BACKGROUND:Previous studies on posterior cervical single door and double door laminoplasty for repair of multilevel cervical myelopathy mainly focus onneurological function and clinical parameters and lack of certain comprehensiveness.
OBJECTIVE:To explore the effects of posterior cervical single door and double door laminoplasty for repair of multilevel cervical myelopathy.
METHODS:We selected 120 patients with multilevel cervical myelopathy and randomly divided into single door group (n=60) and double door group (n=60). The single door group underwent single door laminoplasty. The double door group underwent double door laminoplasty. The blood loss,length of stay, complication rate, neurological function improvement, motion range of cervical vertebrae and imaging changes were compared between the two groups.
RESULTS AND CONCLUSION:(1) Blood loss was significantly less, length of stay was significantly shorter, and the incidence of axial symptom was significantly reduced in the double door group than in the single door group (alP< 0.05). (2) No significant difference in complication rate such as side leakage of cerebrospinal fluid, hematoma, infection and paralysis was detected between the two groups (P> 0.05). The incidence of axial symptoms was significantly less in the double door group than in the single door group (P< 0.05). (3) There were no significant differences in preoperative Japanese Orthopaedic Association scores, postoperative Japanese Orthopaedic Association scores, and improvement in neurological function between the two groups (P> 0.05). Postoperative Japanese Orthopaedic Association scores were significantly increased as compared with that preoperatively in both groups (P<0.05). (4) No significant difference in motion range of cervical vertebrae, inflexion, extension angle and sagittal diameter of spinal canal was detectable between the two groups (P> 0.05). Motion range of cervical vertebrae, extension angle, and inflexion angle were smaler after treatment compared with that preoperatively in both groups (P< 0.05). The increased degree of sagittal diameter of spinal canal was smaler, and the motion range of cervical vertebrae kept better in the double door group than in the single door group. (5) These results indicate that the effect of double door laminoplasty for repair of multilevel cervical myelopathy was significant. The double door laminoplasty can shorten the length of stay, reduce blood loss, axial symptoms, and loss rate of motion range of the cervical vertebrae. In the clinic, treatment can be carried out according to different indications.

Objective To search a new,simple,minimally invasive,safety and effective method to treat the cervical disc herniation.Methods 210 patients with cervical disc herniation received percutaneous nucleoplasty were evaluated.Results They were followed prospectively from two weeks to two months,fifty-nine patients improved significantly,the general clinical effective rate was 96.2%.No complication occurred.Conclusion The percutaneous nucleoplasty is an effective,rapid suited to outpatient,minimally invasive and safe procedure for cervical disc heriation.

Objective:To identify the epitope of mAb15A11 which is specific against RA associated autoantigen cartilage oligomeric matrix protein ( COMP ).Methods: A filamentous phage library displaying random linear dodecapeptides was used to mapping the epitope of mAb15A11.After three rounds of screenings,40 phage clones were selected at random and sequenced.The specificity of phages was confirmed by enzyme immunoassays.Homology search by ClustalW2 and structure analysis by PyMol to identified the epitope amino acid sequence.Western blot analysis of COMP and ELISA analysis of COMP-derived peptides were used to confirm epitope′s characterization.Results: After repeated screenings using bio-panning method, 2 clones were identified, which interacted specifically with mAb 15A11.Homology search did not find succession consensus sequence within COMP molecular,which indicated that the epitope was not linear.PyMol Structure analysis identified the rationality of conformational epitope.Western blot analysis and ELISA of EDTA-treated COMP further prove an conformational structure of the epitope recognized by mAb 15A11.ELISA analysis of COMP-derived peptides demonstrated both disulfide bonds between 229 C-243 C and 237 C-253 C and every epitope amino acid of 232 G,238 H,240 H,241 A,244 V,247 R and 251 R were essential to the binding of mAb 15A11 with COMP.Conclusion: In this study, the potential B cell antigentic epitopes of mAb 15A11 was identified by phage display library.The epitope amino acids sequence and char-acterization were also recognized.It may have important theoretical value for the study of reaction mechanism of COMP antibody and antigen and may also show application significance in the detection of rheumatoid arthritis.

The cyp51 primers and two pairs of mutant primers which removed different transmembrane region were designed based on Ustilago maydis cyp51 gene structure analysis. The full cyp51 DNA fragment as well as mutant cyp51 genes were amplified and cloned by using the total DNA from Ustilago maydis as template, then subcloned into different expression vectors. The recombinant expression plasmids were transformed into Escherichia coli BL21 (DE3), BL21 (DE3) pLysS and Rosetta (DE3) respectively. A series of experiments leads to the finding that only pET32-YH-35 could be highly expressed at the optimal condition of 30 degrees C induced with 0.5 mmol/L IPTG The expressed protein (CYP51) showed biological activity by spectra analysis of the protein binding to 4 standard fungicides and to 14 XF-synthetic fungicide compounds, and only one XF-synthetic fungicide compound (XF-113) was similar to standard fungicides in binding constant. This compound is promising to be a new effective antifungal drug. These results will facilitate the further study on the mechanism of pathogenic fungi CYP51 and pesticide molecules, and will provide a new idea for efficient design and development of new anti-fungal drugs.
Antifungal Agents ; isolation & purification ; Cloning, Molecular ; Cytochrome P-450 Enzyme System ; genetics ; metabolism ; Escherichia coli ; genetics ; metabolism ; Fungal Proteins ; genetics ; metabolism ; Plasmids ; genetics ; Recombinant Proteins ; genetics ; metabolism ; Sterol 14-Demethylase ; Ustilago ; enzymology ; genetics

Objective To investigate the efficacy of entecavir (ETV) versus tenofovir disoproxil fumarate (TDF) and the treatment measures for poor response in previously untreated chronic hepatitis B (CHB) patients with high viral load. Methods A total of 165 CHB patients who received antiviral therapy and met the inclusion criteria in Department of Infectious Diseases, The First Affiliated Hospital of Guangxi Medical University, from June 2016 to July 2021 were enrolled. The patients enrolled had a baseline HBV DNA level of > 6lg copies/ml and were previously untreated CHB patients who had used ETV or TDF for 48 weeks, and quantitative real-time PCR was used to measure HBV DNA. Virologic response rate was calculated after 48 weeks of treatment; a logistic regression analysis was used to investigate the influencing factors for the response of HBV DNA < 500 copies/mL and HBV DNA < 100 copies /mL at 48 weeks; a stratified analysis was performed to compare the virologic response rate of HBV DNA < 500 copies /ml and HBV DNA < 100 copies/ml after 48 weeks between the patients with different ages, sexes, baseline HBV DNA levels, baseline alanine aminotransferase (ALT) levels, types of first-line medication, and HBeAg statuses. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups, and the binary logistic regression model was used for multivariate analysis. Results After 48 weeks of treatment, 85.5% (141/165) of the patients achieved an HBV DNA load of < 500 copies/mL, and 66.1% (109/165) of the patients achieved an HBV DNA load of < 100 copies /mL, with no significant difference in treatment outcome between the ETV group and the TDF group. The multivariate logistic regression analysis showed that sex( OR =2.793, 95% CI : 1.197-6.517), baseline HBV DNA( OR =0.369, 95% CI : 0.142-0.959), baseline ALT( OR =4.556, 95% CI : 1.770-11.732), and baseline HBeAg( OR =0.120, 95% CI : 0.033-0.429) were influencing factors for complete virologic response(all P < 0.05). For the patients with normal ALT (≤40 U/L) at baseline, 75.6% (34/45) achieved an HBV DNA load of < 500 copies/mL after 48 weeks of treatment, and 53.3% (24/45) achieved an HBV DNA load of < 100 copies/mL, with no significant difference in treatment outcome between the ETV group and the TDF group. For the patients with abnormal ALT (> 40 U/L) at baseline, 89.2% (107/120) achieved an HBV DNA load of < 500 copies/mL after 48 weeks of treatment, and the proportion of such patients in the TDF group was significantly higher than that in the ETV group (96.1% vs 84.1%, χ 2 =4.386, P =0.036); 70.8% (85/120) achieved an HBV DNA load of < 100 copies/mL, the proportion of such patients was no significant difference between the TDF group and the ETV group (78.4% vs 65.2%). The response of HBV DNA < 100 copies/ml of the normal baseline ALT group and the abnormal baseline ALT group, there were no significant differences between the patients aged≤30 years and aged > 30 years (77.8% vs 47.2%, 85.2% vs 66.7%). For the patients who did not achieve complete virologic response (HBV DNA ≥100 copies/mL) after 48 weeks of treatment, 87.9% (29/33) achieved complete virologic response after the original treatment regimen was prolonged for 48 weeks, and 100% (9/9) of the patients achieved complete virologic response after switching to or adding the first-line nucleos(t)ide analogues (NUCs) without cross-resistance sites with the original regimen for another 48 weeks. Conclusion The patients aged > 30 years should receive antiviral therapy as early as possible, regardless of viral load and ALT level, especially those with a family history of liver cirrhosis or hepatocellular carcinoma; the patients aged ≤30 years who have a normal ALT level and a high viral load should consider initiating antiviral therapy after providing informed consent. For the patients with poor response after 48 weeks of treatment, first-line NUCs without cross-resistance sites with the original regimen should be switched to or added in time.