间均无显著的相关性,AH-CMV与NLR具有显著的负相关(P<0.05),相关系数为-0.36(95％CI:-0.68～-0.02),NLR与CD3、CD8T细胞具有显著的负相关(P<0.01),相关系数分别为-0.45(95％CI:-0.73～-0.17)、-0.46(95％CI:-0.72～-0.20).结论 CMVR与nonCMVR患者均处于免疫抑制状态,NLR比值在一定程度上反映了房水中CMV病毒载量的水平,可以为AIDS患者CMVR的诊断与治疗提供简便、可靠的临床常规检测指标.

Introduction: Currently, unilateral biportal endoscopy (UBE) as a new minimally invasive technique has been applied to conventional arthroscopic systems for the treatment of spinal disease. Aim: To analyze the clinical effect of UBE in the treatment of lumbar diseases. Material and methods: A systematic review of the literature published up to May 2021 was performed in the English database PubMed, Embase, and the Chinese database CNKI, Wanfang. There were 9 studies included in this systematic review and meta-analysis. The outcomes measured included operative time, Visual Analog Scale (VAS), and the Oswestry Disability Index (ODI). Results: A total of 528 patients were collected from the selected 9 articles. The random effects model showed that the value of pooled effect mean deviation (MD) in each study was 58.62 (95% CI (57.53, 59.72), p < 0.001). At the end of postoperative follow-up, the standard mean difference (SMD) VAS scores of legs -4.12 (95% CI (-5.15, -3.09), p < 0.001) and back -3.10 (95% CI (-4.35, -1.84), p < 0.001) were lower than the preoperative values. At the same time, the results of the random-effects model showed that the SMD of the ODI score was -7.07 (95% CI (-8.69, -5.46), p < 0.001) and at the end of follow-up was lower than preoperatively. Conclusions: UBE surgery has a good clinical effect in the treatment of lumbar diseases, and can be widely used in the treatment of free prolapse lumbar disc herniation (LDH).

Background: Parasellar chondrosarcomas are extremely rare. This study describes the characteristics of parasellar chondrosarcoma and analyzes the risk factors and prognosis based on the resection degree. Methods: Fifteen patients with pathologically diagnosed parasellar chondrosarcoma were retrospectively analyzed for the clinical data, surgical methods, and prognosis to identify relationships between the surgical resection degree, tumor recurrence, and imaging characteristics. Results: Twelve patients had eye dysfunction and ptosis. Differentiation from other parasellar tumors by imaging is difficult. The preoperative Karnofsky Performance Scale (KPS) score positively correlated with the tumor resection degree (p = 0.026) and negatively correlated with the maximum tumor diameter (p = 0.001). Tumor recurrence negatively correlated with the resection degree (p = 0.009). The postoperative KPS score positively correlated with the preoperative KPS score (p < 0.001) and tumor resection degree (p = 0.026), and negatively correlated with the maximum tumor diameter (p = 0.016) and age (p = 0.047). An improved KPS score positively correlated with the tumor resection degree (p = 0.039). Patients who underwent total resection of the chondrosarcoma had longer progression-free survival than those who underwent partial resection (p = 0.0322). Conclusion: Parasellar chondrosarcomas are difficult to resect completely. Preoperative KPS score is an important factor for the degree of resection. KPS score, age, maximum tumor diameter, and resection degree may be important prognostic factors.

目的 分析2012～2019年北京佑安医院手足口病(HFMD)流行趋势变化,比较不同型别HFMD中性粒细胞/淋巴细胞比值(NLR).方法 回顾分析2012年6月至2019年12月北京佑安医院收治HFMD流行病学资料和临床资料,统计分析各型别肠道病毒(EV)的流行趋势及NLR水平变化.结果 共收集8726例经临床确诊的手足口病例,好发年龄为1～3岁和3～6岁,男性多于女性,在2014年发病例数达到高峰(n=2032),随后逐年下降,2012、2014和2016年EV71、CA16为主要感染型别,2017年后EV71感染比例下降,CA16感染比例上升.其他EV型别在2013、2015和2018为主要型别,与EV71、CA16交替出现高峰,对2017、2018年97例样本分型显示主要型别为CA6、CA10,且存在共感染病例.EV71病例住院比例最高为30.88％,但NLR维持在低水平为1.54,CA6、CA10共感染病例NLR水平最高为4.26,但住院比例较低为8.33％.结论 不同型别EV的共同流行与共感染增加了病毒之间基因重组和病例重症化的风险,长期、持续监测其流行趋势变化,对H FMD及时、早期预防与控制具有重要意义.