BACKGROUND:With the rapid development of minimally invasive spinal surgery and enhanced recovery after surgery,endoscopic intervertebral fusion techniques have gradually emerged and been widely used in clinical practice in recent years. OBJECTIVE:To analyze the early clinical efficacy of uniaxial spinal endoscopic intervertebral fusion combined with posterior percutaneous pedicle screw fixation in the treatment of lumbar degenerative diseases. METHODS:135 patients with lumbar degenerative diseases treated by uniaxial spinal endoscopic intervertebral fusion combined with posterior percutaneous pedicle screw fixation in the Suining Central Hospital from October 2020 to December 2021 were enrolled in this study.There were 59 males and 76 females,aged 47-79 years.The lower limb and lumbar pain was evaluated by visual analog scale and lumbar function was assessed by Oswestry disability index before the operation,1 week,1,and 6 months after the operation,and at the end of follow-up.The overall pain recovery of patients was evaluated by the scoring criteria for low back pain surgery of Spine Group of Chinese Orthopedic Association and the lumbar physiological curvature and intervertebral fusion were evaluated on lumbar lateral X-ray preoperatively and at the end of follow-up. RESULTS AND CONCLUSION:(1)The 135 patients were followed up for(17.8±3.0)months after surgery.There was 1 case of endplate injury,1 case of cerebrospinal fluid leakage,1 case of nerve root injury,1 case of intervertebral cage subsidence and displacement,1 case of chronic infection,and 1 case of pedicle screw rupture.The complication rate was 5.2%.(2)The lumbar visual analog scale score and Oswestry disability index significantly decreased in the waist and lower limbs at various time points postoperatively compared with those preoperatively in 135 patients(P<0.05).The scoring criteria for low back pain surgery of the Spine Group of the Chinese Orthopedic Association were significantly better at the last follow-up than that preoperatively in 135 patients(P<0.05).(3)At the last follow-up,there was no significant difference in physiological curvature of lumbar vertebra as compared with that preoperatively in 135 patients(P>0.05),with a fusion rate of 95.8%.(4)It is concluded that uniaxial spinal endoscopic intervertebral fusion combined with posterior percutaneous pedicle screw fixation in the treatment of lumbar degenerative diseases has shown satisfactory early clinical results and is a highly safe minimally invasive spinal surgery mode.

Objective:To investigate the protective effect of Xuebijing injection on acute lung injury (ALI) associated with cardiopulmonary bypass (CPB) by regulating the apoptosis of polymorphonuclear neutrophils (PMN).Methods:Thirty male Sprague-Dawley (SD) rats were randomly divided into sham operation group (Sham group), CPB model group (CPB group) and Xuebijing pretreatment group (XBJ group) according to the random number table method, with 10 rats in each group. Rats in the CPB group and XBJ group undergoing CPB procedures for 60 minutes. Rats in the Sham group did not undergo CPB. Rats in the XBJ group received intraperitoneal injection of 4 mL/kg Xuebijing injection 2 hours before CPB. Rats in the Sham group and CPB group were injected with an equal amount of normal saline. 4 hours after CPB, arterial blood was collected for blood gas analysis to calculate respiratory index (RI), and lung tissue of rats was collected for determination of lung index (LI) and pulmonary water containing rate. PMN in bronchoalveolar lavage fluid (BALF) were collected and the activity of caspase-3 was detected. The apoptosis rate was detected by flow cytometry. The expressions of microRNA-142-3p (miR-142-3p) and FoxO1 mRNA were detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR). The protein expression of FoxO1 was detected by Western blotting. In addition, HL-60 cells were divided into control oligonucleotide transfection group, miR-142-3p mimics transfection group, and miR-142-3p inhibitor transfection group. After 48 hours of transfection, the activity of miR-142-3p binding to FoxO1 was detected using dual luciferase reporter genes.Results:Compared with Sham group, RI, LI and pulmonary water containing rate were significantly increased in CPB group. The caspase-3 activity and apoptosis rate of PMN obtained from BALF were significantly decreased, the expression of miR-142-3p was decreased, and the expression of FoxO1 protein was increased. However, compared with CPB group, RI, LI and pulmonary water containing rate were significantly decreased in XBJ group [RI: 0.281±0.066 vs. 0.379±0.071, LI: 4.50±0.26 vs. 5.71±0.42, pulmonary water containing rate: (80.31±32.50)% vs. (84.59±3.41)%, all P < 0.01]. The caspase-3 activity and apoptosis rate of PMN obtained from BALF were significantly increased [caspase-3 activity: 0.350±0.021 vs. 0.210±0.014, apoptosis rate: (15.490±1.382)% vs. (8.700±0.701)%, both P < 0.01], the expression of miR-142-3p was significantly up-regulated (2 -ΔΔCt: 2.61±0.17 vs. 0.62±0.05, P < 0.01), and the protein expression of FoxO1 was decreased [FoxO1/GAPDH (relative expression level): 0.81±0.04 vs. 1.22±0.06, P < 0.01]. However, there was no statistically significant difference in FoxO1 mRNA expression among the three groups. The bioinformatics analysis results showed that miR-142-3p can bind to the FoxO1 3'untranslated region (3'UTR). In HL-60 cells, compared with control oligonucleotide transfection group, the transfection of miR-142-3p mimics could reduce the expression of FoxO1 protein [FoxO1/GAPDH (relative expression level): 0.48±0.06 vs. 1.00±0.05, P < 0.01], however, the transfection of miR-142-3p inhibitor increased the expression of FoxO1 protein [FoxO1/GAPDH (relative expression level): 1.37±0.21 vs. 1.00±0.05, P < 0.05]. But, transfection with miR-142-3p mimics or inhibitor had no effect on FoxO1 mRNA expression. The luciferase reporter gene showed that miR-142-3p could bind to the FoxO1 3'UTR to inhibit FoxO1 expression. Conclusion:Xuebijing injection may promote the apoptosis of pulmonary alveolar PMN through the miR-142-3p/FoxO1 axis, and play a role in the prevention and treatment of CPB-induced ALI.

Objective:To investigate the status of hypoglycemia fear, diabetes distress, self-regulatory fatigue and self-management in type 2 diabetes patients. The chain mediating effects of self-regulated fatigue and psychological distress on hypoglycemic fear and self-management were investigated.Methods:The Hypoglycemia Fear Survey-Worry Subscale (CHFSII-WS), Diabetes Distress Scale (DDS), Self-Regulatory Fatigue Scale (SRF-S) and Summary of Diabetes Self-Care Activities (SDSCA) were used to investigate the type 2 diabetes patients from the department of Endocrinology of the First Affiliated Hospital in Jinzhou Medical University. And constructed the structural equation model.Results:The scores of fear of hypoglycemia in type 2 diabetes patients were positively correlated with psychological pain and self-regulating fatigue ( r=0.739, 0.625, P<0.05), but negatively correlated with self-management level ( r=-0.602, P<0.05). The psychological pain score was positively correlated with the self-regulating fatigue score ( r=0.669, P<0.05) and negatively correlated with the self-management level score ( r=-0.609, P<0.05). The score of self-regulation fatigue was negatively correlated with the score of self-management ( r=-0.596, P<0.05). Pathway analysis showed that hypoglycemia fear could directly affect self-management behavior, indirectly predict self-management level through self-regulation fatigue and psychological pain respectively, and negatively affect self-management behavior through chain mediation of self-regulation fatigue and psychological pain ( χ2/ df=3.079, GFI=0.920, CFI=0.961, NFI=0.943, IFI=0.961, RMSEA=0.078). Conclusions:The Self-regulated fatigue and psychological distress acts as the chain mediators of hypoglycemic fear and self-management in patients with type 2 diabetes.

Objective To investigate the preventive effect of Xuebijing injection on acute lung injury induced by cardiopulmonary bypass (CPB) and the underlying mechanism. Methods ① In vivo experiment: 30 Sprague-Dawley (SD) rats were randomly divided into sham group, CPB group, Xuebijing pretreatment group (XBJ+CPB group) with 10 rats in each group. CPB model was reproduced in rats; and CPB was not performed in sham group, but only through arteriovenous puncture. In the XBJ+CPB group, 4 mL/kg Xuebijing injection was injected intraperitoneally 2 hours before CPB, sham group and CPB group were injected with equal volume of normal saline at the same time. The blood from femoral artery was analyzed 4 hours after operation, and the oxygenation index (PaO2/FiO2) was calculated. Then the rats were sacrificed to collect bronchoalveolar lavage fluid (BALF), and the lung permeability index (PPI) was calculated. The lung tissues were harvested, and the wet/dry weight ratio (W/D) of lung tissue was measured. The index of quantitative evaluation of alveolar injury (IQA) was measured. The levels of interleukins (IL-1, IL-6) and tumor necrosis factor-α(TNF-α) in lung tissue and BALF were measured by enzyme-linked immunosorbent assay (ELISA). The content of malondialdehyde (MDA) and the activities of myeloperoxidase (MPO) and superoxide dismutase (SOD) in lung tissue were detected by biochemical method. The microRNA-17-5p (miR-17-5p) expression in lung tissue was determined by quantitative reverse transcription-polymerase chain reaction (RT-qPCR).② In vitro experiments: type Ⅱ alveolar epithelial cells (AECⅡ) were cultured in vitro, and they were randomly divided into control group (the cells were treated by preoperative serum of CPB in patients with ventricular septal defect), CPB group (the cells were treated by serum after CPB in patients), and XBJ+CPB group (Xuebijing injection 10 g/L+serum after CPB in patients). After 12 hours of culture in each group, the expression of miR-17-5p was detected by RT-qPCR. AECⅡ cells were transfected with miR-17-5p mimic, inhibitor or corresponding control oligonucleotide (negative control), respectively, to observe the effect of miR-17-5p on Xuebijing regulating CPB-induced apoptosis rate and caspase-3 activity. Results ① In vivo experiment: compared with the sham group, the PPI, lung W/D ratio, IQA, and IL-1, IL-6, TNF-α in lung tissue and BALF, as well as MDA content and MPO activity in lung tissue were significantly increased, PaO2/FiO2 and SOD activity in lung tissue were significantly decreased. The parameters of the XBJ+CPB group were significantly improved, suggesting that Xuebijing pretreatment could improve CPB-induced ALI in rats. The expression of miR-17-5p in lung tissue of the CPB group was significantly down-regulated as compared with sham group (2-ΔΔCt: 0.48±0.13 vs. 1.00±0.11, P < 0.05);while the expression of miR-17-5p in the XBJ group was significantly up-regulated as compared with the CPB group (2-ΔΔCt: 1.37±0.09 vs. 0.48±0.13, P < 0.05), indicating that the improvement of Xuebijing injection on lung injury after CPB might be related to miR-17-5p. ② In vitro experiment: the changes in miR-17-5p expression in each group of AECⅡ cells confirmed in vivo results. After transfection of miR-17-5p mimic, the apoptotic rate and caspase-3 activity of each group were significantly lower than those transfected with negative control, and the decrease was more significant in the XBJ+CPB group [apoptotic rate: (7.37±0.95)% vs. (12.60±1.90)%, caspase-3 (A value): 0.82±0.09 vs. 1.37±0.08, both P < 0.05]. After transfection of miR-17-5p inhibitor, the apoptotic rate and caspase-3 activity of each group were significantly more than those transfected with negative control [in the XBJ+CPB group: apoptotic rate was (16.30±1.86)% vs. (12.60±1.90)%, caspase-3 (A value) was 1.78±0.13 vs. 1.37±0.08, both P < 0.05]. This indicated that the apoptosis of AECⅡ cells cultured in serum after CPB was significantly reduced by miR-17-5p, and further reduced by the pretreatment with Xuebijing. Conclusions Xuebiing injection can reduce the inflammatory reaction and oxidative stress of lung tissue in rats with ALI induced by CPB, and improve oxygenation. The mechanism may be related to up-regulation of miR-17-5p expression in AECⅡ cells and inhibition of apoptosis of AECⅡ cells.

Objective: During the 2016 winter season, GII.2 norovirus(NoV) suddenly emerged in China. To elucidate its mechanism of epidemic, this study focused on characteristics of binding between the P protein of capsid and histo-blood group antigens (HBGAs). Methods: The research object was GⅡ.2 ZTX strain which had an outbreaks by the end of 2016 in Beijing. Recombinant prokaryotic expression plasmid was constructed, and the expression of virus P protein was determined and purified. The P protein characteristics of binding to HBGAs was studied through saliva and oligosaccharide binding experiments. Results: Soluble P protein was successfully obtained, and combined with type A, B, AB saliva. Conclusions The result illuminate the combination with new outbreaks of NoV and salivary types, which provided a basis for its pathogenic mechanism and prevention and control measures.

Objective To report a case of Costello syndrome complicated by curis laxa,and to make a molecular genetic diagnosis.Methods Clinical data were collected from a case of Costello syndrome complicated by cutis laxa.Skin tissues were resected from the patient,and peripheral blood samples were obtained from the patient's parents and 150 unrelated healthy controls.Genomic DNA was extracted from these samples,and all the exons and their flanking sequences of the HRAS gene were analyzed by DNA sequencing.Results The 13-month-old female patient presented with growth retardation,severe malnutrition,coarse facial appearance,severely loose skin over the limbs,and decrease or disappearance of subcutaneous fat.A heterozygous mutation c.34G ＞ T (p.Gly12Cys) was detected in exon 2 of the HRAS gene in the patient,but not in her parents or 150 unrelated healthy controls.Conclusion The c.34G ＞ T (p.Gly12Cys) mutation in exon 2 of the HRAS gene may be responsible for Costello syndrome in the patient.

Objective To investigate the effect of Xuebijing injection on inflammatory factors in patients with Stanford B aortic dissection (AD) after endovascular repair and approach its clinical significance.Methods Sixty patients with Stanford type B AD for endovascular repair admitted to the Department of Cardiothoracic Surgery of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine (TCM) from January 2014 to June 2016 were enrolled, and they were divided into a Xuebijing group and a control group according to the random number table method, 30 cases in each group. The patients of Xuebijing group received 100 mL Xuebijing injection+ 50 mL normal saline intravenous drip during operation, while the patients of control group received an equal volume of normal saline, 2 times a day in both groups for consecutive 3 days. Peripheral venous blood was collected before and after treatment for 1, 2, and 3 days, and the levels of C-reactive protein (CRP), tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) were measured by enzyme-linked immunosorbent assay (ELISA), and the prognosis of the two groups was observed.Results With the prolongation of time, the postoperative levels of CRP, TNF-α and IL-6 in the two groups showed a tendency of first increase and then decrease compared with the preoperative levels, the above indexes of the two groups were all significantly higher, CRP (mg/L) and TNF-α (ng/L) peaked on the 2nd day postoperatively (control group: CRP was 146.34±13.92 and TNF-α was 72.22±7.63, Xuebijing group: CRP was 114.92±9.89 and TNF-α was 53.44±6.80, allP < 0.05), however, IL-6 (ng/L) peaked on the 1st day postoperatively (control group: 146.08±10.29, Xuebijing group: 117.88±8.84), then decreased, all reached the valley on the 3rd day postoperatively (control group: CRP, TNF-α, IL-6 was 112.59±8.54, 43.73±4.10, 70.03±4.66 respectively, Xuebijing group CRP, TNF-α, IL-6 was 87.75±7.67, 39.43±4.63, 56.65±3.27, respectively), and at the same time point, the level of CRP, TNF-α, IL-6 in the Xuebijing group were significant lower than those in the control group, the change were the most significant on 3 days after operation [CRP (mg/L): 87.75±7.67 vs. 112.59±8.54, TNF-α (ng/L): 39.43±4.63 vs. 43.73±4.10, IL-6 (ng/L): 56.65±3.27 vs. 70.03±4.66, P < 0.05]. There were no serious complications such as renal failure, severe hypoxemia, infection, paraplegia, stent shift and so on, no hospital death occurred and all patients were discharged in rehabilitative condition. Conclusions Endovascular repair in patients with Stanford type BAD may activate an inflammatory response inducing the release of a large amount of inflammatory factors during the early postoperative period, Xuebijing injection can inhibit the inflammatory reaction and prevent the occurrence of postoperative complications.

Interactions between noroviruses (NoVs) and the receptors of histo-blood group antigens (HB-GAs) affect the infectivity and host susceptibility of NoVs. We elucidated the binding profile of a GII. 12 NoV to HBGAs. First, we synthesized the P domain sequence of the GII. 12 NoV strain Pune (GenBank accession number EU921353). Protein of the P domain was expressed in a prokaryotic system. Formation of the P particle was monitored by gel-filtration chromatography. Antiserum was prepared by immunization of mice with GII. 12 P particles. The binding profile of the GII. 12 NoV Pune strain was determined by binding of the P particle with a panel of saliva samples with various known HBGAs phenotypes. The GII. 12 NoV was bound strongly to saliva samples of subjects with B and AB types and weakly to A, O secretor, and non-secretor saliva samples, suggesting higher affinity with B antigen by GII. 12 NoV. These results were consistent with those determined by a previous crystallography study of GII. 12 NoV. These data suggested that individuals with B and AB blood types may be more susceptible to infection by GII. 12 NoV compared with those with other blood types. Our findings may provide a basis for the prevention and control of an epidemic of GII. 12 NoV.
Animals ; Blood Group Antigens ; metabolism ; Caliciviridae Infections ; metabolism ; virology ; Female ; Gastroenteritis ; metabolism ; virology ; Genotype ; Humans ; Mice ; Mice, Inbred BALB C ; Norovirus ; genetics ; metabolism ; Protein Binding ; Receptors, Virus ; metabolism ; Viral Proteins ; genetics ; metabolism

Objective To evaluate the effects of high frequency ultrasound in the assessment of vascular function during exercise in healthy subjects. Methods Forty-nine healthy subjects were enrolled in this study. The parameters of vascular function were measured at different stages (rest, exercise peak and recovery). Compliance coefficient (CC), distensibility coefficient (DC), stiffness indexα, stiffness indexβand pulse wave velocity (PWV) were measured by RF-Data technique of ultrasound vascular measurement (quantitative arterial stiffness, QAS). Endocardium-circumferential strain (EN-CS), epicardium-circumferential strain (EP-CS), endocardium-circumferential strain rate (EN-CSR) and epicardium-circumferential strain rate (EP-CSR) were collected by two-dimensional speckle tracking imaging (X-strain). The correlation between EN-CS, EN-CSR, EP-CS, EP-CSR and CC, DC, stiffness indexα, stiffness indexβand PWV were analyzed. Results At different stages (rest, exercise peak and recovery), CC were (1.436±0.448), (1.041±0.432) and (1.191±0.467) mm2/kPa DC were (0.040±0.016), (0.031±0.013) and (0.034±0.013) 1/kPa. CC and DC signiifcantly decreased at exercise peak (F=12.99 and 7.65, both P<0.01). At different stages (rest, exercise peak and recovery), PWV were (5.037±0.798), (5.845±1.165) and (5.683±1.367) m/s, stiffness indexαwere 2.298±0.633, 3.303±1.697 and 3.092±1.533, stiffness index β were 4.762±1.284, 6.794±2.515 and 6.158±3.089. PWV, stiffness index α and stiffness index β significantly increased at exercise peak (F=9.21, 13.24 and 12.33, all P<0.01). At different stages (rest, exercise peak and recovery), EN-CS were (7.825±2.445)%, (9.105±4.234)%and (6.271±2.527)%, EN-CSR were (0.831±0.276), (1.219±0.556) and (0.765±0.282) s-1, EP-CS were (6.894±2.465)%, (7.936±3.628)%and (5.489±2.306)%, EP-CSR were (0.714±0.247), (1.019±0.414) and (0.656±0.237) s-1. EN-CS, EN-CSR, EP-CS and EP-CSR signiifcantly increased at exercise peak (F=25.92, 43.76, 21.22 and 47.98, all P<0.01). EN-CS, EN-CSR, EP-CS and EP-CSR were positively correlated with PWV, stiffness indexαand stiffness indexβ(r:from 0.253 to 0.494, all P<0.05), negatively correlated with CC and DC (r:from-0.234 to-0.562, all P<0.05). Conclusions CC, DC, stiffness indexα, stiffness indexβ, PWV, EN-CS, EN-CSR, EP-CS and EP-CSR all can relfect the changes of vascular function during exercise. Properly exercise has positively direct effect on vascular elasticity.

Objective To observe the kinetics of myocardial during isovolumic relaxation (IVR) in normal subjects during exercise stress testing,and evaluate the relationship between the recovery rate of circumferential strain during IVR and the diastolic function of the heart.Methods Echocardiography was performed in 43 healthy students at rest,at peak stress and at recovery of the exercise test.The ratio of peak early-diastolic mitral orifice flow velocity and peak early-diastolic mitral annular velocity in left ventricular posterior wall (E/e) was measured.The records of the movement in the basal,papillary muscle and apical short-axis views of the left ventricular were stored.The circumferential strain during the end systolic (ES) and the end isovolumetric relaxation (IRA) of the subendocardial and subepicardial layers in the three short axis were analyzed using X-strain software.The circumferential strain recovery rate of the subendocardial and subepicardial layers during the IVR (ENCSrec,EPCSrec) were calculated.The circumferential strain of the subendocardial and subepicardial layers in the three short-axis during ES and IRA phases in different status were compared.The relationship between the circumferential strain recovery rate during IVR and E/e were analyzed.Results The circumferential strain of the basal,papillary level in short axis during ES and IRA phases decreases at the beginning and then increased along with the exercise intensity (P ＜0.05).The circumferential strain of the subendocardial layer is greater than the subepicardial layer in the three shortaxis during ES and IRA in different exercise status (P ＜0.01).The ENCSrec and EPCSrec of the three short-axis increases at the beginning and then decreased along with the exercise intensity (P ＜0.05).The ENCSrec and EPCSrec of 3 short axis are correlated with E/e in different exercise phases (P ＜0.05).Conclusions In normal subjects,the kinetics of circumferential strain during IVR is consisted with the physiological changes of the heart during IVR in different exercise phases.The circumferential strains in different myocardial layers are different during IVR.The circumferential strain recovery rate of left ventricular myocardial during IVR may reflex the diastolic function of the heart.