The cervical sagittal balance is a description of cervical spine at the standing position. The position of cervical spine is measured by the corresponding sagittal parameters. The commonly used sagittal parameters of cervical spine include cervical lordosis (CL), cervical sagittal vertical axis (cSVA), T 1 Slope (T 1S), etc. Cervical sagittal balance is closely related to the overall balance of the spine, and the imbalance of sagittal parameter is also related to the progression of cervical disease, the choice of surgical methods and the postoperative efficacy. In recent years, more and more researchers have begun to pay attention to the sagittal balance of the cervical spine, especially the variation of sagittal parameters after cervical surgery, which can predict the postoperative neurological recovery and the change of long-term efficacy or complications. However, due to the variety of cervical surgery methods and the variety of cervical sagittal balance parameters, the existing studies can only reflect the relationship between the two from a certain aspect, while lacking overall and comprehensive description. In this paper, the relationship between sagittal plane balance and cervical surgery was reviewed by systematically searching literatures and screening relevant studies. According to our review, the cervical sagittal parameters have different tendency after different cervical surgery. Generally, anterior cervical surgery can maintain or improve the sagittal plane balance of the cervical spine, among which anterior cervical discectomy and fusion (ACDF) surgery has a best effect.After posterior cervical surgery, the cervical sagittal parameters tend to be unbalanced or compensated, and patients with preoperative sagittal imbalance, advanced age, and complex OPLL are more likely to have postoperative imbalance or imbalance aggravation. Therefore, attention should be paid to preoperative evaluation and reasonable surgical design in clinical practice to prevent the occurrence of sagittal imbalance of patients after surgery.

Objective:To develop a catalytic system for the asymmetric Morita-Baylis-Hillman ( MBH) reaction of conjugated ni-troalkene with activated aldehyde, and screen out the chiral catalysts with high activity and enantioselectivity. Methods: Totally 21 chiral organocatalysts were applied in the asymmetric MBH reaction ofβ-nitrostyrene with ethyl glyoxylate, and the ee value was deter-mined by chiral HPLC. The effects of temperature, solvent and substrate ratio on the catalytic reaction were investigated. Results: In the presence of cinchona alkaloid catalyst (DHQ)2AQN, β-nitrostyrene reacted with ethyl glyoxylate in toluene at 0℃ affording the MBH adduct in 60% yield with good enantioselectivity (up to 56.9% ee). Conclusion: The bis-cinchona alkaloids with aromatic bridging group are the efficient catalysts for the asymmetric MBH reaction ofβ-nitrostyrene with ethyl glyoxylate, and moderate isolated yield and enantioselectivity are obtained.

Objective To evaluate the effect of hydrogen on the activation of caspase-3 in brain tissues during cerebral ischemia-reperfusion (I/R) in rats.Methods Thirty-six healthy adult male Sprague-Dawley rats,weighing 220-250 g,were divided into 3 groups (n=12 each) using a random number table:sham operation (group S),I/R group and hydrogen group (group H).Cerebral ischemia was induced by occlusion of the middle cerebral artery followed by reperfusion in I/R and H groups.In group H,hydrogen-rich saline 5 ml/kg (0.6 mmol/L) was injected intraperitoneally at 3 days before establishment of the model and immediately after the onset of reperfusion.At 24 h of reperfusion,the rats were sacrificed,and hippocampal tissues were obtained for determination of neuroapoptosis (by TUNEL),apoptotic neuron count and expression of activated caspase-3 (by Western blot).The brain tissues in the ischemic area were obtained and stained with haematoxylin and eosin for examination of the pathological changes.Results Compared with group S,the expression of activated caspase-3 was significantly up-regulated,and the apoptotic neuron count was increased in I/R and H groups (P<0.05).Compared with group I/R,the expression of activated caspase-3 was significantly down-regulated,the apoptotic neuron count was decreased (P<0.05),and the pathological changes of brain tissues were significantly reduced in group H.Conclusion The mechanism by which hydrogen inhibits neuroapoptosis during cerebral I/R is probably related to inhibited activation of caspase-3 in brain tissues of rats.

HIV-1 integrase (IN) is a key enzyme for the viral replication. The protein-protein interaction (PPI) between HIV-1 IN and a cellular cofactor lens epithelium-derived growth factor (LEDGF/p75) is a validated target for anti-HIV drug discovery. In order to build the platform for screening inhibitor against PPI between IN and LEDGF/p75, the vector containing the LEDGF/p75 protein cDNA was constructed and expressed in Escherichia coli and the function of the LEDGF/p75 protein was assayed. The LGDGF/p75 encoding gene optimized according to the preference codon usage of E. coli, was synthesized and cloned into the expression vector pGEX-4T-1 to form a recombined plasmid, then transformed into host cell E. coli BL21 (DE3). The recombined clones were identified and confirmed by BamH I/Sal I digestion and sequencing, the successfully recombined plasmid in the host cell was induced by IPTG and the condition of the expression was optimized. The expressed protein was purified by the Ni2+ affinity chromatography column and SDS-PAGE was used to analyze the molecular weight and specificity. In addition, ELISA assay was used to analyze the function of the recombinant protein. The recombinant LGDGF/p75 was soluble, and expressed highly and stably in E. coli. The protein was proved to enhance HIV-1 IN strand transfer activity in vitro by ELISA. It will be helpful to build the platform of screening inhibitors against PPI between IN and LEDGF/p75.
Cloning, Molecular ; Escherichia coli ; metabolism ; HIV Integrase ; metabolism ; HIV-1 ; physiology ; Humans ; Intercellular Signaling Peptides and Proteins ; biosynthesis ; Protein Binding ; Virus Replication

Objective To evaluate the effect of hydrogen-rich saline on the expression of phosphor-p38 mitogen-activated protein kinase (p-p38MAPK) during cerebral ischemia-reperfusion (I/R) in rats.Methods Seventy-two adult male Sprague-Dawley rats,weighing 220-250 g,were randomly divided into 3 groups (n =20 each) using a random number table:sham operation group (group S),I/R group and hydrogen-rich saline group (group I/RH).Cerebral ischemia was induced in chloral hydrate-anesthetized rats by 2 h middle cerebral artery occlusion in I/R and I/RH groups.The artery was only exposed but not occluded in group S.At 3 days before operation and immediately after onset of reperfusion,hydrogen-rich saline (0.6 mmol/L) 10 ml/kg was intraperitoneally injected in group I/RH,while the equal volume of normal saline was given in S and I/R groups.Neurological deficits were blindly assessed and scored at the end of 24 h reperfusion.The animals were then sacrificed,and brains were removed for microscopic examination and for determination of the cerebral infarct size (by TTC),brain water content,cell apoptosis (by TUNEL),and expression of p38MAPk and phosphor-p38MAPK (p-p38MAPK) (by immunohistochemistry and Western blot).Apoptosis index was calculated.Results Compared with group S,neurological deficit score,apoptosis index,brain water content and cerebral infarct size were significantly increased,and the expression of p38MAPK and p-p38MAPK was up-regulated in I/R and I/RH groups.Compared with group I/R,neurological deficit score,apoptosis index,brain water content and cerebral infarct size were significantly decreased,and the expression of p38MAPK and p-p38MAPK was down-regulated in group I/RH.The pathological changes of cerebral tissues were significantly attenuated in group I/RH as compared with group I/R.Conclusion Hydrogen-rich saline can reduce cell apoptosis through inhibiting p-p38MAPK expression,thus attenuating cerebral I/R injury in rats.

Based on the infrared spectra of Lophatheri Herba and Commelinae Herba, one-dimensional infrared spectra, second derivative spectra and two-dimensional correlated spectra were used to find out the differences between Lophatheri Herba and its imitations, respectively. The common peak ratio and variant peak ratio dual-indexes sequential were calculated and established according to infrared spectra of eleven batches of herbs. Infrared spectral data of Lophatheri Herba cluster analysis was applied to explore the similarity between each sample. The grouping results trend of sequential analysis of dual-indexes and cluster analysis was accordant. The results showed that the differences could be found by multi-level identification, and the source and the quality of the herbs could be effectively distinguished by the two analysis methods. Infrared spectroscopy, used in the present work exhibited some advantages on quick procedures, less sample required, and reliable results, which could provide a new method for the identification of traditional Chinese medicine with the imitations and adulterants, and the control of quality and origin.
Drugs, Chinese Herbal ; analysis ; chemistry ; Plant Leaves ; chemistry ; Plants, Medicinal ; chemistry ; Reproducibility of Results ; Spectrophotometry, Infrared ; methods ; Spectroscopy, Fourier Transform Infrared ; methods

OBJECTIVETo investigate the clinical value of intraoperative ultrasonography in cervical laminoplasty.

METHODSThirty patients underwent cervical laminoplasty for cervical compressive myelopathy in our hospital from April 2010 to April 2012. Spinal cord compression ratio was calculated in preoperative MRI axial images for every patient. The spinal cord decompression status was evaluated by intraoperative ultrasonography during cervical laminoplasty. The pre- and post-operative Japanese Orthopaedic Association Scoring System (JOA) score was recorded, and the recovery ratios of surgery were graded using the Hirabayashi equation. The relationship between the parameters and neural recovery was explored.

RESULTSThe intraoperative ultrasonography was used to evaluate the ventral compression of the spinal cord. The ultrasonographic dynamic viewings were classified into three types based on the spinal cord contact with ventral structures after decompression: Type 1, non-contact (n=2); Type 2, contact and apart (n=16); and Type 3, contact (n=12). The patients were divided into two groups: group A, showing Type 1 or 2 findings, representing satisfied decompression; and group B, showing Type 3 findings with insufficient decompression. The recovery ratio was (73.3±21.0)%(31.3%-100.0%) in group A, but decreased to (43.2±33.1)%(0-83.3%) in group B(t=3.05,p=0.005). Pearson analysis showed that the patient age(r=-0.294,p=0.122), preoperative JOA score(r=0.059,p=0.759), and spinal compression ratio(r=0.269,p=0.151) was not correlated with Hirabayashi recovery ratio.

CONCLUSIONIntraoperative ultrasonography during laminoplasty is a feasible and promising method for evaluating spinal cord decompression status and predicting the prognosis following surgery.

Adult ; Aged ; Aged, 80 and over ; Decompression, Surgical ; Female ; Humans ; Laminectomy ; methods ; Male ; Middle Aged ; Monitoring, Intraoperative ; methods ; Spinal Cord Compression ; diagnostic imaging ; surgery ; Ultrasonography

To evaluate the value of Dynesys dynamic fixation for treatment of lumbar degenerative disease by comparing with lumbar spinal fusion. Methods The clinical data of 60 patients with lumbar degenerative disease, who were treated inChanghai Hospital from June 2009 to June 2010, were retrospectively analyzed. Twenty-six patients, including 15 males and 11 females, with age ranging 32-56 years (average [42.45 ± 10.12] years), received Dynesys implantation for segments L4-L5 (13 cases) and L5-S1 (13 cases). Thirty-four patients, including 20 males and 14 females, with age ranging 38­60 years(average [45.24 ± 12.15] years), received fusion implantation for segments L4-L5 (18 cases) and L5S (16 cases). The following parameters were observed and compared between the two groups: operation time, blood loss, hospital stay, preoperative Oswestry disability index (ODI), ODI at last follow-up, low back and leg pain visual analogue scale (VAS), results of health status questionnaire (SF-36), segmental angulation degree of lumbar spine, and intervertebral height. Results All the 60 patients were followed up for 3-4 years (average [3.2 ± 0.2] years). The operation time and intra-operative blood loss were significantly different between the two groups (P < 0.05), and no difference was found for average hospital days. The ODI, VAS, and SF-36 clinical scores at last follow-up were significantly improved compared with those before operation in the two groups (P < 0.01), with the improvement in Dynesys group being more significant than the fusion group (P < 0.01). The segmental angulation degree of lumbar spine had no noticeable improvement in the two groups at last follow- up, and there were no significant differences between the two groups. There was no intervertebral height loss at the last follow-up in the two groups, and there was no significant difference in intervertebral heights between the two groups. Conclusion Dynesys dynamic lumbar fixation shows no more advantages in terms of radiological results compared with the fusion group. Moreover, fusion fixation is not suggested to have more adjacent segment degeneration (ASD) than Dynesys dynamic lumbar fixation. But clinically Dynesys dynamic lumbar fixation yields a greater improvement, with the advantages of less bleeding and shorter operation time. In middle-aged and elderly patients with degenerative diseases, Dynesys dynamic lumbar fixation is an acceptable choice.

Objective:To assess the value of the ROX index in evaluating the efficacy of high-flow nasal cannula oxygen therapy (HFNC) in patients with coronavirus infected disease (COVID-19).Methods:This is a retrospective study. The included patients were diagnosed as COVID-19 in the intensive care unit (ICU) of the Cancer Center of Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from February 15, 2020 to March 15, 2020. All the patients were treated by HFNC. According to whether the patient subsequently received non-invasive positive pressure ventilation or invasive positive pressure ventilation, patients were divided into the HFNC success group and the HFNC failure group. Parameters in the two groups such as basic characteristics, lactic acid, number of chest radiographs, APACHE II, lymphocyte count, baseline respiratory rate, baseline percutaneous oxygen saturation, baseline PaO 2/FiO 2, baseline ROX index, and ROX index after 2, 6 and 12 h HFNC treatment were analyzed with t test, Chi-square test or rank sum test. Results:A total of 57 cases were included in this study. There were no significant differences in sex, age, comorbidities, lactic acid, quadrants of chest radiograph lung infection, APACHE II, lymphocyte count, and baseline respiratory frequency, transcutaneous oxygen saturation, oxygenation index, and ROX index between the HFNC success group and the HFNC faliure group ( P>0.05). Logistic regression analysis showed that ROX index after 2 h HFNC treatment ( OR=0.069), ROX index after 6 h HFNC treatment ( OR=0.194) and ROX index after 12 h HFNC treatment ( OR=0.036) were all protective factors for the therapeutic effect of HFNC treatment in COVID-19 patients. ROC curve showed that there were significant differences in ROX index after 2 h HFNC treatment, ROX index after 6 h HFNC treatment, and ROX index after 12 h HFNC treatment ( P<0.05). In the evaluation index, the area under the ROC curve of the ROX index after 2 h HFNC treatment was 0.838, the sensitivity was 64.5%, and the specificity was 100%. After 6 h HFNC treatment, the area under the ROX index ROC curve was 0.762, the sensitivity was 64.5%, and the specificity was 92.3%. After 12 h HFNC treatment, the ROX index ROC curve area was 0.866, the sensitivity was 67.7%, and the specificity was 100%. Conclusions:The ROX index can be used to evaluate the efficacy of HFNC in COVID-19 patients in a timely, simple and real-time manner.

Objective:To explore the long-term clinical efficacy and complications of modified spinous process splitting laminoplasty using coralline hydroxyapatite (SLAC).Methods:The patients who underwent SLAC surgery in this hospital from 2005.5 to 2011.7 were included retrospectively. The perioperative data were collected and followed up. A total of 165 cases were included. Among them, there were 115 males and 50 females; the average age was 56.5±11.4 years (range: 26-84 years), and the average follow-up period was 136.5±23.2 months (range: 108-182 months). The modified Japanese Orthopedic Association (mJOA) score, the neck disability index (NDI) score were used to evaluate the clinical symptoms of patients, and follow-up imaging to observe the changes in cervical spine curvature and mobility.Results:In terms of functional score: mJOA score increased from 11.4±2.9 before surgery to 15.0±1.8 in the early postoperative period but dropped to 14.0±2.5 at the last follow-up ( F=77.096, P<0.001), and NDI score decreased from 19.2%±14.4% before surgery to 13.0%±15.0% in the early postoperative period, but it rose to 14.0%±14.9% at the last follow-up ( F=6.915, P<0.001). The improvement rate of mJOA was 63.5% (early postoperatively) and 50.8% (last follow-up). Regarding the curvature of the cervical spine, the C 2-C 7 Cobb angle decreased from 14.8°±9.1° before surgery to 11.1°±10.5°, and it was maintained at the last follow-up (11.0°±10.1°) ( F=1.083, P=0.342). The cervical spine range of motion decreased significantly, mainly because the Cobb angle in the flexion position decreased from -19.8°±13.6° before the operation to -3.7°±10.6° at the last follow-up ( P<0.001). Seventy-two patients (44.0%) had complications after operation. Six patients (3.6%) developed neurological symptoms aggravated during follow-up, and their mJOA decreased by more than 3 points. 62 patients (37.6%) developed axial symptoms, of which 7 cases were relieved early (within 6 months post-op), 55 patients had persisted symptom and 17 cases (10.3%) remained painful. C 5 nerve root palsy occurred in 10 cases (6.1%) after the operation, 9 cases resolved within two years and the last patient did not resolve. Conclusion:SLAC surgery can effectively alleviate the patient's neurological symptoms and maintain long-term efficacy and cervical lordosis. The occurrence of persistent axial symptoms and the loss of cervical flexion range are long-term complications after SLAC surgery.