Objective To study the effect of different approaches of Cage bone graft combined with pedicle screw fixation fusion in trea-ting lumbar spondylolisthesis. Methods From January 2011 to December 2012,120 patients with lumbar spondylolisthesis in our hospital were randomly divided into anterior lumbar interbody fusion (ALIF) group(n=40),postero lateral fusion (PLF) group(n=40) and posteri-or lunbar interbody fusion (PLIF) group(n=40). The related index and body’s function were observed. Results In PLIF group,the opera-tion time was(82. 3 ± 12. 1) h,intraoperative bleeding volume was (60. 3 ± 9. 5) mL,postoperative ambulation time was (5. 5 ± 0. 7) d, NRS score was(1. 5 ± 0. 2),ODI score 3,6,9,12 months after operation were respectively (24. 1 ± 3. 4),(19. 4 ± 3. 1),(13. 5 ± 2. 5), (9. 8 ± 1. 6),which was significantly lower than ALIF group and PLF group;the intervertebral height(9. 3 ± 1. 2)mm were significantly high-er than those of ALIF group and PLF group. Conclusion PLIF has positive clinical value in treating lumbar spondylolisthesis as it can re-duce the operation wound,promote postoperative recovery,and improve the long-term function of body.

Objective To compare the efficacy of urinary type Ⅳ collagen( Ⅳ C), N-acetyl-β-D-glucosaminidase( NAG ), serum cystatin C ( CysC ), β2 microglobulin ( β2-MG ) in early diagnosis of diabetic nephropathy(DN) ,and to develop a multiple regression equation using above mentioned indices. Methods One hundred and eight cases of DM patients were enrolled in the study. All those DM patients were divided into two groups according to 24 hr urinary albumin excretion(UAE): non-DN group( UAE ＜30 mg/24 h)and DN group (UAE ≥30 mg/24 h). Receiver operating characteristics (ROC)curve was developed using urinary IVC, NAG,serum CysC and β2-MG,and the efficiency of the four indices for early diagnosis of diabetic nephropathy were assessed by area under the curve ROC (AUCROC). Furthermore, the regression equation of four indicators was developed. All statistical analyses were performed using SPSS 13.0. Results The levels of urine Ⅳ C, NAG,CysC,β2-MG,were(3.91±1.93)ng/ml, ( 12.20 ±3.46)U/L, ( 1.18 ±0.41 )mg/L , (2. 50 ±0. 74)mg/ml in the non-DN group, respectively; and ( 14.14 ± 11.17 ) ng/ml, ( 23.12 ± 13.57 ) U/L, ( 2.69 ± 1.69 ) mg/L and(5.21 ± 2.78)mg/ml in the DN group, respectively. There were significant differences in the comparison of the four indicators between the two groups ( Ps ＜ 0.01 ). AUCROC of Ⅳ C, NAG, CysC and β2-MG were 0. 747,0.732,0.764 and 0.823 respectively;which meant the diagnostic efficacy for DN decended from β2-MG, CysC,Ⅳ C, to NAG in order. All these indices showed significant efficiency in assisting diagnosis of early DN ( Ps ＜0.01 ). The regression equation of UAE and the four indices was: UAE = - 242.624 + 6.362IVC + 8.662NAG + 64. 622CysC + 29.488β2-MG, and the equation had statisticl significance( P ＜ 0.O1 ). Conclusion Urine Ⅳ C, NAG,serum CysC, and β2-MG showed significant value in assisting diagosis of early DN, and could be sensitive indices for DN.

Objective To study the clinical significance of urinary type Ⅳ collagen(IVC)and UmAlb/UCr ratio in the diagnosis of early diabetic nephropathy. Methods We collected 52 cases of diabetes(group A)without DN(UAE ＜30 mg/24 h),35 cases of diabetes(group B)with early DN(UAE as 30-300 mg/24 h),and 50 cases of healthy controls. The differences of urine IVC,UmAlb/UCr were compared among group A,B and the control group. ROC curve was used for evaluating the use of urine IVC and UmAlb/UCr in the diagnosis of early DN. The correlation of urine IVC and UmAlb/UCr with UAE were investigated,and linear model curve were established. IVC in urine was detected by chemiluminescence,UmAlb was detected by immunoturbidimetric assay,UCr was detected by enzymatic. Statistical analysis were performed with SPSS13.0 statistical software. Results The urine IVC testing of group A,B and the control group were(2. 64 ± 0. 91),(3.91 ± 1.93)and(10. 08 ± 6. 50)μg/L,respectively. The UmAlb/UCr(mg/mmol)testing of group A,B and the control group were(1.50 ± 0. 40),(2. 58 ±2. 10)and(17.95 ± 13. 38)mg/mmol,respectively. Urine IVC and UmAlb/UCr were significant difference between group A,B and the control group(Ps ＜ 0. 01);the ROC area under the curve(AUCROC)of urine IVC and UmAlb/UCr were 0. 724,0. 945,the two indicators for early diagnosis of DN were significant(Ps ＜ 0. 01);The pearson correlation coefficients of the urine IVC and UmAlb/UCr were 0. 529,0. 919 ,respectively. They were positive and significant correlation(Ps ＜ 0. 01),On the basis of the correlation coefficient and linear model fitting curve with the UAE,the relationship of UmAlb/UCr with the UAE was better than that of IVC. Conclusions Urine IVC and UmAlb/UCr ratio,which significantly assists diagnosis in diabetic nephropathy ,can be used as a sensitive diagnostic indicator of diabetic nephropathy. Moreover,the relationship of UmAlb/UCr with the UAE is better than that with IVC.

Objective To explore the relationships of insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) with growth of very low birth weight (VLBW) infants in the early postnatal stage. Methods According to the individual gestational age and birth weight, 32 cases of VLBW infants were divided into small for gestational age (SGA) group and appropriate for gestational age (AGA) group. After birth, all the infants were given the same nutritional intake. The body weight, body length, head circumference and body mass index (BMI) were monitored at different time points (d0, d7, d14 and d28 after birth). Serum IGF-1 and IGFBP-3 levels were measured by radiommunoassay, and IGF-1/IGFBP-3 molar ratio was calculated. Results There was no signiifcant difference of body weight, body length, head circumference and BMI between two groups at d0, d7, d14 after birth. Body weight and BMI in SGA group were less than those in AGA group at d28 after birth (P<0.05). The levels of IGF-1, IGFBP-3 and IGF-1/IGFBP-3 in SGA group and IGF-1/IGFBP-3 in AGA group did not change with age after birth. The levels of IGF-1 and IGFBP-3 were increased in AGA group after birth. The level of IGF-1 in AGA group at d14 and d28 after birth was higher than that in AGA group at d0 after birth (P<0.05). The level of IGFBP-3 in AGA group at d28 after birth was higher than that in AGA group at d0 after birth (P<0.05). The levels of IGF-1 and IGFBP-3 in SGA group at d28 after birth were lower than those in AGA group at d28 after birth (P<0.05). Conclusions Serum IGF-1 and IGFBP-3 levels in SGA group are lower than those in AGA group. Low levels of IGF-1 and IGFBP-3 may result in growth retardation.

Objective To explore the relationship between the immune function of cellin peripheral blood with the virureplication and hepatitiviru(HCV)-cAg expression in the patientwith chronihepatiti(CHC) .MethodPeripheral blood lymphocytesubpopulation ,HCV-Rnand HCV core antigen (HCV-cAg) in 63 healthy people undergoing the physical exami-nation (control group) and 85 caseof CHC(Chgroup) were analyzed by the flow cytometry ,real-time Pcand ELIS,respec-tively .ResultThe percentageof total cell,T4 cell,T8 cell,double negative cell(DN) and double positive cell(DP) in the Chgroup were (67 .37 ± 10 .43)% ,(37 .11 ± 10 .28)% ,(21 .63 ± 8 .87)% ,(7 .80 ± 4 .57)% and (0 .20 ± 0 .29)% , respectively ,the absolute contentwere in turn (0 .70 ± 0 .44) × 109/L ,(0 .37 ± 0 .22) × 109/L ,(0 .22 ± 0 .17) × 109/L ,(0 .08 ± 0.06)×109/Land(0.19±0.68)×107/L,respectively.TheratioofT4/T8was(2.18±1.26)% .Theresultsindicatedthatthe percentage of T8 cellin the Chpatientwadecreased obviously (P＜0 .01) ,which resulted in the ratio of T4/T8 raising(P＜0 .05);meanwhile ,the absolute contentof the total cell,T4 cell,T8 celland Dnwere all decreased obviously (P＜0 .05);moreove,the percentage of T4 celland Dnin the patientwith HCV-Rnpositive and HCV-cAg positive wasignificantly in-creased (P＜0 .05) .Conclusion When HCV replicating in the patientwith CHC,the T lymphocyte subpopulation haobviouab-normity .The low immune function or immune tolerance ofT cells may be the important cause of recurrence and uncurability of CHC.

Objective:To explore the clinical feasibility of finger-pressing therapy based on the theory of treating impotence alone with Yang Ming to reduce incidence of ICU acquired weakness (ICU-AW) in critically ill children and provide a feasible nursing plan for ICU acquired asthenia in critically ill children.Methods:A quasi-experimental study was conducted. A total of 73 critically ill children were admitted to the PICU of Kunming Children′s Hospital from January 1 to April 30, 2021. According to the random number table, the subjects were divided into the observation group (37 cases) and the control group (36 cases). Children in the control group received routine PICU nursing. The children in the observation group were treated with PICU routine nursing and finger-pressing therapy based on the theory of treating impotence alone with Yang Ming. The two groups were compared in terms of limb muscle strength score (MRC-Score), incidence of ICU-AW, basic activities of life (Barthel Index, BI), limb muscle thickness.Results:After intervention, the MRC-Score of the observation group was 50 (46, 52) points, which was higher than 46 (40, 48) points of the control group, and the difference between the two groups was statistically significant ( Z=-3.70, P<0.05). The incidence of ICU-AW in the observation group was 32.43% (12/37), and the incidence of ICU-AW in the control group was 72.22% (26/36). The difference between the two groups was statistically significant ( χ2=11.58, P<0.05). The BI score of the observation group was 63 (50, 70), which was higher than 44 (40,60) of the control group, and the difference between the two groups was statistically significant ( Z=-3.94, P<0.05). The reduction degree of quadriceps femoris thickness in the observation group at D3-D1 was (-0.381 ± 0.131) cm, which was lower than (-0.762 ± 0.182) cm in the control group, and the difference between the two groups was statistically significant ( t=10.29, P<0.05). Conclusions:The application of finger-pressing therapy guided by theory of treating impotence alone with Yang Ming in the early rehabilitation of critically ill children can enhance muscle strength, prevent muscle atrophy and reduce the incidence of ICU-AW in critically ill children.

OBJECTIVETo study the association of methylenetetrahydrofolate reductase (MTHFR) gene C677T mutation and plasma homocysteine (Hcy) levels with hyperlipidemia.

METHODSBlood samples were collected from 1591 adults for detecting MTHFR gene C677T polymorphism with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), plasma Hcy levels with enzymatic cycling method, and blood lipid levels as well. The patients were divided according to the lipid levels into hyperlipidemia group (n=694) and healthy control group (n=897) and the differences in MTHFR gene C677T polymorphisms and plasma Hcy levels were compared.

RESULTSThe hyperlipidemia group and healthy control group showed no significant differences in CC, CT, or TT genotype frequencies or C and T allele frequencies of MTHFR C677T gene, and had comparable plasma Hcy levels (P>0.05). Patients with 3 different MTHFR C677T genotypes had significant differences in plasma Hcy levels (P<0.01) but not in blood lipid levels (P>0.05). Pairwise comparison indicated a significantly higher plasma Hcy level in TT genotype than in CC and CT genotypes (P<0.01), and the latter two genotypes showed no significant difference (P>0.05).

CONCLUSIONMTHFR C677T polymorphisms and plasma Hcy levels are closely related but neither of them is associated with hyperlipidemia. The TT genotype is associated with a significantly higher plasma Hcy level than CC and CT genotypes.

Adult ; Gene Frequency ; Genotype ; Homocysteine ; blood ; Humans ; Hyperlipidemias ; blood ; genetics ; Methylenetetrahydrofolate Reductase (NADPH2) ; genetics ; Mutation ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length

DNA is a biological polymer that encodes and stores genetic information in all living organism. Particularly, the precise nucleobase pairing inside DNA is exploited for the self-assembling of nanostructures with defined size, shape and functionality. These DNA nanostructures are known as framework nucleic acids (FNAs) for their skeleton-like features. Recently, FNAs have been explored in various fields ranging from physics, chemistry to biology. In this review, we mainly focus on the recent progress of FNAs in a pharmaceutical perspective. We summarize the advantages and applications of FNAs for drug discovery, drug delivery and drug analysis. We further discuss the drawbacks of FNAs and provide an outlook on the pharmaceutical research direction of FNAs in the future.

Stimulator of interferon genes (STING) is a cytosolic DNA sensor which is regarded as a potential target for antitumor immunotherapy. However, clinical trials of STING agonists display limited anti-tumor effects and dose-dependent side-effects like inflammatory damage and cell toxicity. Here, we showed that tetrahedral DNA nanostructures (TDNs) actively enter macrophages to promote STING activation and M1 polarization in a size-dependent manner, and synergized with Mn²⁺ to enhance the expressions of IFN-β and iNOS, as well as the co-stimulatory molecules for antigen presentation. Moreover, to reduce the cytotoxicity of Mn²⁺, we constructed a TDN-MnO₂ complex and found that it displayed a much higher efficacy than TDN plus Mn²⁺ to initiate macrophage activation and anti-tumor response both in vitro and in vivo. Together, our studies explored a novel immune activation effect of TDN in cancer therapy and its synergistic therapeutic outcomes with MnO₂. These findings provide new therapeutic opportunities for cancer therapy.