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Objective To investigate the clinical efficacy of posterior surgery for children with thoracic and lumbar tuberculosis. Methods Clinical data of 9 children with vertebral tuberculosis who underwent posterior surgery in our department from January 2013 to June 2021 were collected and retrospectively analyzed. The operation time, blood loss, length of hospital stay and other indicators, as well as the general condition after operation and during follow-up were summarized and analyzed. Kyphosis correction was evaluated with the results of X-ray filming and CT scanning. Visual analogue score (VAS), Oswestry disability index (ODI) and Frankel scores were used to evaluate the recovery of neurological function. Results For the 9 children, there were 5 males and 4 females, at a mean age of 6.4±3.3 years, and there were 4 cases of thoracic, 2 of thoracolumbar and 3 of lumbar tuberculosis. Preoperative Frankel scores showed that there were 2 cases in Grade C, 3 in Grade D, and 4 in Grade E for neural status. The mean follow-up time was 29.2±8.6 months. All patients had attained neurological improvements with Frankel grade increasing by more than 1 grade. At the final follow-up, the VAS score decreased from 3.2±2.0 to 1.0±0.5, while ODI score from 31.3±21.3 to 13.7±8.7. The Cobb angle of kyphosis was decreased from (46.2±23.8)° preoperatively to (22.6±16.9)° postoperatively. All patients achieved satisfactory osseous fusion in 1 year after surgery. Only 1 patient had tuberculosis recurrence and received a second operation. The mean operation time was 398.2±203.7 min, mean blood loss was 550.0±355.3 mL, and mean hospital stay was 20.0±8.4 d. Conclusion Posterior approach can achieve satisfactory outcomes and avoid the occurrence of kyphosis in the treatment of thoracic and lumbar tuberculosis in children.

Objective To investigate the role and mechanism of vitamin D and vitamin D receptor (VDR) in various stages of osteoclastogenesis. Methods First, bone marrow derived macrophages (BMMs) were extracted from the bone marrow of the femurs and tibias of C57BL/6 mice, and the BMMs were induced into osteoclasts by receptor activator of nuclear kappa B ligand (RANKL) and macrophage colony-stimulating factor (M-CSF). At the same time, different concentrations of 1, 25(OH)2D3 (0.1, 10 and 1 000 nmol/L) were added to activate VDR. TRAP and FAK staining, pit formation assay, qPCR and Western blotting were performed in this study. Results 1, 25(OH)2D3, as a strong agonist of VDR, effectively activated VDR at a dose of 1 000 nmol/L and inhibited the expression of c-Fos and NFATc1 at mRNA and protein levels at the early stage of osteoclast differentiation, and also inhibited the expression of CtsK and MMP9 at mature stage (P < 0.05). The dose significantly down-regulated the phosphorylation of IκBα (P < 0.05), and thereby suppressed the nuclear translocation and phosphorylation of p65. Conclusion 1, 25(OH)2D3 at 1 000 nmol/L significantly up-regulates the expression of VDR, and activates VDR to inhibit osteoclast differentiation, fusion and bone resorption activity through the IκBα/NF-κB p65 signaling pathway.

Objective: To assess the reliability and validity of the scale RYDM, as well as the resilience status and its impact factors., Methods: 964 students were investigated. The participants were chosen through the stratified cluster sampling. The software of SPSS 17.0 was used for the analysis., Results: (1) RYDM: The Cronbach alpha coefficient of the RYDM was 0.945. The split-half reliability was 0.865. The re-test reliability was 0.838. The correlations between total scale and 2 factor scales were 0.896 and 0.9743 respectively. The correlation between the 2 factor scales was 0.776. (2) The scores on family closeness, family high expectations, community expectation of left-behind children were lower than that of the no-left-behind children (P < 0.05). The protective factors of mental resilience in left-behind children were age, frequency of conflict with the guardian, worry degree about out-working parent(s) (P < 0.05)., Conclusion: Reliability and validity of the RYDM scale are psychometrically qualified. The resilience of the left-behind children is worse in some aspects than that of the no-left-behind children, which is influenced most by family factors.