Objective To compare the curative effect difference between the simple posterior approach and the combined posterior and anterior approach for the treatment of lumbar tuberculosis, to explore the feasibility of the simple posterior lesion clearance particle bone graft internal fixation surgery. Methods A retrospective analysis was performed for 42 patients who underwent simple posterior or combined posterior and anterior surgery for lumbar tuberculosis in Hebei Chest Hospital from May 2020 to August 2022, and were divided into the simple posterior group and combined posterior and anterior group according to the surgical method. There were 24 cases in the simple posterior group, including 13 males and 11 females, aged 22-80 years. There were 18 cases in the combined posterior and anterior group, including 10 males and 8 females, aged 17-69 years. The operation time, intraoperative blood loss, postoperative bed rest time, ESR and CRP were compared between the two groups. Low back pain and functional recovery were assessed using the Pain Visual Analogue Scale(VAS) and the Oswestry Dysfunction Index(ODI). The degree of Cobb Angle correction, the degree of loss at 1 year and the postoperative fusion time were compared between the two groups. Bridwell bone fusion criteria and CT bone fusion criteria were used to evaluate bone fusion. Results The operation time of the simple posterior group was lower than that of the combined posterior and anterior group(t/P=5.995/<0.001). The intraoperative blood loss in the posterior group was lower than that in the combined posterior and anterior group(t/P=2.134/0.039). The postoperative bed time in posterior group was lower than that in the combined posterior and anterior approach group(t/P=5.835/<0.001). There were significant differences in ESR and CRP between 2 groups 6 months after operation and before operation(P<0.01).VAS and ODI scores before surgery and 1 year follow-up was compared between the two groups, and there was significant statistical significance(P<0.01). there="" was="" no="" significant="" difference="" between="" the="" two="" p="">0.05). There was no significant difference in the degree of Cobb Angle correction, the degree of loss one year after surgery and the time of fusion between the two groups(P>0.05).There was no significant difference in the fusion rate of bone graft between the two groups according to Bridwell fusion criteria and CT bone fusion criteria(P>0.05).Conclusion Both the simple posterior approach and the combined posterior and anterior approach can obtain satisfactory results in the treatment of lumbar tuberculosis. The treatment of lumbar tuberculosis by simple posterior lesion removal particle bone graft internal fixation surgery is safe and feasible, and has achieved good clinical efficacy. simple posterior lesion removal particle bone graft has the advantages of short operation time, less bleeding and less trauma.

Objective To explore the effectiveness and safety of high tibial osteotomy(HTO) combined with arthroscopic microfracture in the treatment of knee varus osteoarthritis. Methods Sixty-three patients with knee varus osteoarthritis admitted to Department of Orthopedics of Urumqi Friendship Hospital were prospectively selected from February 2020 to July 2021 and were divided into control group(32 cases) and study group(31 cases) according to the random envelope method. The control group underwent HTO combined with arthroscopic surgery, and the study group was given HTO combined with arthroscopic microfracture, and both groups received the same postoperative rehabilitation training. The Outerbridge grading cartilage repair at the time of initial surgery and secondary exploration, levels of inflammatory factors before and after surgery, Visual Analogue Scale(VAS) score and International Knee Documentation Committee Subjective Function(IKDC) score were compared between the two groups of patients, and the complications of the two groups were counted and compared. Results There was no significant difference in cartilage injury between the two groups at the time of initial surgery(P>0.05). At the time of second postoperative exploration, the cartilage repair effect in study group was significantly better than that in control group(χ2=5.980, P=0.014). The levels of tumor necrosis factor-α(TNF-α) and prostaglandin E2(PGE2) in study group at 3 days after the second surgery were significantly lower than those in control group(t=2.784, 3.103,P=0.007, 0.003). The VAS score in both groups at 6 months, 1 year and 2 years after surgery showed a gradient over time, and the score was lower than that before surgery(P<0.05), and the VAS scores in study group at various time points after surgery were lower than those in control group(t=2.160, 2.864, 2.665, P=0.035, 0.006, 0.010). The IKDC score in the two groups revealed a gradient at 6 months, 1 year and 2 years after surgery and was higher than that before surgery(F=138.229, 160.509, all P<0.001), and="" the="" ikdc="" scores="" at="" various="" time="" point="" after="" surgery="" were="" higher="" in="" study="" group="" than="" those="" control="" t="2.997," p="" .="" there="" was="" no="" significant="" difference="" total="" incidence="" rate="" of="" complications="" between="" two="">0.05). Conclusion HTO combined with arthroscopic microfracture can promote articular cartilage repair, relieve pain and improve knee function in patients with knee varus osteoarthritis, and it has good safety and high clinical value in cartilage recovery of knee varus osteoarthritis.

Objective To investigate the changes in serum levels of microRNA-335-5p(miR-335-5p) and microRNA-141-3p(miR-141-3p) in patients with polycystic ovary syndrome(PCOS) and their diagnostic value. Methods A total of 145 patients with PCOS treated in the Gynecology Department of Nantong Hospital of Traditional Chinese Medicine from February 2019 to June 2022 were selected as PCOS group and divided into IR subgroup and non-IR subgroup according to HOMA-IR. They were divided into obese subgroup and non-obese subgroup according to BMI. According to the level of testosterone, they were divided into high androgen subgroup and non-high androgen subgroup. Another 110 female health examination subjects in the same period were selected as control group. The serum miR-335-5p and miR-141-3p levels of the two groups/different clinical conditions were detected and compared by fluorescence quantitative PCR. Pearson correlation or Spearman rank correlation coefficient described the correlation between serum miR-335-5p and miR-141-3p and clinical indicators. Multi factor logistic was applied to analyze the factors that affected the occurrence of PCOS. ROC curve was applied to analyze the diagnostic value of serum miR-335-5p and miR-141-3p levels for PCOS. Results By comparison of clinical data, the levels of BMI, FINS, LH, testosterone(T) and HOMA-IR in PCOS group were significantly higher than those in control group(t/P=4.881/<0.001, 16.326/<0.001, 37.901/<0.001, 43.690/<0.001,15.395/<0.001). Compared with control group, serum miR-335-5p and miR-141-3p levels in PCOS group were decreased(t/P=10.516/<0.001, 8.767/<0.001). The levels of miR-335-5p and miR-141-3p in IR subgroup, obesity subgroup and hyperandrogenism subgroup were lower than those in non-IR subgroup, non-obesity subgroup and non-hyperandrogenism subgroup(t/P=2.882/0.005, 3.783/<0.001, 5.196/<0.001, 4.515/<0.001, 5.069/<0.001, 4.296/<0.001); Correlation analysis showed that serum miR-335-5p, miR-141-3p levels were negatively correlated with IR,BMI,testosterone(P<0.01).Serum miR-335-5p, miR-141-3p, BMI, Fins, LH, testosterone and HOMA-IR were all risk factors for PCOS[OR(95%CI)=1.812(1.348-2.436)、2.536(1.647-3.842)、2.913(1.523-5.573)、1.293(1.207-1.385)、1.692(1.180-2.427)、3.452(2.518-4.733)、4.620(1.916-11.139)]; The area under the curve(AUC) of serum miR-335-5p, miR-141-3p and their combination in the diagnosis of PCOS patients were 0.818, 0.733 and 0.873. The combined detection of miR-335-5p and miR-141-3p had more diagnostic efficacy than that of serum miR-335-5p and miR-141-3p alone(Z=2.882, 4.767, P<0.001). Conclusion Serum miR-335-5p and miR-141-3p are low expressed in patients with PCOS, they may be involved in IR, obesity, and hyperandrogenism secretion in PCOS patients. The combined diagnosis of the two has more diagnostic efficacy for PCOS and is expected to become an important method for assisting in the diagnosis of PCOS.

Objective To explore the diagnostic value of transvaginal ultrasound(TVUS) combined with serum secretory leukocyte peptidase inhibitor(SLPI) and soluble mesothelin-related peptide(SMRP) in benign and malignant ovarian tumors. Methods From January 2022 to June 2023, 120 patients with ovarian tumor diagnosed and treated in the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine were selected and divided into benign group(70 cases) and malignant group(50 cases) according to the pathological diagnosis results. The patients were examined by gray-scale ultrasound and color Doppler ultrasound with color Doppler ultrasound diagnostic instrument, and the parameters were recorded. The levels of SLPI and SMRP were detected by ELISA. Multivariate Logistic regression analysis was used to analyze the influencing factors of benign and malignant ovarian tumors; ROC curve analysis of TVUS combined with SLPI and SMRP in the diagnosis of benign and malignant ovarian tumors. Results In the benign group, there were 59 cases(84.3%) of benign and 11 cases(15.7%) of malignant TVUS, 17 cases(34.0%) of benign and 33 cases(66.0%) of malignant(χ2=31.759, P<0.001). The maximum diameter of lesion, the highest systolic equivalent blood flow velocity(Vs) and the lowest diastolic peak blood flow velocity(Vd) in malignant group were higher than those in benign group(t/P=6.074/<0.001, 3.247/0.002, 3.048/0.003). Compared with the benign group, the levels of SLPI and SMRP in the malignant group were higher(t=7.515, 7.818, P<0.001). High SLPI, high SMRP, high Vs and high Vd are independent risk factors for ovarian malignant tumor[OR(95%CI)=1.625(1.066-2.477), 1.834(1.053-3.194), 1.375(1.033-1.831), 1.624(1.059-2.490)]. The AUC of serum TVUS, SLPI, SMRP and their combination in the diagnosis of benign and malignant ovarian tumors were 0.751, 0.820, 0.813 and 0.948, respectively. The AUC of the combined diagnosis of TVUS, SLPI, SMRP and their combination was better than that of their individual diagnosis(Z=5.468, 3.441 and 3.517, P<0.001). Conclusion The increased expression of SLPI and SMRP in serum of patients with malignant tumor is the influencing factor of malignant tumor. TVUS combined with SLPI and SMRP has high value in diagnosing benign and malignant ovarian tumors and can be used in clinical practice.

Objective To investigate the predictive value of serum S100 calcium binding protein A11(S100A11) and allogeneic inflammatory factor 1(AIF1) in patients with high grade cervical intraepithelial neoplasia(CIN). Methods Ninety-eight CIN patients(CIN group) treated in Northwest University First Hospital from January 2021 to January 2024 were selected. During the same period, 50 patients with chronic cervicitis confirmed by biopsy were selected as the disease control group, and 50 healthy women who underwent physical examinations were selected as the healthy control group. Enzyme linked immunosorbent assay was used to detect serum S100A11 and AIF1 levels in each group. Multivariate Logistic regression analysis was used to identify factors that influence the occurrence of high-grade CIN. The predictive value of serum S100A11 and AIF1 on the occurrence of high-grade CIN was analyzed by analyzing the receiver operating characteristic curve. Results The serum levels of S100A11 and AIF1 in the CIN group were higher than those in the healthy control group and the disease control group, and the differences were statistically significant(F/P=369.360/<0.001, 269.282/<0.001). The serum S100A11 and AIF1 levels in CIN patients with high CIN grade Ⅱ-Ⅲ and high-risk HPV infection positivity were higher than those in CIN grade Ⅰ and high-risk HPV infection negative patients, and the differences were statistically significant(F/P=95.082/<0.001,92.990/<0.001;t/P=7.903/<0.001,5.392/<0.001). Positive high-risk HPV infection, elevated serum S100A11, and elevated AIF1 were independent risk factors affecting the occurrence of high-grade CIN[OR(95%CI)=1.278(1.149-1.420),1.270(1.114-1.448),1.339(1.079-1.661)]. The area under the curve of combined detection of serum S100A11 and AIF1in predicting for high-grade CIN occurrence was 0.906, higher than serum S100A11, AIF1 alone 0.795, 0.813, and the difference was statistically significant(Z=3.930, 3.515, P<0.001). Conclusion The serum S100A11 and AIF1 levels in CIN patients are elevated, which are related to CIN grading and high-risk HPV infection. The combination of the two has high predictive value for the occurrence of high-grade CIN.