Objective To evaluate the impairment of large and small fibers of peripheral nerves in patients with diabetes mellitus according to the current perception threshold ( CPT ) comparing with nerve conduction studies ( NCS) and sympathetic skin response ( SSR).Methods Fourty-nine diabetic patients were enrolled from August to December 2014 in Tianjin Third Central Hospital.The CPT was examined by the Neurometer?CPT/C in diabetic patients and 23 healthy subjects.Electrical stimulations of 2 000, 250 and 5 Hz were delivered respectively to the first toe distal section , the bottom of the knee-patella middle line and the index finger distal section.NCS and SSR were performed in diabetic patients.The patients were divided into normal NCS ( NCSN) group and abnormal NCS ( NCSA) group according to the results of the nerve conduction.According to the results of SSR , the patients were divided into normal SSR ( SSRN) group and abnormal SSR ( SSRA ) group.Results In three testing areas , the CPT in NCSN group had no significant difference compared with control group , which was tested by different frequency;NCSA group had increased CPT (393.5 ±68.4, 213.1 ±39.7, 172.5 ±52.8, 221.6 ±48.0, 91.7 ±33.1, 76.2 ±27.8, 274.0 ±48.4, 120.1 ±26.6, 75.3 ±21.9) compared with control group (278.1 ±53.6, 128.9 ±46.7, 78.7 ±28.7, 149.3 ±54.6, 52.3 ±23.2, 41.9 ±18.7, 214.2 ±46.0, 96.0 ±29.3, 48.6 ±17.0; F=36.277, 40.827, 50.301, 10.240, 12.837, 13.832, 11.749, 5.559, 17.412,all P<0.01).At the first toe section, CPT decreased in SSRN group ( 91.0 ±29.0, 55.2 ±21.3 ) compared with control group (128.9 ±46.7, 78.7 ±28.7;F=23.071, 22.646, both P<0.05), which was tested by the currents of 250 Hz and 5 Hz frequency.In three testing areas , the SSRA group had increased CPT compared with control group , which was tested by different frequency.Conclusion Hyperesthesia as an early manifestation of small fiber damage can be detected by CPT in diabetic patients; CPT has no advantage in the evaluation of large fiber damage.

Objective:To investigate the related factors affecting the recovery of cholinesterase (ChE) activity in patients with acute chlorpyrifos poisoning.Methods:In February 2020, the clinical data of acute chlorpyrifos poisoning patients admitted in our hospital from January 2016 to December 2019 were retrospectively analyzed. The outcome variable was the time of ChE activity recovered to 50% lower limit of normal value, and multivariate linear regression analysis was performed to explore its influencing factors.Results:A total of 78 patients, 43 males and 35 females, with an average age (39.58±14.77) years were enrolled in this study. The average time of serum ChE activity recovered to 50% lower limit of normal value was (24.45±2.64) days. There was a correlation between hemoperfusion ( r=-0.644) , atropine dosage ( r=0.498) , chlorophosphorus dosage ( r=0.432) and the time of serum ChE activity recovered to 50% lower limit of normal value, in which hemoperfusion was significantly negatively correlated with the time of serum ChE activity recovered to 50% lower limit of normal value ( β=-4.222, P<0.05) . Conclusion:The recovery of serum ChE activity in patients with acute chlorpyrifos poisoning is very slow. Hemoperfusion can quickly remove chlorpyrifos, its metabolites and inflammatory mediators in the blood, thus effectively promoting the recovery of ChE activity.

Objective:To investigate the related factors affecting the recovery of cholinesterase (ChE) activity in patients with acute chlorpyrifos poisoning.Methods:In February 2020, the clinical data of acute chlorpyrifos poisoning patients admitted in our hospital from January 2016 to December 2019 were retrospectively analyzed. The outcome variable was the time of ChE activity recovered to 50% lower limit of normal value, and multivariate linear regression analysis was performed to explore its influencing factors.Results:A total of 78 patients, 43 males and 35 females, with an average age (39.58±14.77) years were enrolled in this study. The average time of serum ChE activity recovered to 50% lower limit of normal value was (24.45±2.64) days. There was a correlation between hemoperfusion ( r=-0.644) , atropine dosage ( r=0.498) , chlorophosphorus dosage ( r=0.432) and the time of serum ChE activity recovered to 50% lower limit of normal value, in which hemoperfusion was significantly negatively correlated with the time of serum ChE activity recovered to 50% lower limit of normal value ( β=-4.222, P<0.05) . Conclusion:The recovery of serum ChE activity in patients with acute chlorpyrifos poisoning is very slow. Hemoperfusion can quickly remove chlorpyrifos, its metabolites and inflammatory mediators in the blood, thus effectively promoting the recovery of ChE activity.

Objective To evaluate the clinical application of early total care (ETC) for polytrauma patients combined with thoracolumbar fractures.Methods A retrospective case control study was conducted to analyze the clinical data of 137 polytrauma patients combined with thoracolumbar fractures admitted to the First Affiliated Hospital of Soochow University and the Third People's Hospital of Zhang,jiagang from January 2012 to October 2015.There were 90 males and 47 females,aged 26-69 years,with an average age of 48.2 years.The patients were divided into ETC group (n =59) and TMC group (n =78).In the ETC group,physicians from different departments evaluated the patients and developed individualized therapeutic regimens to allow the patients to undergo surgery at early stage after injury.The TMC group preferentially stabilized the patient's condition or transferred the patients to specialist treatment,and then the surgery was performed electively after the condition of the patient was stable.The ISS of the ETC group was (22.15 ± 9.28)points,and that of the TMC group was (23.37 ± 10.74) points.All patients underwent conventional posterior pedicle screw internal fixation.For patients with burst fracture and nerve injury,posterior spinal canal decompression was performed.The thoracolumbar injury classification and severity score (TLICS),spinal load sharing classification (LSC),preoperative and postoperative Glasgow coma score (GCS),Frankel classification,hospitalization time and postoperative complications were compared between the two groups.Results The TLICS scores of ETC group were significantly lower than those of TMC group (P ＜ 0.05) while the LSC scores showed no significant differences between the two groups (P ＞ 0.05).ETC group had shorter hospitalization time [(11.8 ± 3.7)days ∶ (17.5 ±4.5)days] and lower pressure ulcer incidence [(5％ ∶ 21％)] than the TMC group (P ＜ 0.05 or 0.01),but the former had significantly higher wound infection rate [(17％ ∶ 15％)] (P ＜ 0.05).There was no significant difference in pulmonary infection and deep venous thrombosis incidence between the two groups (P ＞ 0.05).No significant differences were found in the preoperative GCS scores between the two group (P ＞ 0.05) while the postoperative GCS scores of TMC group were higher than those of ETC group (P ＜ 0.01).Postoperative GCS scores in both groups were significantly higher than their preoperative GCS (P ＜ 0.05).The results of postoperative Frankel classification in the ETC group were as follows:Grade A in one patient,Grade B in one,Grade C in three,Grade D in four and Grade E in two patients,with an improvement rate of 82％.The results of postoperative Frankel classification in the TMC group were as follows:Grade A in three patients,Grade B in three,Grade C in three,Grade D in four and Grade E in four,with an improvement rate of 65％.Conclusions For polytrauma patients combined with thoracolumbar fractures,ETC can shorten hospitalization time,reduce the pressure ulcer incidence,and better facilitate the recovery of nerve function,yet with higher wound infection risk compared with TMC.TMC was preferred subjectively for patients with unstable thoracolumbar fractures and high TLICS.

Objective: Based on spinopelvic parameters and biomechanical principles, the pedicle-facet joint (PFJ) morphological characteristics of isthmic and degenerative spondylolisthesis were analyzed, and the mechanism of their onset and progression was discussed. Methods: This retrospective cross-sectional study included 194 patients with L5 spondylolysis or L5–S1 low-grade isthmic spondylolisthesis (IS group), 172 patients with L4–5 degenerative spondylolisthesis (DS group), and 366 patients with nonlumbar spondylolysis (NL group). The spinopelvic parameters and PFJ morphological parameters of the patients were measured, the differences in these parameters among and within the 3 groups were compared, and the correlations were analyzed. Results: Sacral slope (SS) and lumbar lordosis (LL) were the highest in the IS group, the second highest in the DS group, and the lowest in the NL group. Among the 3 groups, the L4 facet joint angle (FJA) was the largest in the IS group, the second largest in the NL group, and the smallest in the DS group. The L4 pedicle-facet joint angle (PFA) was the largest in the DS group, the second largest in the IS group, and the smallest in the NL group. Pearson correlation analysis showed that within each group, SS and LL were negatively correlated with FJA and positively correlated with PFA. Conclusion This study found a correlation between the PFJ morphological characteristics of patients with lumbar spondylolisthesis and spinopelvic parameters, suggesting that the morphological characteristics of PFJs may be caused by varying stresses under different spinopelvic morphologies.

Objective: Based on spinopelvic parameters and biomechanical principles, the pedicle-facet joint (PFJ) morphological characteristics of isthmic and degenerative spondylolisthesis were analyzed, and the mechanism of their onset and progression was discussed. Methods: This retrospective cross-sectional study included 194 patients with L5 spondylolysis or L5–S1 low-grade isthmic spondylolisthesis (IS group), 172 patients with L4–5 degenerative spondylolisthesis (DS group), and 366 patients with nonlumbar spondylolysis (NL group). The spinopelvic parameters and PFJ morphological parameters of the patients were measured, the differences in these parameters among and within the 3 groups were compared, and the correlations were analyzed. Results: Sacral slope (SS) and lumbar lordosis (LL) were the highest in the IS group, the second highest in the DS group, and the lowest in the NL group. Among the 3 groups, the L4 facet joint angle (FJA) was the largest in the IS group, the second largest in the NL group, and the smallest in the DS group. The L4 pedicle-facet joint angle (PFA) was the largest in the DS group, the second largest in the IS group, and the smallest in the NL group. Pearson correlation analysis showed that within each group, SS and LL were negatively correlated with FJA and positively correlated with PFA. Conclusion This study found a correlation between the PFJ morphological characteristics of patients with lumbar spondylolisthesis and spinopelvic parameters, suggesting that the morphological characteristics of PFJs may be caused by varying stresses under different spinopelvic morphologies.

Objective: Based on spinopelvic parameters and biomechanical principles, the pedicle-facet joint (PFJ) morphological characteristics of isthmic and degenerative spondylolisthesis were analyzed, and the mechanism of their onset and progression was discussed. Methods: This retrospective cross-sectional study included 194 patients with L5 spondylolysis or L5–S1 low-grade isthmic spondylolisthesis (IS group), 172 patients with L4–5 degenerative spondylolisthesis (DS group), and 366 patients with nonlumbar spondylolysis (NL group). The spinopelvic parameters and PFJ morphological parameters of the patients were measured, the differences in these parameters among and within the 3 groups were compared, and the correlations were analyzed. Results: Sacral slope (SS) and lumbar lordosis (LL) were the highest in the IS group, the second highest in the DS group, and the lowest in the NL group. Among the 3 groups, the L4 facet joint angle (FJA) was the largest in the IS group, the second largest in the NL group, and the smallest in the DS group. The L4 pedicle-facet joint angle (PFA) was the largest in the DS group, the second largest in the IS group, and the smallest in the NL group. Pearson correlation analysis showed that within each group, SS and LL were negatively correlated with FJA and positively correlated with PFA. Conclusion This study found a correlation between the PFJ morphological characteristics of patients with lumbar spondylolisthesis and spinopelvic parameters, suggesting that the morphological characteristics of PFJs may be caused by varying stresses under different spinopelvic morphologies.

Objective: Based on spinopelvic parameters and biomechanical principles, the pedicle-facet joint (PFJ) morphological characteristics of isthmic and degenerative spondylolisthesis were analyzed, and the mechanism of their onset and progression was discussed. Methods: This retrospective cross-sectional study included 194 patients with L5 spondylolysis or L5–S1 low-grade isthmic spondylolisthesis (IS group), 172 patients with L4–5 degenerative spondylolisthesis (DS group), and 366 patients with nonlumbar spondylolysis (NL group). The spinopelvic parameters and PFJ morphological parameters of the patients were measured, the differences in these parameters among and within the 3 groups were compared, and the correlations were analyzed. Results: Sacral slope (SS) and lumbar lordosis (LL) were the highest in the IS group, the second highest in the DS group, and the lowest in the NL group. Among the 3 groups, the L4 facet joint angle (FJA) was the largest in the IS group, the second largest in the NL group, and the smallest in the DS group. The L4 pedicle-facet joint angle (PFA) was the largest in the DS group, the second largest in the IS group, and the smallest in the NL group. Pearson correlation analysis showed that within each group, SS and LL were negatively correlated with FJA and positively correlated with PFA. Conclusion This study found a correlation between the PFJ morphological characteristics of patients with lumbar spondylolisthesis and spinopelvic parameters, suggesting that the morphological characteristics of PFJs may be caused by varying stresses under different spinopelvic morphologies.

Objective: Based on spinopelvic parameters and biomechanical principles, the pedicle-facet joint (PFJ) morphological characteristics of isthmic and degenerative spondylolisthesis were analyzed, and the mechanism of their onset and progression was discussed. Methods: This retrospective cross-sectional study included 194 patients with L5 spondylolysis or L5–S1 low-grade isthmic spondylolisthesis (IS group), 172 patients with L4–5 degenerative spondylolisthesis (DS group), and 366 patients with nonlumbar spondylolysis (NL group). The spinopelvic parameters and PFJ morphological parameters of the patients were measured, the differences in these parameters among and within the 3 groups were compared, and the correlations were analyzed. Results: Sacral slope (SS) and lumbar lordosis (LL) were the highest in the IS group, the second highest in the DS group, and the lowest in the NL group. Among the 3 groups, the L4 facet joint angle (FJA) was the largest in the IS group, the second largest in the NL group, and the smallest in the DS group. The L4 pedicle-facet joint angle (PFA) was the largest in the DS group, the second largest in the IS group, and the smallest in the NL group. Pearson correlation analysis showed that within each group, SS and LL were negatively correlated with FJA and positively correlated with PFA. Conclusion This study found a correlation between the PFJ morphological characteristics of patients with lumbar spondylolisthesis and spinopelvic parameters, suggesting that the morphological characteristics of PFJs may be caused by varying stresses under different spinopelvic morphologies.

Chimeric antigen receptor (CAR)-T cell therapy has achieved remarkable success in the treatment of hematological malignancies. Based on the immunomodulatory capability of CAR-T cells, efforts have turned toward exploring their potential in treating autoimmune diseases. Bibliometric analysis of 210 records from 128 academic journals published by 372 institutions in 40 countries/regions indicates a growing number of publications on CAR-T therapy for autoimmune diseases, covering a range of subtypes such as systemic lupus erythematosus, multiple sclerosis, among others. CAR-T therapy holds promise in mitigating several shortcomings, including the indiscriminate suppression of the immune system by traditional immunosuppressants, and non-sustaining therapeutic levels of monoclonal antibodies due to inherent pharmacokinetic constraints. By persisting and proliferating in vivo, CAR-T cells can offer a tailored and precise therapeutics. This paper reviewed preclinical experiments and clinical trials involving CAR-T and CAR-related therapies in various autoimmune diseases, incorporating innovations well-studied in the field of hematological tumors, aiming to explore a safe and effective therapeutic option for relapsed/refractory autoimmune diseases.