Objective:To explore the effects of age and gender on the sagittal spinal-pelvic parameters during the natural aging process of healthy adults.Methods:A total of 647 Chinese healthy adults who underwent health check-ups at the Second Affiliated Hospital of Zhejiang University School of Medicine and Songyang County People's Hospital, from January 2017 to September 2024 were collected. There were 277 males and 370 females, aged 18-93 years. Anteroposterior and lateral X-ray films of the whole spine were taken to evaluate the spinal-pelvic sagittal morphology. The following parameters were measured: thoracic kyphosis (TK), lumbar lordosis(LL), sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT), global tilt (GT), T 1-pelvic angle (TPA), sagittal vertical axis (SVA), thoracic Cobb angle (T-Cobb), lower end vertebra of thoracic Cobb angle (T-LEV), apex vertebra of thoracic Cobb angle (T-Apex), lumbar Cobb angle (L-Cobb). Compare the differences in spine-pelvis parameters among patients of different genders and age groups (in this study, the subjects were subdivided into the 18-29, 30-39, 40-49, 50-59, 60-69, 70-79, and 80-93 years groups according to the age range). Results:The results showed that GT, SVA, TPA, and PT increased with age ( P<0.05). For males aged 18-29, 30-39, 40-49, 50-59, 60-69, 70-79, and 80-93 years, PT values were 8.58°±6.47°, 9.60°±5.63°, 12.65°±7.13°, 11.00°±6.99°, 13.01°±8.63°, 15.77°±8.02°, and 18.47°±10.03° respectively; for females in the same age groups, the PT values were 8.44°±6.83°, 9.00°±6.44°, 11.84°±7.35°, 12.07°±7.51°, 15.44°±9.39°, 19.26°±8.28°, and 18.17°±9.43° respectively. For males in these age groups, the global tilt (GT) values were 6.37°±7.20°, 8.77°±6.51°, 10.38°±9.07°, 8.80°±7.49°, 10.80°±8.62°, 16.07°±10.42°, and 21.99°±12.65° respectively; for females, the GT values were 4.46°±8.09°, 5.96°±7.83°, 8.17°±6.88°, 9.41°±8.03°, 9.96°±1.39°, 17.89°±9.39°, and 19.55°±12.34° respectively. The sagittal vertical axis (SVA) values for males in the age groups were -7.94±25.57 mm, -2.98±25.69 mm, -4.63±20.90 mm, -6.43±32.81 mm, 7.85±43.39 mm, 36.49±53.89 mm, and 55.57±51.10 mm respectively; for females, they were -24.12±31.35 mm, -17.49±25.12 mm, -17.88±22.72 mm, -8.25±30.91 mm, 8.80±27.45 mm, 28.67±38.22 mm, and 23.23±35.19 mm respectively. For males, the thoracic pelvic angle (TPA) values across the age groups were 4.46°±5.94°, 6.05°±5.38°, 9.58°±9.35°, 7.52°±7.64°, 11.23°±9.59°, 16.32°±12.38°, and 18.49°±11.70° respectively; for females, the TPA values were 2.72°±6.88°, 3.68°±6.26°, 7.30°±6.11°, 7.44°±6.75°, 12.64°±9.79°, 19.08°±10.39°, and 16.79°±13.19° respectively. T-Cobb, T-LEV, and T-Apex increased slowly with age ( P<0.05). The pelvic incidence (PI) remained relatively constant in males ( P>0.05), while it increased slowly with age in females ( P<0.05). Conclusions:Sagittal anteversion of the spinal-pelvis increases with age. Gender differences are reflected in specific changes in the fluctuation amplitude of certain parameters (such as PI), and the fluctuations of indicators like T-Cobb, T-LEV, and T-Apex are closely related to the natural aging process of the spine.

Objective To systematically summarize medication patterns and explore the potential mechanisms of core herbal combinations in treating chronic glomerulonephritis(CGN)based on data mining and network pharmacology,and to provide a reference for clinical treatment strategies.Methods Electronic book databases were searched to screen the CGN prescription from the works of contemporary Xin'an medical practitioners.Frequency statistics,association rule analysis,and clustering algorithms via the traditional Chinese medicine(TCM)Inheritance Support Platform V3.5 were applied to identify high-frequency herbs(frequency of use>10%)and core combinations.Active ingredients and potential targets were predicted using TCMSP,PubChem,and SwissTargetPrediction databases.Disease-related targets were retrieved from OMIM and GeneCards,after obtaining the intersecting targets,followed by protein-protein interaction(PPI)network construction(STRING platform),Cytoscape topological analysis,and GO and KEGG pathway enrichment(DAVID).Results A total of 151 prescriptions related to the treatment of CGN were included,involving 213 flavours of TCM,including 42 varites of high frequency drugs,mainly in the categories of supplementing deficiency,eliminating dampness and diuresis and clearing heat.Theherb properties were mainly cold,warm,and neutral,with flavors of sweet,bitter,and pungent.Herbs primarily targeted the liver,lung,kidney,and spleen meridians.Thecore combination"Astragali Radix,Dioscorea Rhizome,Atractylodis Macrocephalae Rhizoma,Imperata Rhizome,Pyrrosiae Folium,Poria"was identified,with key active ingredients including quercetin,stigmasterol,and β-sitosterol.Core targets involved IL6,EGFR,TNF,AKT1,and PIK3CA,while enriched pathways included PI3K-Akt and AGE-RAGE signaling.Conclusion Contemporary Xin'an practitioners primarily treat CGN by tonifying the spleen,nourishing the kidney,and clearing damp-heat.Thecore herbal combination exerts synergistic effects through multi-target intervention in immune-inflammatory pathways,oxidative stress,and fibrotic pathways,highlighting the holistic therapeutic advantages of TCM formulas via multi-component synergistic regulation and multi-target interactions.This study provides a theoretical foundation for further experimental validation and clinical applications.

Objective:To explore the effects of age and gender on the sagittal spinal-pelvic parameters during the natural aging process of healthy adults.Methods:A total of 647 Chinese healthy adults who underwent health check-ups at the Second Affiliated Hospital of Zhejiang University School of Medicine and Songyang County People's Hospital, from January 2017 to September 2024 were collected. There were 277 males and 370 females, aged 18-93 years. Anteroposterior and lateral X-ray films of the whole spine were taken to evaluate the spinal-pelvic sagittal morphology. The following parameters were measured: thoracic kyphosis (TK), lumbar lordosis(LL), sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT), global tilt (GT), T 1-pelvic angle (TPA), sagittal vertical axis (SVA), thoracic Cobb angle (T-Cobb), lower end vertebra of thoracic Cobb angle (T-LEV), apex vertebra of thoracic Cobb angle (T-Apex), lumbar Cobb angle (L-Cobb). Compare the differences in spine-pelvis parameters among patients of different genders and age groups (in this study, the subjects were subdivided into the 18-29, 30-39, 40-49, 50-59, 60-69, 70-79, and 80-93 years groups according to the age range). Results:The results showed that GT, SVA, TPA, and PT increased with age ( P<0.05). For males aged 18-29, 30-39, 40-49, 50-59, 60-69, 70-79, and 80-93 years, PT values were 8.58°±6.47°, 9.60°±5.63°, 12.65°±7.13°, 11.00°±6.99°, 13.01°±8.63°, 15.77°±8.02°, and 18.47°±10.03° respectively; for females in the same age groups, the PT values were 8.44°±6.83°, 9.00°±6.44°, 11.84°±7.35°, 12.07°±7.51°, 15.44°±9.39°, 19.26°±8.28°, and 18.17°±9.43° respectively. For males in these age groups, the global tilt (GT) values were 6.37°±7.20°, 8.77°±6.51°, 10.38°±9.07°, 8.80°±7.49°, 10.80°±8.62°, 16.07°±10.42°, and 21.99°±12.65° respectively; for females, the GT values were 4.46°±8.09°, 5.96°±7.83°, 8.17°±6.88°, 9.41°±8.03°, 9.96°±1.39°, 17.89°±9.39°, and 19.55°±12.34° respectively. The sagittal vertical axis (SVA) values for males in the age groups were -7.94±25.57 mm, -2.98±25.69 mm, -4.63±20.90 mm, -6.43±32.81 mm, 7.85±43.39 mm, 36.49±53.89 mm, and 55.57±51.10 mm respectively; for females, they were -24.12±31.35 mm, -17.49±25.12 mm, -17.88±22.72 mm, -8.25±30.91 mm, 8.80±27.45 mm, 28.67±38.22 mm, and 23.23±35.19 mm respectively. For males, the thoracic pelvic angle (TPA) values across the age groups were 4.46°±5.94°, 6.05°±5.38°, 9.58°±9.35°, 7.52°±7.64°, 11.23°±9.59°, 16.32°±12.38°, and 18.49°±11.70° respectively; for females, the TPA values were 2.72°±6.88°, 3.68°±6.26°, 7.30°±6.11°, 7.44°±6.75°, 12.64°±9.79°, 19.08°±10.39°, and 16.79°±13.19° respectively. T-Cobb, T-LEV, and T-Apex increased slowly with age ( P<0.05). The pelvic incidence (PI) remained relatively constant in males ( P>0.05), while it increased slowly with age in females ( P<0.05). Conclusions:Sagittal anteversion of the spinal-pelvis increases with age. Gender differences are reflected in specific changes in the fluctuation amplitude of certain parameters (such as PI), and the fluctuations of indicators like T-Cobb, T-LEV, and T-Apex are closely related to the natural aging process of the spine.

Objective To systematically summarize medication patterns and explore the potential mechanisms of core herbal combinations in treating chronic glomerulonephritis(CGN)based on data mining and network pharmacology,and to provide a reference for clinical treatment strategies.Methods Electronic book databases were searched to screen the CGN prescription from the works of contemporary Xin'an medical practitioners.Frequency statistics,association rule analysis,and clustering algorithms via the traditional Chinese medicine(TCM)Inheritance Support Platform V3.5 were applied to identify high-frequency herbs(frequency of use>10%)and core combinations.Active ingredients and potential targets were predicted using TCMSP,PubChem,and SwissTargetPrediction databases.Disease-related targets were retrieved from OMIM and GeneCards,after obtaining the intersecting targets,followed by protein-protein interaction(PPI)network construction(STRING platform),Cytoscape topological analysis,and GO and KEGG pathway enrichment(DAVID).Results A total of 151 prescriptions related to the treatment of CGN were included,involving 213 flavours of TCM,including 42 varites of high frequency drugs,mainly in the categories of supplementing deficiency,eliminating dampness and diuresis and clearing heat.Theherb properties were mainly cold,warm,and neutral,with flavors of sweet,bitter,and pungent.Herbs primarily targeted the liver,lung,kidney,and spleen meridians.Thecore combination"Astragali Radix,Dioscorea Rhizome,Atractylodis Macrocephalae Rhizoma,Imperata Rhizome,Pyrrosiae Folium,Poria"was identified,with key active ingredients including quercetin,stigmasterol,and β-sitosterol.Core targets involved IL6,EGFR,TNF,AKT1,and PIK3CA,while enriched pathways included PI3K-Akt and AGE-RAGE signaling.Conclusion Contemporary Xin'an practitioners primarily treat CGN by tonifying the spleen,nourishing the kidney,and clearing damp-heat.Thecore herbal combination exerts synergistic effects through multi-target intervention in immune-inflammatory pathways,oxidative stress,and fibrotic pathways,highlighting the holistic therapeutic advantages of TCM formulas via multi-component synergistic regulation and multi-target interactions.This study provides a theoretical foundation for further experimental validation and clinical applications.

Objective:To investigate the protective effect of ergosterol on neurons in CA1 area of the hippocampus and its mechanism in rats anesthetized with propofol.Methods:Forty-five SD rats were randomly divided into control group, propofol group and propofol+ergosterol group ( n=15). Rats in the control group were injected intraperitoneally with 100 mg/kg fat emulsion solvent; rats in the propofol group were injected intraperitoneally with 50 mg/kg propofol first, and after the righting reflex was restored, they were injected with 50 mg/kg propofol; propofol+ergosterol group was intraperitoneally injected with 30 mg/kg ergosterol, followed by propofol injection, and the propofol injection method was the same as that of the propofol group. Injection was given continuously for 7 d. After the last injection, the rats in each group were awake for 2 h. The ultrastructure of neurons in hippocampal CA1 area was observed by transmission electron microscopy. HE staining, TUNEL and neuronal nuclear antigen (NeuN) staining, and Western blotting were used to detect the morphology, apoptosis, and postsynaptic density protein 95 (PSD95) expression of neurons in the hippocampal CA1 area, respectively. Western blotting was used to determine the expressions of apoptosis-related proteins and phosphatidylinositol 3-kinase (PI3K)-protein kinase B (Akt) signaling pathway proteins in hippocampal CA1 area of rats. Results:Transmission electron microscopy and HE staining showed that the damage of neurons in the hippocampal CA1 area of the propofol+ergosterol group was slighter than that of the propofol group. As compared with control group, propofol group had significantly higher neuronal apoptosis, significantly higher levels of activated Caspase 3 and Bax protein expressions, significantly decreased Bcl-2 and PSD95 expressions, significantly increased apoptosis inducing factor (AIF) and Cytochrome (Cyt)-C protein expressions, statistically lower Sirt1 protein expression, and significantly lower phosphorylated (p)-PI3K/PI3K level and p-Akt/Akt ratio in the hippocampal CA1 area ( P<0.05). As compared with propofol group, propofol+ergosterol group had significantly lower neuronal apoptosis in the hippocampal CA1 area (27.33±1.37% vs. 17.47±0.87%, P<0.05). As compared with propofol group, propofol+ergosterol group had significantly lower activated Caspase 3 and Bax protein expressions, significantly increased Bcl-2 and PSD95 expressions, significantly decreased AIF and Cyt-C protein expressions, statistically higher Sirt1 protein expression, and significantly higher p-PI3K/PI3K level and p-Akt/Akt ratio in the hippocampal CA1 area ( P<0.05). Conclusion:Ergosterol pretreatment can inhibit propofol-induced neuron apoptosis and alleviate the neuronal damage in the hippocampal CA1 area, whose mechanism may be mediated by PI3K-Akt signaling pathway.

Objective:To investigate the preliminary clinical and radiographic outcomes of percutaneous endoscopic lumbar discectomy (PELD) combined with oblique lateral interbody fusion (OLIF) for the degenerative lumbar spondylolisthesis, lumbar spine instability or lumbar spinal stenosis with ruptured disc herniation.Methods:Data of 11 patients with degenerative lumbar spondylolisthesis, lumbar spine instability or lumbar spinal stenosis with ruptured disc herniation who had undergone PELD combined with OLIF between March 2017 to July 2018 in our spine surgery center were retrospectively analyzed. There were 5 males and 6 females with an average age of 61.2±6.8 years old. All the patients were diagnosed with degenerative lumbar diseases including lumbar spondylolisthesis (7 cases), lumbar spinal stenosis (3 cases) and segmental instability (1 case). The patients were treated with PELD combined with OLIF. The visual analogue scale (VAS) scores of low back pain and lower limb pain and the Oswestry disability index (ODI) of lumbar function, spinal canal anteroposterior diameter, intervertebral disc height, vertical diameter of intervertebral foramen, segmental angle and the whole lumbar lordotic angle were collected.Results:All patients received PELD with local anesthesia before OLIF with general anesthesia. The mean operation time was 52.3±13.2 min and the mean blood loss was 10.9±4.7 ml for PELD. The mean operation time was 56.8±18.0 min and the mean blood loss was 65.5±24.6 ml for OLIF. All patients were followed up for an average of 11.2 months. At the latest follow-up, the mean VAS score for back pain was 1.3±0.8, the mean VAS score for leg pain 1.1±0.5, the mean ODI 14.6%±5.3%, thus all of those were improved significantly compared to those of pre-operation ( t=10.37, 16.49, 8.73; P< 0.05). The radiographic results showed the mean pre-operative intervertebral disc height, vertical diameter of intervertebral foramen, spinal canal anteroposterior diameter, segmental angle, and lumbar lordosis angle was 7.1±1.2 mm, 15.3±2.2 mm, 6.2±1.3 mm, 10.2°±3.5°, 16.2°±6.2°, and thus all of those were increased significantly to the latest follow-up 11.5±1.8 mm, 19.2±2.6 mm, 10.4±2.5 mm, 19.3°±7.8°, 27.4°±8.3°, respectively ( t=5.83, 4.21, 6.59, 10.32, 7.65; P< 0.05). One of the patients had weakness of flexor hip strength and one had a transient paresthesia immediately post-operation. All symptoms were relieved within 1 month. Another one case had cage subsidence and encountered serious back pain after 1 month, and alleviated after percutaneous pedicle screw fixation. Conclusion:PELD combined with OLIF can overcome the limitations of OLIF with indirect decompression effects, resulting in successful direct neural decompression without posterior decompressive procedures and providing a satisfactory outcome for the patients with degenerative lumbar diseases with ruptured disc herniation.

Objective To compare the Roussouly classification of old thoracolumbar fractures combined with post-traumatic kyphosis with that of normal adults, evaluate the effect of different kyphosis angles on sagittal curvature of the thoracolumbar spine so as to provide a theoretical basis for the clinical status and clinical treatment plan of old thoracolumbar fractures combined with post-traumatic kyphosis.Methods A retrospective case control study was made on 49 cases of old thoracolumbar fractures with post-traumatic kyphosis treated from January 2014 to December 2015 (fracture group).Damaged segments of the spine were T11 in four cases, T12 in 14, L1 in 25 and L2 in six.Another 52 normal adult volunteers were chosen as controls.Whole spine X-ray film of the two groups was taken, and the difference in Roussouly classification of the sagittal spine curvature was compared between the two groups.Patients in fracture group were separated into subgroups depending on the Cobb angle (0°-10°, 10°-20°, 20°-30°, 30°-40°, respectively), and the difference in Roussouly classification was compared among subgroups.Results Roussouly classification in control group was five cases of type 1, 12 tpye 2, 25 type 3 and 10 type 4.Results in fracture group was 14 cases of type 1, 11 type 2, eight type 3 and 16 type 4.There were significant differences in Roussouly types between the two groups (P<0.05).According to Roussouly classification, there were two cases of types 1 and 2 and seven cases of types 3 and 4 in subgroup of Cobb angle between 0°-10°;four cases of types 1 and 2 and 10 cases of types 3 and 4 in subgroup of Cobb angle between 10°-20°;12 cases of types 1 and 2 and four cases of types 3 and 4 in subgroup of Cobb angle between 20°-30°;seven cases of types 1 and 2 and three cases of types 3 and 4 in subgroup of Cobb angle between 30°-40°.There were significant differences in Roussouly types among subgroups (P<0.05).Further, Roussouly types 1 and 2 were significantly increased when the Cobb angle was >20° (P<0.05).Conclusions Post-traumatic kyphosis in old thoracolumbar fractures affects spine sagittal curvature.Patients with sagittal spinal imbalance (Roussouly types 1 and 2) are more with increased Cobb angle.Moreover, Cobb angle >20°may be the reference basis for clinical intervention.

Objective To investigate the effects of c?myc promoter binding protein 1(MBP?1)gene on the proliferation of human Saos?2 osteo?sarcoma cells in vitro. Methods Saos?2 cells were divided into three groups:blank control group(untransfected cells),negative group(cells transfected with missense sequence)and experimental group(cells transfected with MBP?1 shRNA). Two MBP?1 shRNA sequences and one neg?ative control shRNA sequence were designed ,synthesized and cloned into pSIREN?retroQ plasma. Then the recombinant plasmids were construct?ed and transfected into human Saos?2 osteosarcoma cells by Lipofectamine 2000. The expressions of MBP?1 mRNA and protein in Saos?2 cells were detected by real?time PCR and Western blot ,respectively. The effects of altered expression of MBP?1 on cell proliferation were measured by CCK?8 cell proliferation assay. The expressions of cyclin D1 and cyclin E in Saos?2 were determined by Western blot. Results PCR and sequenc?ing results indicated that the recombinant plasmids pSIREN?retroQ was constructed. The relative expression level of MBP?1 mRNA in the MBP?1 siRNA transfection group was significantly decreased than that in blank control group(P<0.05). Compared with the blank control group,the ex?pression levels of MBP?1 protein in the experimental group also significantly decreased. The proliferation abilities of Saos?2 cells at 48,72,and 96 hours after MBP?1 siRNA transfection were significantly increased than those in the blank control group(P<0.05). Compared with the blank con?trol group,the expression levels of cyclin D1 and cyclin E protein in the experimental group also significantly increased(P<0.05). Conclusion Knockdown of the expression of MBP?1 gene promotes the proliferation of human Saos?2 osteosarcoma cells. MBP?1 gene may become the new tar?get of gene therapy for osteosarcoma.

Objective To explore the effect of salvianolate combined with Qumei trimetazidine on cardiac function in patients with chronic heart failure.Methods Seventy-four patients with chronic heart failure were randomly divided into treatment group and control group (37 cases per group).Patients in control group were treated with the regular treatment scheme including digitalis,diuretics,vasodilators,angiotensin converting enzyme inhibitor(ACEI),angiotensin receptor blockers (ARB) or β blocker therapy for 24 weeks treatment.Patients in treatment group were given the regular treatment scheme plus salvianolic acid and Qumei trimetazidine treatment,of which,the dose of salvianolic was 0.2 g into 5％ glucose injection 250 ml or 0.9％ sodium chloride injection 250 ml by intravenous injection,1 times/day,and Qumei trimetazidine for 20 mg,3 times/day,for 24 weeks.Cardiac function was observed in patients of two groups before and after treatment.The level of brain natriuretic peptide (BNP) was measured.Results Heart function were improved,the total effective rate in treatment group was 91.9％ (34/37),higher than that of control group (70.3％ (26/37),x2 =5.638,P ＜ 0.05).In treatment group,left ventricular ejection fraction (LVEF),stroke volume (SV),cardiac output (CO) of patients after treatment were (52 ± 7) ％,(65.10 ± 12.87) ml,(5.65 ± 1.18) L/min respectively,significant different from that before treatment ((39 ±5)％,(46.53 ± 12.14) ml,(4.79 ± 1.02) L/min,and the differences were statistic significant (t =9.192,6.384,3.352,P ＜ 0.05).Meanwhile,in treatment group,systolic pressure,diastolic pressure,heart rate,left ventricular end diastolic diameter (Dd),left ventricular diastolic posterior wall thickness(PWT),interventricular septal thickness (IVST),left ventricular mass (LVMW),plasma brain natriuretic peptide of patients after treatment were (105 ± 8) mmHg,(75 ± 9) mmHg,(76±8) time/min,(48.7 ±3.7) mm,(9.1 ±1.4) mm,(8.7 ±1.2) mm,(170±59) g,(104.1 ±19.5) ng/L respectively,significant different from that of before treatment((134 ± 12) mmHg,(84 ±8) mmHg,(118 ±11) time/min,(55.2 ±7.8) mm,(11.7 ±2.3) mm,(10.5 ±2.4) mm,(228 ± 111) g,(568.7±179.5) ng/L t=-12.231,-4.546,-18.782,-4.579,-5.874,-4.080,-2.806,15.652,P ＜ 0.01).The same trend was seen in control group in terms of LVEF,SV,systolic blood pressure,heart rate,PWT,plasma BNP before and after treatment(LVEF:(38 ±6)％ vs.(43 ± 8)％ ;:(46.76 ± 11.80) ml vs.(58.69 ± 11.58) ml; systolic blood pressure:(132 ± 10) mmHg vs.(116 ± 11) mmHg; heart rate:(116 ± 10) time/min vs.(77 ±9) time/min;PWT:(11.5 ±2.6) mm vs.(10.4 ±2.0) mm;plasma BNP:(570.2 ± 177.3) ng/L vs.(211.6 ± 21.2) ng/L;t =3.041,4.389;-6.546,-17.632,-2.039,12.21 ;P ＜ 0.05 or P ＜ 0.01).Moreover,after treatment,systolic pressure,diastolic pressure,LVEF,SV,CO,Dd,PWT,IVST,LVMW,plasma brain natriureticpeptide in treatment group were significantly better than that of control grouo (t =-4.919,-2.867,5.510,2.252,2.581,-2.319,-3.238,-3.628,-2.231,-22.701,P ＜0.01 or P ＜ 0.05).Conclusion The effect of salvianolate combined Qumei trimetazidine on treating chronic heart failure is significant,and there is a reverse effect on the left ventricle.