Objective To investigate the effect of Caveolin-1 on extracellular regulated protein kinases of rabbit carotid artery anastomotic restenosis.Methods 40 New Zealand white rabbits were randomly divided into normal control group,carotid artery end to end anastomosis surgical group,empty vector transfection on the site of anastomosis group and Caveolin-1 transfected group.Left carotid artery endto-end anastomosis was performed,and the mixture of Caveolin-1 plasmid and liposome lipofectin 2000 (transfected group) or empty plasmid and lipofectin 2000 mixture (empty vector group) were transfected on anastomosis.Specimens were taken at 7 d after surgery for Western blot and RT-PCR to detect the expression of protein and mRNA.Specimens were taken for HE staining at 28 d to observe the proliferation of intima,and measured the ratio of intima/media area by Image-Pro Plus 6.0 software.Results Compared with surgical group,the ratio of intima/media area in Caveolin-1 transfected group decreased by about 50％.Compared with surgical group and empty vector group,the Caveolin-1 mRNA expression and protein activity significantly increased (t =36.59,P ＜ 0.01) ; the ERK1/2 mRNA expression and protein activity significantly decreased on rabbit carotid artery anastomotic site in Caveolin-1 transfected group (t =32.64and 7.27,P ＜ 0.01).Conclusions Caveolin-1 inhibits anastomotic restenosis possibly by regulating the activation of ERK.

Objective To investigate the effect of caveolin-1 on rabbit carotid artery anastomotic stenosis and its relationship with TNF-α.Methods 40 New Zealand white rabbits were randomly divided into normal group,surgical group,empty vector group and caveolin-1 transfecting group.Carotid artery end-to-end anastomosis was done in the rabbits except these in normal group.Five specimens were randomly taken on day 7 after surgery for Westem blot to detect the expression of caveolin-1 and TNF-α; The rest specimens were taken for HE staining at fourth week.The ratio of intima/media area were measured by Image-Pro Plus 6.0 software in order to observe the proliferation of intima.Results Compared with normal group,in surgical group intimal proliferation was significant,the intima/media ratio was significantly higher (P ＜ 0.05) ; Compared with surgical group,in caveolin-1 transfected group neointimal proliferation was not obvious,the intima/media ratio decreased (P ＜ 0.05).Western blot showed that:compared with the surgical group,caveolin-1 expression in transfected group was significantly higher (P ＜ 0.05) ; compared with normal group,the TNF-α expression in surgical group increased (t:41.28,P ＜ 0.05) ; Compared with surgical group,TNF-α expression in transfected group decreased significantly (t:36.37,P ＜ 0.05).Conclusions Caveolin-1 inhibits vascular anastomotic stenosis,possibly by down-regulating TNF-α expression.

Objective To observe the clinical curative effect of unilateral biportal endoscopy(UBE)in the treatment of extreme lateral lumbar disc herniation(ELLDH).Methods From June 2019 to June 2022,25 patients with ELLDH were treated with UBE-guided discectomy,including 16 males and 9 females.The age ranged from 26 to 62 years with a mean of(53.67±17.45)years.History ranged from 3 d to 10 years.There were 9 cases of internal foraminal type(type Ⅰ),13 cases of external foraminal type(type Ⅱ)and 3 case of mixed type(type Ⅲ).There were 8 cases of L4/5 space and 17 cases of L5/S1 space.All the patients underwent anterior and lateral lumbar X-rays,CT and MRI scans before surgery.The visual analogue scale(VAS)pain score and Oswestry disability index(ODI)assessed lower limb and lower back pain and functional recovery before surgery and at 3 d and 3 months after surgery,respectively.Macnab criteria evaluated the immediate surgical outcome.Results The UBE technique was used to treat ELLDH.The operative time was(79.79±23.97)min,the intraoperative bleeding volume was 40～80 mL,with an average of(55.80±10.74)mL.Follow-up time was(7.02±4.26)months.Preoperative VAS of lower limb was(7.04±0.92),lower back VAS was(3.49±1.52),ODI was(35.03±2.97)%.Compared with the preoperative results,the lower limb VAS was(2.17±0.61),lower back VAS was(1.48±0.43),and ODI was(18.77±3.15)%on day 3 after surgery,lower limb VAS was(1.38±0.65),lower back VAS was(1.03±0.48)and ODI was(6.05±1.80)%on the 3 months after surgery were improved(P＜0.05).The excellent and good rate was 96.0%(excellent 20,good 4,fair 1),and no obvious complications were observed during the follow-up.Conclusion UBE is effective,with little trauma,clear intraoperative visual field,good intraoperative experience,and less traumatic and safe in the treatment of ELLDH.