Objective To observe the clinical effect of transforaminal endoscopic surgical system (TESSYS) technique for atypical lumbar disc herniation. Methods Eighteen patients with atypical lumbar disc herniation underwent TESSYS technique under local anesthesia. Numerical rating scale (NRS) was used to evaluate the sciatica and/or back pain. The outcomes were evaluated by Oswestry disability index (ODI) and the Macnab score. Results The postoperative NRS scales were significantly lower than preoperative one (P<0.01). The postoperative ODI was lower than preoperative one (P < 0.05). Good rate of modified Macnab criteria was 88.89%. One patient occurred right hip pain and disappeared after partial closure. one patient turned to open surgery at 1 week. Conclusion The TESSYS technique was an effective method for atypical lumbar disc herniation. It has satisfactory clinical effect which is worthy of spreading for clinical application.

Background Epidemiologieal survey suggests that visual impairment in teenagers is a worldwide public health problem,and its leading cause is uncorrected refractive error.To conduct an extensive screening of visual impairment in teenagers and analyze the relevant affecting factors are significant works for the prevention and management of refractive errors.But high-quality epidemiological data on visual impairment and refractive error from large groups of children are lacking in Shanghai.Objective This study was to investigate the prevalence of ametropia and visual impairment in schoolchildren aged 6 to 12 years old.Methods In this cross-sectional study,4 686 students from 6 elementary schools in Baoshan District of Shanghai,a rural-urban fringe zone,China were selected by clustering sampling from May 2010 to April 2011.The eye examinations included visual acuity,ocular surface,ocular anterior segment,ocular media,fundus and intraocular pressure measurement,and the data autorefraction under cycloplegia and eye position were recorded.The cause of visual impairment was evaluated.Results A total of 4 594 students received examination with the response rate 98.0％,and autorefraction under cycloplegia was completed in 84.8％ schoolchildren (3 975/4 594).The prevalence rate of uncorrected visual acuity 0.5 or worse in both eyes was 14.4％ (662/4 594),with the wearing glasses rate 51.8％ (343/662).The percentage of students with the uncorrected visual acuity 0.5 or worse in at least one eye was 22.4％ (1 031/4 594).The prevalence rate of refractive error in the visual impaired students was 96.9％ (999/1 031),followed by amblyopia (37/1 031,3.6％).The prevalence rate of myopia,hyperopia,and astigmatic in the pupils after cycloplegia was 31.1％,4.3 ％ and 33.0％,respectively.In addition,the prevalence rate of myopia in public elementary schools was higher than that in migrant elementary schools (33.9％ versus 30.3％) (x2 =5.46,P =0.02).Logistic regression analysis showed that myopia was associated with age (OR =1.60,95 ％ CI:1.53-1.68,P ＜ 0.01) and female (OR =1.33,95％ CI:1.16-1.54,P＜0.01).Conclusions The leading cause of vision impairment is myopia in the elementary school students in Shanghai,China.The screening-ratio of refractive error and the coverage of refractive correction in the elementary school students in Shanghai are matters of urgent concern.

OBJECTIVETo investigate the correlation of G487A polymorphism of aldehyde dehydrogenase-2 (ALDH2) gene with hypertension in patients with coronary heart disease complicated by type 2 diabetes.

METHODSThis study was conducted among 167 patients with coronary heart disease complicated by diabetes mellitus. The polymorphisms of gene G487A ALDH2 were determined using polymerase chain reaction-restricted fragments length polymorphism technique (PCR-RFLP). According to the genotypes, the patients were divided into GG group (n=105) and GA/AA group (n=62), and the incidence of hypertension, risk factors of hypertension, systolic and diastolic pressures, and pulse pressure indexes were compared between the two groups. Multivariate logistic regression analysis was performed to adjust the effects of the confounding factors.

RESULTSThe incidence of hypertension in GA/AA group was significantly higher than that in GG group (P<0.05), and the former group showed a significantly greater differences between systolic and pulse pressure; the diastolic pressure was comparable between the two groups. Multivariate logistic regression analysis showed that GA/AA was associated with an increased risk of hypertension in synergy with high insulin level and insulin resistance.

CONCLUSIONALDH2 gene G487A polymorphism may be associated with hypertension in patients with coronary heart disease complicated by type 2 diabetes, and the patients with an A allele have a greater risk of developing hypertension.

Aged ; Alcohol Dehydrogenase ; genetics ; Coronary Disease ; complications ; genetics ; Diabetes Mellitus, Type 2 ; complications ; genetics ; Female ; Humans ; Hypertension ; etiology ; Male ; Middle Aged ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Risk Factors

Objective To investigate the influence of long-term exposure to oil and gas toxicants on the peripheral blood T lym-phocyte subsets in Karamay Uygur and Han refining workers and the underlying mechanism.Methods 175 cases of Uighur and Han refinery workers who had long-term close contact with poison of oil and gas(112 cases of Han people and 63 cases of Uygur people)and 110 healthy people(70 cases of Han people,40 cases of Uighur)were selected as research subject.The peripheral blood T lymphocyte subsets of all cases were detected for comparative analysis.Results Compared with healthy control group,the median of CD4+in the uighur refinery workers was significantly reduced(P<0.05);the CD8+in Han ethnic refinery workers was signifi-cantly lower,while the ratio of CD4+/CD8+increased significantly(P<0.05).Compared with Han ethnic,the median of CD3+, CD8+in uighur significantly increased,while the ratio of CD4+/CD8+decreased significantly(P<0.05).Conclusion Long-term close contact(more than 5 years)of oil and gas poison will significantly reduce the function of peripheral blood T lymphocyte sub-sets of refinery workers,and the effect on Han ethnic oil refinery workers was significantly higher than that on Uighur,,so corre-sponding measures on effective occupational protection are necessary to carry out.

Arsenic compounds are widely used for the therapeutic intervention of multiple diseases.Ancient pharmacologists discovered the medicinal utility of these highly toxic substances,and modern phar-macologists have further recognized the specific active ingredients in human diseases.In particular,Arsenic trioxide(ATO),as a main component,has therapeutic effects on various tumors(including leukemia,hepatocellular carcinoma,lung cancer,etc.).However,its toxicity limits its efficacy,and con-trolling the toxicity has been an important issue.Interestingly,recent evidence has pointed out the pivotal roles of arsenic compounds in phase separation and membraneless organelles formation,which may determine their toxicity and therapeutic efficacy.Here,we summarize the arsenic compounds-regulating phase separation and membraneless organelles formation.We further hypothesize their potential involvement in the therapy and toxicity of arsenic compounds,highlighting potential mecha-nisms underlying the clinical application of arsenic compounds.

Objective:To investigate the role of subventricular zone (SVZ) irradiation in the prognosis of patients with glioblastoma (GBM), and to analyze the factors affecting the prognosis of patients with GBM.Methods:Clinical data of 52 patients with GBM treated in the Affiliated Cancer Hospital of Nanjing Medical University from 2017 to 2020 were analyzed retrospectively. According to the median dose of ipsilateral or contralateral SVZ, the patients were divided into the high-dose group and low-dose group. The prognostic differences between two groups were compared and the prognostic factors were analyzed.Results:The median progression-free survival (PFS) was 17.1 months (95% CI:12.4-30.7)and the median overall survival (OS) was 38.3 months (95% CI:20.4-44.5). Univariate analysis showed that whether the tumor invading SVZ ( P = 0.039), the degree of resection ( P = 0.009) and MGMT promoter methylation status ( P = 0.039) were the influencing factors of PFS. Age ( P = 0.018), Kanofsky performance score ( P = 0.043), whether the tumor invading SVZ ( P = 0.038), degree of resection ( P = 0.020) and MGMT promoter methylation status ( P = 0.019) were the influencing factors of OS. The analysis of SVZ dose as a continuous variable showed that SVZ dose was the influencing factor of PFS ( P < 0.05) rather than OS ( P ≥ 0.05). Whether the tumor invading SVZ or not, there was no significant difference in survival between the high-dose and low-dose groups. Multivariate analysis showed that whether the tumor invading SVZ and MGMT promoter methylation were the independent prognostic factor for PFS (both P < 0.05), and OS (both P < 0.05). The SVZ dose related variables were not statistically significant in multivariate analysis. Conclusions:Patients with tumors directly invading SVZ achieve worse survival. Increasing the ipsilateral or contralateral SVZ dose does not improve patient survival. Whether SVZ irradiation affects the survival of patients still needs to be further confirmed by prospective randomized clinical studies.

Virus-related lymphoma exhibits a dual nature as both a hematologic malignancy and a viral infectious disease， making it more resistant to treatment and associated with poorer prognosis. This paper analyzes the understanding and therapeutic advantages of traditional Chinese medicine （TCM） in virus-related lymphoma. It proposes a TCM-based approach centered around syndrome differentiation， using standardized measurements of the overall TCM condition， multi-omics research of hematologic tumors， and artificial intelligence technologies to identify the "pre-condition" of virus-related lymphoma. A risk warning model will be established to early identify high-risk populations with viral infections that may develop into malignant lymphoma， thereby establishing a risk warning system for virus-related lymphoma. At the same time， a TCM health management approach will be applied to manage and regulate virus-related lymphoma， interrupting its progression and forming a human-centered， comprehensive， continuous health service model. Based on this， a standardized， integrated clinical prevention and treatment decision-making model for virus-related lymphoma， recognized by both Chinese and western medicine， will be established to provide TCM solutions for primary prevention of major malignant tumors.

Objective: To investigate the distribution of traditional Chinese medicine (TCM) syndromes and syndrome elements in lymphoma, as well as the correlation between TCM syndromes and Western clinical indicators, in order to analyze associations between TCM syndromes and these indicators. Methods: From January 2023 to May 2024, 216 patients with lymphoma who met the inclusion criteria in the Department of Hematology, Third People′s Hospital Affiliated to Fujian University of Traditional Chinese Medicine were enrolled. Four diagnostic methods were applied to perform TCM syndrome differentiation and extract syndrome elements. The correlations between various syndromes and blood test indicators of lactate dehydrogenase (LDH), β2-microglobulin (β2-MG), immunoglobulin G (IgG), immunoglobulin M (IgM), immunoglobulin A (IgA), white blood cell (WBC), hemoglobin (Hb), platelet count (PLT), neutrophil (NEUT), immunohistochemical markers of B-cell lymphoma-6 (BCL6), B-cell lymphoma-2 (BCL2), proto-oncogene MYC, and Ki67 protein expression, Ann Arbor staging, international prognostic index (IPI) score, bone marrow infiltration, concurrent infections during chemotherapy, and post-chemotherapy bone marrow suppression rate were analyzed. Results: Five TCM syndromes, ranked by frequency, were syndromes of yin deficiency with phlegm accumulation(41.67%), qi depression with phlegm obstruction(30.56%), cold-phlegm congelation and stagnation(12.96%), phlegm-blood stasis toxin(12.04%), and lingering pathogen due to deficient vital qi(2.77%). Yin deficiency(50.93%) and phlegm(45.37%) were the more prevalent syndrome elements. The TCM syndromes were correlated with β2-MG, PLT, MYC, BCL2/MYC, Ki67 protein expression, and bone marrow infiltration (P<0.05). No statistically significant differences were observed in Ann Arbor staging or IPI score across the syndromes. Compared to the syndrome of cold-phlegm congelation and stagnation, the syndrome of qi depression with phlegm obstruction exhibited higher levels of NEUT, MYC, BCL2/MYC, and Ki67 protein expression, as well as a higher rate of post-chemotherapy bone marrow suppression (P<0.05); the syndrome of phlegm-blood stasis toxin showed higher MYC and BCL2/MYC protein expression and a higher rate of post-chemotherapy bone marrow suppression rate (P<0.05); the syndrome of yin deficiency with phlegm accumulation demonstrated higher MYC and BCL2/MYC protein expression and bone marrow infiltration rates, whereas PLT level was lower (P<0.05); the syndrome of lingering pathogen due to deficient vital qi had higher MYC, BCL2/MYC, and Ki67 protein expression levels, as well as a higher rate of post-chemotherapy bone marrow suppression rate (P<0.05). Compared to the syndrome of qi depression with phlegm obstruction, the syndrome of phlegm-blood stasis toxin exhibited lower Ki67 protein expression (P<0.05); the syndrome of yin deficiency with phlegm accumulation had higher β2-MG level, bone marrow infiltration rate, and rate of concurrent infections during chemotherapy, whereas PLT and NEUT levels and the rate of post-chemotherapy bone marrow suppression rate were lower (P<0.05). Compared to the syndrome of phlegm-blood stasis toxin, the syndrome of yin deficiency with phlegm accumulation had higher β2-MG level, whereas NEUT and the rate of post-chemotherapy bone marrow suppression were lower(P<0.05); the syndrome of lingering pathogen due to deficient vital qi exhibited a higher Ki67 protein expression (P<0.05). Compared to the syndrome of yin deficiency with phlegm accumulation, the syndrome of lingering pathogen due to deficient vital qi also showed a higher Ki67 protein expression(P<0.05). Conclusion The syndrome of yin deficiency with phlegm accumulation is relatively common in lymphoma. There is a correlation between TCM syndromes and Western medicine clinical indicators. The presence of heat signs in the syndromes may indicate active disease and poor prognosis, while the presence of strong pathogenic factors and weak vital qi in the syndromes may indicate a severer chemotherapy-related bone marrow suppression.