BACKGROUND: Inflammatory mediators-induced neurodocitis in the nucleus pulposus is a main factor for backleg pain. Receptor pathway studies confirmed that the nervous system had self-circulation. Administration by receptors has the same effect as targeting drug delivery. OBJECTIVE: To evaluate the therapeutic efficacy of drug injection on synovium of lumbar zygapophyseal joints and muscular attachment point of neural scute in 1 236 patients with discogenic low back pain. DESIGN,TIME AND SETTING: The case analysis experiment was performed at the First People’s Hospital from March 2002 to March 2007. PARTICIPANTS: 1 236 patients with discogenic low back pain were selected at the Department of Pain,including 370 males and 866 females,aged from 20 to 80 years. The patients accompanied with bulging of lumbar intervertebral disc and protrusions less than 1/3 vertebral canal. METHODS: Drugs were injected on bulges of lumbar intervertebral disc,protuberate zygapophysis and neural scute. General pharmaceutical formulation: Betamethason copound injection 5 mg+ levofloxacin 0.1 g+20 g/L lidocaine 5 mL+sacine metered to 20 mL+ sodium hyaluronate 20 mg. The administration was once a week and one course of treatment had three administrations. There was no overweight loading during one month. MAIN OUTCOME MEASURES: Therapeutic efficacy; relapse rate. RESULTS: In 1 236 patients with one course of treatment,there were healing in 1 142 cases (94%),improvement in 89 cases (7.2%),inefficacy in 5 cases (0.4%). In 322 patients with one year consummate data,there were no relapse in 250 cases (77.6%),relapse in 72 cases (22.4%). In 206 patients with two year consummate data,there were no relapse in 155 cases (75.2%),relapse in 51 cases (24.8%). In 91 patients with three year consummate data,there were no relapse in 74 cases (81.3%),relapse in 17 cases (18.7%). In 62 patients with four year consummate data,there were no relapse in 52 cases (83.8%),relapse in 10 cases (16.2%). In 32 patients with five year consummate data,there were no relapse in 27 cases (84.3%) and relapse in 5 cases (15.6%). CONCLUSION: Drug injection on synovium of lumbar zygapophyseal joints and muscular attachment point of neural scute through receptor-mediated pathway is simple and available in patients with discogenic low back pain.

Objective To study the effect ofRunfei Zhisou Pills (RZP) on cell apoptosis in rat model of chronic obstructive pulmonary disease (COPD) and its mechanism.Methods Totally 32 male Wistar rats were randomly divided into control group,model group,1-month RZP group,and 3-month RZP group.Rats in 1-month and 3-month RZP group,received RZP of 0.9 g/kg once daily for 1 and 3 months respectively,and rats in control and model groups received water with equal volume for 1 month.The rat COPD model was established using tobacco smoke combined with intratracheal instillation of LPS.Morphological changes of lung tissue in COPD rats were observed with HE staining under light microscope.The VEGF levels in bronchoalveolar lavage fluid (BALF) were detected by ELISA.The VEGF and VEGFR2 protein expression in lung tissues was measured by Western blotting.Cell apoptosis in lung tissues was detected with TUNEL method,and apoptosis index (AI) was counted.Results Compared with control group,the pathological changes of lung tissue in model group were obvious,the AI significantly increased,VEGF in BALF and VEGF and VEGFR2 in lung tissue decreased significantly.Compared with model group,morphological improvement of lung tissue was obvious,the AI significantly decreased,and VEGF in BALF,VEGF and VEGFR2 in lung tissue increased significantly in 1-month and 3-month RZP groups.Conclusion RZP can inhibit cell apoptosis of COPD,and the mechanism may be related with up-regulation of VEGF and VEGFR2.

Objective To investigate the effect of activation of NF-κB signaling pathway on pathogenesis of lung in diabetes mellitus(DM) rat. Methods The experimental type 2 diabetic rats were built by injecting streptozotocin (STZ) and feeding with high fat and glucose food. At the 12nd and 24th week, we observed the alteration of morphology in the lung of rats in the control group(20 rats) ,the DM group(30 rats)using spectroscopic analysis. The collagen accumulation of lung was observed by masson trihrome staining, and alteration of NF-κB P65, IκBα, and PKC in lung was observed by immunohistochemistry. Results The tissue structure of lung in the DM rats distributed deranged in the light microscope, alveolar wall were thicken, extracellular matrixes increased and pulmonary fibrosis appeared. With the development of pathogenic condition, the expression increased obviously. The staining optical density value of NF-κB P65 in tissue of lung in the 12 w and 24 w DM group were 0. 20 ± 0. 01 and 0. 35 ± 0. 06 respectively, which was significantly higher than those of the control group at the corresponding time point ( 0. 12 ± 0. 02 and 0. 17 ± 0. 03, respectively, Ps ＜ 0. 0l ). The staining optical density value of IκB in tissue of lung in the 12 w and 24 w DM group were 0. 29 ±0. 02 and 0. 36 ± 0. 03, respectively, which were significantly higher than those of the control at the corresponding time point (0. 08 ± 0. 02 and 0. 22 ± 0. 08, respectively, Ps ＜ 0. 01 ). Conclusion The signaling pathway of NF-κB/IκB participate in the occurrence and development in the pathogenesis of lung in DM, and may be one of the mechanisms of lung injury.

Objective To investigate the toxicity-reducing and action-enhancing effects of total glucosides of paeony (TGP) on tripterygium glycosides (TG) in treating murine lupus nephritis (LN).Methods Chronic graft-versus-host disease (cGVHD) murine LN model was established.Modeling mice were randomly divided into three groups:LN group,TG group (in the dose of 30 mg?kg-1?d-1),and TG+TGP group (TG in the dose of 30 mg?kg-1?d-1 and TGP in the dose of 200 mg?kg-1?d-1),6 mice in each group.Another six normal mice served as control.Medication groups received corresponding medicine according to the experimental design,and mice in the normal control group and LN group received the same volume of saline,qd,for 4 weeks.After the treatment,the levels of 24-hour urinary protein excretion (UPE),blood urea nitrogen (BUN),serum creatinine (SCr),serum alanine transferase (ALT) and aspartate transferase (AST),and contents of superoxide dismustase (SOD),malondialdehyde (MDA),and glutathione peroxidase (GSH-Px) in liver tissue homogenate were measured.Meanwhile,the pathologic changes of kidneys in each group were detected.Results Compared with LN group,levels of UPE,BUN and SCr in TG group and TG+TGP group were decreased notablely (P

Objective:To establish a real-time fluorescent quantitative PCR for the detection of torque teno virus types 7 (TTV7), 8 (TTV8) and 10 (TTV10) and analyze its performance in clinical sample detection.Methods:Specific primers were designed based on the gene sequences of TTV7, TTV8 and TTV10 in GenBank. Recombinant plasmids of pMD19-T-TTV7, pMD19-T-TTV8 and pMD19-T-TTV10 were constructed and used as positive standard control to establish a real-time fluorescent quantitative PCR based on FAM-Eclipse probe method. The specificity and sensitivity of the established method were evaluated. Moreover, it was validated in terms of clinical sample detection.Results:The standard curve equations of the real-time fluorescent quantitative PCR for detecting TTV7, TTV8 and TTV10 were y=-0.340 2 x+ 114.780 0 ( R2=0.998 8), y=-0.351 1 x+ 114.940 0 ( R2=0.995 3) and y=-0.348 9 x+ 115.020 0 ( R2=0.991 7), respectively, and there was no cross-reaction with other viruses. The detection sensitivity of the established method for TTV7, TTV8 and TTV10 were 108 copies/μl, 84 copies/μl and 98 copies/μl, and the positive detection rates in clinical pediatric serum samples were 10.9%, 2.1% and 4.3%, respectively. Conclusions:The established real-time fluorescent quantitative PCR for detection of TTV7, TTV8 and TTV10 was featured by strong specificity and high sensitivity, which could be used for rapid TTV detection in clinical serum samples.

Objective To analyze the occupational hazards and protective measures for personnel in an iodine-125(¹²⁵I) seed source production company. Methods In 2022, a ¹²⁵I seed source production enterprise in Guangdong Province was selected as the research subject. The occupational hazards in the workplace of the research subject was identified using the system engineering analysis method. The FLUAK program based on Monte Carlo method was used to simulate the blocking protection of the production of the ¹²⁵I seed source, and to estimate the dose of internal and external irradiation of seed source that affected workers. Results The main occupational radiation hazards in the seed production were non-sealed radioactive materials, including external irradiation from X-ray and γ ray and internal irradiation from aerosols formed by iodine volatilization. Estimated maximum dose equivalent rate around the chest and eye lens for workers were 0.52 and 0.02 μSv/h, respectively. The expected annual effective dose for workers in each work site was 0.035 mSv, and the expected annual equivalent dose to the eye lens for all workers in various work sites was 0.001 mSv. The maximum annual equivalent dose of operator's hand was 80.620 mSv. The maximum dose of internal irradiation to the worker was 18.750 mSv, which was caused by the volatilization of nuclides. Conclusion With effective protection measures for internal and external irradiation in place, the annual exposure doses for seed production personnel and operator’s hand are below the national limits. Adequate measures should be taken on hand protection.

Objective To compare the efficacy and safety of suction ureteral stent and conventional ureteral stent in the treatment of patients with urinary calculi,so as to evaluate the clinical application value.Methods A total of 196 patients with urinary calculi admitted to in our hospital during Dec.2022 and May 2023 were selected to undergo ureteral holmium laser lithotripsy with hard ureteroscopy or soft ureteroscopy,including 100 with suction ureteral stent(suction group)and 96 with conventional ureteral stent(conventional group).Basic data,visual analog scale(VAS),extubation time,extubation success rate,gross hematuria,lumbar and abdominal pain,and urinary tract infection were compared between the two groups.Results Compared with the conventional group,the suction group had lower VAS[(2.94±1.24)vs.(5.78±1.50)],shorter extubation time[(4.28±0.51)min vs.(13.51±1.81)min],and the differences were statistically significant(P＜0.01).After extubation,the suction group had a lower incidence of complications(P＜0.05).Conclusion Compared with conventional ureteral stent,extraction of suction ureteral stent has the advantages of simpler operation,better patient comfort,fewer complications,shorter extubation time and lower medical costs.

Objective To simulate and analyze the dose distribution from external exposure and its influencing factors of induced radioactivity in proton therapy site. Methods Referencing a domestically under-construction proton therapy facility, a geometric model of the proton therapy site was constructed, and the FLUKA program was used to simulate the distribution of the induced radioactive dose of the proton therapy site under the conditions of different energies, beam angles, irradiation time, cooling time and medium of the treatment site. Results For a 230 MeV proton beam with a current of 3.0 nA, directed along the negative Z-axis and irradiating a phantom for two minutes, at the shutdown moment, the ambient dose equivalent rates in air and vacuum 5, 30, and 50 cm away from the phantom surface were (1 039.02±5.82)-(127.86±1.20) and (1 037.96±4.38)~(127.35±0.93) μSv/h, respectively. The mean difference was 0.51~1.06 μSv/h, and the air-immersed external irradiation accounted for <1% of the total irradiation, which rapidly decreased to 1/15 of the shutdown moment value after cooling for 10 minutes. Under the condition of 130~250 MeV, the ambient dose equivalent rates at the shutdown moments 5, 30 and 50 cm away from the surface of the phantom were (427.49±3.12)-(1 058.41±4.66), (100.36±0.92)-(259.70±1.69) and (50.15±0.68)-(131.93±1.11) μSv/h, respectively. Irradiation for one-five minutes, and at the moment of shutdown at 5, 30, and 50 cm from the surface of the phantom were (688.19±3.33)-(1 594.04±8.08), (167.60±1.35)-(388.24±2.96) and (84.73±0.69)-(195.94±1.56) μSv/h. The peripheral dose-equivalent rate of the sensed radioactivity decreases with the irradiation time, the energy of the beam, and the distance from the model. The peak dose equivalent rate around the induced radioactivity exists in the beam direction, which is significantly larger than that in the non-beam direction. Conclusion Proton therapy sites are characterized by relatively large levels of induced peripheral radioactive dose equivalent rates, mainly originating from patients. In actual practice, a suitable working position can be chosen according to the direction of the beam current, especially the direction of the final irradiation field beam current, in the non-beam current direction and as far away from the patient as possible. Within 10 minutes after the end of treatment, staff should try to avoid close contact with the patients.

Objective Toinvestigatetherelationshipbetweentheexpressionofstromalcellderived factor (SDF)-1,intercellular adhesion molecule (ICAM)-1 and renal tubular necrosis score in rats with renalischemicreperfusioninjury(IRI).Methods SixtySprague-Dawley(SD)ratswererandomlydivided into operation group and sham operation group with 30 rats in each group. Then each group was divided into 6 subgroups (1 h,6 h,12 h,24 h,48 h or 72 h )according to different time of measurement after operation with 5 rats in each subgroup. Renal IRI mode1 s were built in rats of operation group. The bilateral renal arteries were dissected in rats of sham operation group and then the incision was sutured. The renal function, renal tubular necrosis score and the variation of SDF-1 ,ICAM-1 expression in renal tissues at different time points were measured. The relationship between the expression of SDF-1 ,ICAM-1 in renal tissues and renal tubularnecrosisscoreinratsofoperationgroupwasanalyzedbyPearsoncorrelationanalysis.Results The levels of urea nitrogen (BUN)and serum creatinine (Scr)after operation in each subgroup of operation group were significantly higher than those before operation and those in the corresponding subgroups of sham operation group (all in P<0.05). They increased significantly 12 h after operation and reached the peak at 48 h after operation. The renal tubular necrosis score in operation group increased gradually over time (all in P<0.05 ).The highest renal tubular necrosis score was in the 48 h operation subgroup (P<0.05 ). Compared with those in 1 h operation subgroup,the expression of SDF-1 ,ICAM-1 in rats' renal tissues of 6 h operation subgroup began to increase significantly,and they reached the peak at 48 h after operation and began to drop down at 72 h after operation. The expression of SDF-1 ,ICAM-1 in rats renal tissues in operation group were positively correlated with the levels of BUN,Scr and renal tubular necrosis score at different time points after operation (r=0.614,0.662,0.751;0.640,0.703,0.785;P<0.05).Conclusions Whenrat'srenaltissuedevelops IRI,the expression of SDF-1 ,ICAM-1 ,BUN,Scr and renal tubular necrosis score increased.The expression of SDF-1 ,ICAM-1 are positively correlated with BUN,Scr and renal tubular necrosis score. The increased expression of SDF-1 ,ICAM-1 can serve as an indicator of the severity of renal IRI.

Gallbladder carcinoma (GBC) is the most common malignancy of the biliary tract, radical resection is the only effective treatment for GBC at present. However, the postoperative effect is still poor. Therefore, identifying the key prognostic factors and establishing an individual and accurate survival prediction model for GBC are critical to prognosis assessment, treatment options and clinical decision support in patients with GBC. The prediction value of current commonly used TNM staging system is limited. Cox regression model is the most commonly used classical survival analysis method, but it is difficult to establish the association between prognostic variables. Nomogram and machine learning techniques including Bayesian network have been used to establish survival prediction model of GBC in recent years, which representing a certain degree of advancement, however, the model precision and clinical application still need to be further verified. The establishment of more accurate survival prediction models for GBC based on machine learning algorithm from Chinese multicenter large sample database to guide the clinical decision-making is the main research direction in the future.