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Background: Global spread and impact of the coronavirus disease 2019 (COVID-19) pandemic are determined to a large extent,by resistance to the pandemic and public response of all countries in the world;while a country's resistance and response are in turn determined by its political and socio economic conditions.To inform future disease prevention and control,we analyzed global data to exam the relationship between state vulnerabilities and COVID-19 incidences and deaths.Methods: Vulnerability was measured using the Fragile States Index (FSI).FSI is created by the Fund for Peace to assess levels of fragility for individual countries.Total FSI score and scores for 12 specific indicators were used as the predictor variables.Outcome variables were national cumulative COVID-19 cases and deaths up to September 16,2020,derived from the World Health Organization.Cumulative incidence rates were computed using 2019 National population derived from the World Bank,and case fatality rates were computed as the ratio of deaths/COVID-19 cases.Countries with incomplete data were excluded,yielding a final sample of 146 countries.Multivariate regression was used to examine the association between the predictor and the outcome measures.Results: There were dramatic cross-country variations in both FSI and COVID-19 epidemiological measurements.FSI total scores were negatively associated with both COVID-19 cumulative incidence rates (β =-0.0135,P ＜ 0.001) and case fatality rates (β =-0.0147,P ＜ 0.05).Of the 12 FSI indicators,three negatively associated with COVID-19 incidences were E1(Economic Decline and Poverty),E3 (Human Flight and Brain Drain),and S2 (Refugees and Internally Displaced Persons);two positively associated were P1 (State Legitimacy) and X1 (External Intervention).With regard to association with case fatality rates,C1 (Security Apparatus) was positive,and P3 (Human Rights and Rule of Law) and X1 was negative.Conclusion: With FSI measures by the Fund of Peace,overall,more fragile countries are less likely to be affected by the COVID-19 pandemic,and even if affected,death rates were lower.However,poor in state legitimacy and lack of external intervention are risk for COVID-19 infection and lack of security apparatus is risky for COVID-19 death.Implications of the study findings are discussed and additional studies are needed to examine the mechanisms underpinning these relationships.
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The outbreak of COVID-19 has spread quickly across 114 countries/territories/areas in six continents worldwide and has been announced as a pandemic by WHO. This study analyzed global COVID-19 epidemiological trends, examined impact of the pandemic on global health security, diplomacy, and social environment in China, and provided short- and long-term strategic policy recommendations for China’s subsequent preparedness and responses.
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Objective To investigate the effects of intervertebral bridging ossifications in patients of osteoporotic vertebral compression fracture (OVCF) on bone fracture healing.Methods A total of 170 patients of thoracolumbar vertebral endplate fracture who were admitted into our hospital were selected.Divided these patients into the observation group,namely 60 patients with nonunion of vertebral endplate after 3 months of conservative treatment,and the control group, including 110 patients with well healed vertebra after 3 months of conservative treatment.Compared the distribution of intervertebral bridging ossifications of the two groups 3 weeks after injury.Results The incidence of bridging ossification at levels of T9 to T10,T10to T11,T11to T12 in the observation group were significantly higher than that in the control group.And it showed a significantly higher incidence of bridging ossification at the second proximal intervertebral segment in the observation group than that of the control group.There was a significantly greater sagittal wedge angle in the observation group compared with the control group.Conclusion Conservative treatment may increase the risk of nonunion of osteoporotic vertebral compression fractures when there is a bridging ossification at the second proximal intervertebral level or the sagittal wedge angle was greater than 14.2°in a fresh osteoporotic vertebral compression fracture.It should be a careful choose whether to take conservative treatment or surgical intervention.
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Objective To explore the relationship among the prevertebral soft tissue swelling, surgical extent, surgical segments, and complications and to investigate the clinical significance of lateral radiographs for evaluating the postoperative prevertebral soft tissue swelling. Methods 123 patients who underwent anterior cervical fusion with plate augmentation for cervical spondylosis were included in this study. The postoperative prevertebral soft tissue swelling was measured by lateral radiographs. The data were analysed according to surgical extent and surgical segments. Patients were divided into the swelling group (61cases, >9. 98 mm) and the non-swelling group (62 cases, <9. 98 mm) based on the degree of prevertebral soft tissue swelling. The incidences of complications, such as dyspnea and dysphagia, were ana-lysed. Results The rate of dyspnea was 21. 3% in swelling group, which was higher than 8. 1% in non-swelling group (P<0. 05). The rate of dysphagia was 83. 6% in swelling group, which was higher than 25. 8% in non-swelling group (P<0. 05). In addition, postoperative prevertebral soft tissue swelling was 8. 29 mm averagely after one-level fusion, which was less than that after two or more levels fusion (11. 55 mm and 10. 40 mm) (P<0. 05). Postoperative prevertebral soft tissue swelling was 10. 94 mm after high-level fusion (above C4), which was more than that low-level fusion (below C5) (8. 63 mm) (P<0. 05). Conclusion After anterior cervical fusion for cervical spondylosis, when the degree of prevertebral soft tissue swelling is greater the incidences of complications such as dyspnea and dysphagia might be higher. In addition, prevertebral soft tissue swelling increments are significantly greater in patients who had undergone multi-level or high-level fusion ( above C5 ) . Evaluation of prevertebral soft tissue swelling using lateral radiographs is a clinically meaningful procedure.
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Objective To observe the regulatory effect of bFGF and TGF-β1 for the proliferation of mesenchymal progenitor cells ( MPCs) derived from primary osteoarthritis cartilage, and to provide theoretical evidence in preventing and curing primary OA. Methods Different concentrations of bFGF and TGF-β1 ( alone or combined) were used to treat primary OA cartilage and their effects on proliferation of MPCs were tested by MTT method. Results Either bFGF (10. 0~50. 0 ng/mL) or TGF-β1 (0. 1 ~1. 0 ng/mL) alone can significantly promote the proliferation of MPCs derived from primary OA cartilage (P0. 05). The combination of 10. 0 ng/mL bFGF and 1. 0 ng/mL TGF-β1 significantly increased the prolifer-ation of MPCs from primary OA (P<0. 05). Conclusion Both bFGF and TGF-β11 play important roles in the proliferation of MPCs in primary OA cartilage,and they can increase the proliferation in different degree with different concentrations. There must be feasible methods of gene technology to promote cell proliferation and differentiation of MPCs for repairing articular car-tilage injury.
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BACKGROUND:Three-dimensional visualization technique has been widely used in clinical treatment. Preoperative visualization technique al ows safe demonstration on the complex spine fracture models, and also prepare screw placement scheme according to three-dimensional model of patients. OBJECTIVE:To discuss the clinical result of treating short-segment lumbar vertebrae fracture with pedicle screw visualization. METHODS:A total of 32 patients with lumbar vertebrae fracture were treated with 182 pedicle screws. Before the screw implantation, the structure of bilateral pedicle was observed using Mimics software and the implantation parameters were measured. The operation methods and related complications were told to the patients through the reconstructed three-dimensional images. The satisfaction of the patients, operation time, and the position of pedicle screws by postoperative CT scan were assessed. The percentages of anterior vertebral height and Cobb’s angle were measured before operation, 2 weeks after operation and 8 months after operation. RESULTS AND CONCLUSION:The excellent satisfaction rate of the patients was 100%, the mean operation time was 185 minutes, and 173 pedicle screws (95.1%) were total y inserted within the pedicle. Al patients were fol owed up for 7-22 months. The results showed that the fracture healed wel . The percent of anterior vertebral height and Cobb’s angle at 2 weeks after operation were significantly decreased compared with them before operation (P0.05). Single-segment lumbar vertebrae fracture was wel treated by the pedicle screw visualization technique. This method assists to make up preoperation plan, increase the rate of patients’ satisfaction, shorten operation time, and increase the accuracy of pedicle screw insertion.
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Objective To observe the growth and proliferation capabilities of MPCs in primary OA articular cartilage and their differen-tiation properties into chondrocytes by applying related genes SOX6 and SOX9, so as to provide theoretical evidence in preventing and curing primary OA. Methods SOX6 and SOX9 genes were respectively ligated into adenovirus shuttle plasmids pAdTrack-CMV-SOX6 and pAdTrack-CMV-SOX9, then the recombinant plasmids were used to infect MPCs derived from primary OA articular cartilage. TB and the ex-pressions of collagen type Ⅱ protein and mRNA in differentiated MPCs were compared between the infected group and the uninfected group. Results Either SOX6 gene or SOX9 gene could stably infect MPCs from primary OA cartilage. TB and collagen typeⅡwere strongly posi-tive in the SOX6-infected or SOX9-infected MPCs, while they were weekly positive in the uninfected MPCs. Collagen typeⅡmRNA expres-sion in SOX6-infected MPCs derived from primary OA cartilage was 3. 8 times of that in uninfected cells (P<0. 01), and that in SOX9-in-fected MPCs was 5. 15 times of that in the uninfected cells (P<0. 01). Conclusion The stable transfection of SOX6 and SOX9 genes into MPCs derived from primary OA cartilage could significantly promote chondrogenic differentiation of MPCs. There must be feasible methods of gene technology to promote cell proliferation and differentiation of MPCs for repairing articular cartilage injury.