BACKGROUND:Recent research indicates that disc degeneration is closely related to abnormal stress load,and mechanotransduction proteins play a key role in it. OBJECTIVE:To investigate the role and mechanism of mechanotransduction proteins in the mechanotransduction process induced by abnormal mechanical stimulation in disc degeneration,and to summarize the current treatment strategies targeting mechanotransduction to delay intervertebral disc degeneration. METHODS:Using"intervertebral disc,nucleus pulposus,annulus fibrosus,cartilaginous endplate,cell,mechanics,signal transduction,protein,biomechanics"as Chinese search terms,and"intervertebral disc,nucleus pulposus,annulus fibrosus,cartilaginous endplate,cell,mechanical stimulation,signal transduction,protein,biomechanics"as English search terms,relevant literature in the PubMed and CNKI databases was searched.A total of 88 articles were ultimately included for review. RESULTS AND CONCLUSION:Disc cells can sense external mechanical stimulation through various mechanotransduction proteins and convert it into biological responses within the cells.These transduction proteins mainly include collagen proteins in the extracellular matrix,cell membrane surface receptors(such as integrins and ion channels),and cytoskeleton structural proteins.Their regulation of mechanotransduction processes primarily involves the activation of multiple pathways,such as the PI3K/AKT signaling pathway,nuclear factor-kB signaling pathway,and Ca2+/Calpain2/Caspase3 pathway.Mechanotransduction proteins play a key role in the mechanotransduction of disc cells.Abnormal expression of these proteins or resulting changes in the extracellular matrix environment can disrupt the mechanical balance of disc cells,leading to disc degeneration.In-depth study of the expression and regulatory mechanisms of mechanotransduction proteins in disc cells,and identification of key pathological links and therapeutic targets,is of significant importance for developing treatment strategies for disc degeneration.Current strategies to delay intervertebral disc degeneration by targeting mechanotransduction mainly include regulation of transduction proteins and improvement of the extracellular matrix.However,research in this area is still in its early stages.As research continues,new breakthroughs are expected in the regulation of disc degeneration by mechanotransduction proteins.

Objective:To assess the safety and efficacy of thiotepa, busulfan, and etoposide (TBE) conditioning followed by autologous hematopoietic stem-cell transplantation (TBE auto-HSCT) in primary central nervous system lymphoma (PCNSL) patients.Methods:Clinical data from 27 PCNSL patients who received TBE auto-HSCT at the Fifth Medical Center of PLA General Hospital between November 1, 2021, and April 30, 2024, were retrospectively analyzed.Results:Twenty-seven patients [16 males, 11 females; median age 57 (23–72) years] were included, with 12 (44.4%, 12/27) over 60. Twenty-five had newly diagnosed PCNSL and 2 were relapsed. Median time from diagnosis to transplantation was 6.9 (5.0–10.0) months. TBE auto-HSCT increased complete remission (CR) rate from 63.0 to 96.3% ( P= 0.005), and 9 of 10 patients in partial remission achieving CR post-transplant. Median follow-up was 24.5 months (range 2.0–36.0). Two-year progress-free and OS rates were (87.2±6.9) % and (88.6±6.2) %, respectively. Common grade 3 nonhematologic adverse events were diarrhea (18.5%, 5/27) and bacterial infections (14.8%, 4/27). One patient (64 years old) died from carbapenem-resistant Enterobacteriaceae infection within 2 months post-transplant, yielding a 100-day treatment-related mortality of 3.7% (1/27) . Conclusion:TBE-conditioned high-dose chemotherapy with auto-HSCT is effective, safe, and well-tolerated in PCNSL patients, including the elderly.

Objective:To assess the safety and efficacy of thiotepa, busulfan, and etoposide (TBE) conditioning followed by autologous hematopoietic stem-cell transplantation (TBE auto-HSCT) in primary central nervous system lymphoma (PCNSL) patients.Methods:Clinical data from 27 PCNSL patients who received TBE auto-HSCT at the Fifth Medical Center of PLA General Hospital between November 1, 2021, and April 30, 2024, were retrospectively analyzed.Results:Twenty-seven patients [16 males, 11 females; median age 57 (23–72) years] were included, with 12 (44.4%, 12/27) over 60. Twenty-five had newly diagnosed PCNSL and 2 were relapsed. Median time from diagnosis to transplantation was 6.9 (5.0–10.0) months. TBE auto-HSCT increased complete remission (CR) rate from 63.0 to 96.3% ( P= 0.005), and 9 of 10 patients in partial remission achieving CR post-transplant. Median follow-up was 24.5 months (range 2.0–36.0). Two-year progress-free and OS rates were (87.2±6.9) % and (88.6±6.2) %, respectively. Common grade 3 nonhematologic adverse events were diarrhea (18.5%, 5/27) and bacterial infections (14.8%, 4/27). One patient (64 years old) died from carbapenem-resistant Enterobacteriaceae infection within 2 months post-transplant, yielding a 100-day treatment-related mortality of 3.7% (1/27) . Conclusion:TBE-conditioned high-dose chemotherapy with auto-HSCT is effective, safe, and well-tolerated in PCNSL patients, including the elderly.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

[Objective] To investigate the correlation between human leukocyte antigen (HLA) gene polymorphism and hepatitis B virus (HBV) infection. [Methods] Venous blood samples were collected from 501 healthy individuals undergoing physical examinations at Yan’an Hospital in Kunming, Yunnan Province. Enzyme linked immunosorbent assay (ELISA) was used to detect HBV halves. Based on the results of HBV half detection, the patients were divided into three groups: HBV carrier group, previous infection group, and healthy control group. The HLA-A antigen genotype was detected using polymerase chain reaction with sequence specific primers (PCR-SSP) genotyping technology, and the distribution frequency of HLA-A gene polymorphism was compared between HBV carrier group and healthy control group, as well as between previous infection group and healthy control group. SPSS17.0 software was used for data statistical analysis. [Results] In the healthy control group, the HLA-A2 positivity rate was 47.49%, and the allele frequency was 31.29%.The overall frequency of gene distribution in the healthy control group was consistent with the HLA-A allele table commonly and confirmed in China published by the Chinese Bone Marrow Bank. The HLA-A2 positivity rate and allele frequency in the HBV carrier group were 63.04% and 42.23%, respectively; The difference in HLA-A2 positivity rate and allele frequency among carriers was statistically significant (P<0.05). the HLA-A2 positivity rate and allele frequency in the HBV previous infection group were 56.14% and 35.97%, respectively, which did not significantly differ from those in the healthy control group (P>0.05). [Conclusion] HLA-A2 gene may be a susceptibility gene for chronic hepatitis B HBV carriers.

Objective:This study examined the associations between the levels of bile acids in early pregnancy and the occurrence of overweight.Methods:From 2010 to 2012, 22 302 pregnant women were recruited by Tianjin Women and Children′s Health Center to investigate gestational diabetes. Two hundred and forty-three women with gestational diabetes mellitus provided overnight fasting blood samples in the first trimester, and 243 counterparts without gestational diabetes mellitus matched on age were selected randomly to establish a nested case-control study. The association between bile acids and overweight were evaluated by binary logistic regression with data from 166 overweight pregnant women (body mass index≥24.0 kg/m 2) and 320 normal weight subjects (body mass index <24.0 kg/m 2). Results:Compared to non-overweight group, the level of primary unconjugated bile acids in overweight group was significantly higher. After adjustment of confounding factors, the OR of cholic acid (CA)>0.086 nmol/mL for overweight was 2.09 (95% CI 1.14-3.80, adjusted P=0.040), and OR of chenodeoxycholic acid (CDCA)>0.043 nmol/mL was 2.15 (95% CI 1.22-3.78, adjusted P=0.040) compared with the lower groups. However, the significant associations between the other bile acids and overweight were not detected. Stepwise selection was used to identify significant bile acid species in logistic regression. We found that only CA was independently associated with overweight, and the OR of CA>0.086 nmol/mL vs≤0.086 nmol/mL was 2.03 (95% CI 1.11-3.74, P=0.022). Conclusion:CA and CDCA in early pregnancy maybe associated with overweight, and CA might be independently associated with overweight.

Objective:To evaluate the effect of early hyperbaric oxygen therapy (HBOT) on neurological function recovery of basal ganglia hemorrhage patients who didn’t receive hematoma evacuation.Methods:A total of 41 basal ganglia hemorrhage patients treated in Nanjing Zijin Hospital and PLA Air Force Hospital of The Eastern Theater Command from January 2015 to January 2020 were included in this study. They did not undergo hematoma evacuation surgery due to small hematoma volume, 18 of whom received early HBOT (treatment group), and the remaining 23 patients received the same HBOT two weeks after hemorrhage (control group). The hematoma volume and the changes of perihematomal edema (PHE) were observed using regular head CT scan, and the incidences of PHE expansion in the two groups were compared on the 10th day after the hemorrhage. All the 41 patients’ neurological functions were assessed by the National Institutes of Health stroke scale (NIHSS) and Glasgow outcome scale (GOS) upon their admission and three months after admission.Results:No re-hemorrhage was found in any patient on the head CT scan. On the 10th day after admission, the incidence of PHE expansion was 16.7% in the treatment group and 91.3% in the control group, respectively, the difference was statistically significant ( P<0.01). After three months of treatment, the NIHSS scores of both groups were decreased, and the GOS scores of both groups were increased. The NIHSS score of the treatment group was lower than that of the control group, while the GOS score in the treatment group was higher than that of the control group, both with statistically significant differences ( P<0.05). Conclusion:Early HBOT is a safe treatment for basal ganglia hemorrhage patients without hematoma evacuation, and it can reduce the occurrence of PHE and improve the prognosis of patients.

Objective:To evaluate the effect of early hyperbaric oxygen therapy (HBOT) on neurological function recovery of basal ganglia hemorrhage patients who didn’t receive hematoma evacuation.Methods:A total of 41 basal ganglia hemorrhage patients treated in Nanjing Zijin Hospital and PLA Air Force Hospital of The Eastern Theater Command from January 2015 to January 2020 were included in this study. They did not undergo hematoma evacuation surgery due to small hematoma volume, 18 of whom received early HBOT (treatment group), and the remaining 23 patients received the same HBOT two weeks after hemorrhage (control group). The hematoma volume and the changes of perihematomal edema (PHE) were observed using regular head CT scan, and the incidences of PHE expansion in the two groups were compared on the 10th day after the hemorrhage. All the 41 patients’ neurological functions were assessed by the National Institutes of Health stroke scale (NIHSS) and Glasgow outcome scale (GOS) upon their admission and three months after admission.Results:No re-hemorrhage was found in any patient on the head CT scan. On the 10th day after admission, the incidence of PHE expansion was 16.7% in the treatment group and 91.3% in the control group, respectively, the difference was statistically significant ( P<0.01). After three months of treatment, the NIHSS scores of both groups were decreased, and the GOS scores of both groups were increased. The NIHSS score of the treatment group was lower than that of the control group, while the GOS score in the treatment group was higher than that of the control group, both with statistically significant differences ( P<0.05). Conclusion:Early HBOT is a safe treatment for basal ganglia hemorrhage patients without hematoma evacuation, and it can reduce the occurrence of PHE and improve the prognosis of patients.

Objective To investigate the effect of impulse noise expose on the expression of growth associated protein 43(Gap-43) in inferior colliculus in rat.Methods SPF grade Male SD rats were randomly divided into 5 groups.The normal control group received noise exposure.The model groups received an averange impulse noise exposure of 156 dB SPL with a pulse duration of 0.23 ms, once for 6 s, for 50 times.Auditory brainstem responses (ABRs) were measured before and 3,7,14, and 28 d after noise exposure with tone pips of 2,4,8,16, and 32 kHz, from 20 to 110 dB SPL.Bilateral inferior colliculus of rats in the model groups was collected and treated by immunohistochemical staining.Gap-43 expression of rats in different groups was measured by determining the gray value of inferior immunohistochemical images.Results After noise exposure, ABRs threshold in the model groups were significantly higher than those of in the normal group (P<0.05 or P<0.01).ABRs threshold at 14 and 28 days after noise exposure were significantly lower than 3 days after impulse exposure (P<0.05).Expression of Gap-43 in inferior colliculus was significantly up-regulated in the noise exposed groups compared with the normal group (P<0.05 or P<0.01).Expression of Gap-43 was significantly down-regulated 28 days after noise expose compared with 3 days after noise expose(P<0.05).Conclusion Impulse noise exposure leads to significant elevation of ABR thresholds and up-regulation of Gap-43 expression in inferior colliculus.Impulse noise exposure may induce auditory cortex prominent remodeling.

Objective To develop the Applied nursing undergraduate students training framework objective, clear the entry of applied training target for undergraduate nursing students. Methods Through literature review and panel discussions, Delphi expert consultation questionnaires were preliminary designed. 23 experts were issued via email and paper questionnaires, conducted two expert advice and analysis. Results A total of 20 valid questionnaires were recovered after two consultation. The expert advice of good scientific reliability:experts had positive reply, and the authority level was 0.857, Kendall were 0.130-0.293, it showed a good level of coordination (P < 0.05). By two rounds of expert advice, three capacity index target level for Applied nursing undergraduate students training were gotten: attitudes, values and basic literacy; knowledge of the target; the ability. The secondary capacity index for target had 15 items, and the third capacity index had 63 items. Conclusions TheAppliednursing undergraduate students training objectives and targets were refined through Delphi which provide the basis for the Applied nursing undergraduate training model and curriculum reform.