[This corrects the article DOI: 10.1016/j.apsb.2019.01.013.].

Objective To investigate the expression of α7 nicotinic acetylcholine receptor (α7nAChR) in thymic T follicular helper cells (TFH) and its significance in patients with myasthenia gravis (MG). Methods Fifteen MG patients who underwent surgical treatment at the Myasthenia Gravis Comprehensive Diagnosis and Treatment Center of Henan Provincial People’s Hospital from June 2022 to June 2023 were selected as a MG group, including 7 males and 8 females, aged 12-30 years. Twelve patients who underwent partial thymectomy to optimize surgical field exposure during cardiac surgery at Fuwai Central China Cardiovascular Hospital from June 2022 to June 2023 were selected as a control group, including 5 males and 7 females aged 20-35 years. Thymus single cell suspension was obtained by grinding the thymus tissue, and flow cytometry was used to detect the expression of α7nAChR in TFH cells. The thymus cell suspension was purified using density gradient centrifugation, followed by immunomagnetic bead separation to obtain CD4+T cells. CXCR5 antibody and coupled magnetic beads were added to isolate TFH cells. Real-time fluorescent polymerase chain reaction and Western blotting were performed to further investigate the expression of α7nAChR in TFH cells. Results Compared with the control group, the proportion of thymic TFH cells in the MG group was significantly increased (P<0.05), along with significantly decreased mRNA and protein expression levels of α7nAChR within these cells (P<0.01). Conclusion The findings suggest that there is a reduced expression of α7nAChR within thymic TFH cells in MG patients, leading to weakened immunosuppressive function which may indirectly contribute to disease onset and progression.

Objective To identify lipid metabolism genes in cerebral infarction;To explore the intervention effect of Huoxue Rongluo Prescription.Methods Multi-chip combined differential analysis(GSE61616,GSE30655)was used to identify lipid metabolism genes in cerebral infarction in combination with Reactome database,and the expression differences of lipid metabolism genes in cerebral infarction were identified and verified in GSE97537 chip;Pearson correlation analysis was used to analyze the correlation of 51 cerebral infarction samples in GSE61616,GSE30655,GSE97537,GSE137595,GSE22255,GSE163614,and GSE78731 datasets;PPI,GO and KEGG analysis of lipid metabolism genes in cerebral infarction were performed through STRING database and R clusterProfiler package.SD rats were made to the model of cerebral infarction,and was administered with Huoxue Rongluo Prescription extract 11.7 g/kg by intragastric administration for 7 days.The symptoms of neurological deficit,the changes of Nissl bodies and the mRNA expressions of PLA2G4A,SPHK1,and PTGES key genes in lipid metabolism in cerebral infarction were observed.Results TSPO,CYP1B1,PLIN2,CH25H,PLA2G4A,ANGPTL4,PTGS1,SPHK1,and PTGES were identified as lipid metabolism genes in cerebral infarction,and were significantly highly expressed and positively correlated in cerebral infarction.Among them,PTGS1,PLA2G4A,and SPHK1 interacted with each other,which were the key genes of lipid metabolism in cerebral infarction;the lipid metabolism gene in cerebral infarction mainly exerted molecular functions such as oxidoreductase activity,iron ion binding,heme binding,etc.,mediating arachidonic acid metabolism,phospholipase D signaling pathway,VEGF signaling pathway,involved in regulation of lipid metabolism process,fatty acid metabolism process,fatty acid derivative metabolism process.The symptoms of neurological deficit in the model rats with cerebral infarction were severe(P<0.001),and Huoxue Rongluo Prescription could effectively improve the neurological deficit of model rats(P<0.001).The Nissl staining indicated that the neuronal structure was abnormal and the number was significantly reduced after cerebral infarction(P<0.001).Huoxue Rongluo Prescription could increase the number of neurons(P<0.001)and repair the neuronal structure.RT-qPCR showed that the key genes of lipid metabolism in cerebral infarction were significantly higher in cerebral infarction(P<0.001),corroborated with the bioinformatics results,and Huoxue Rongluo Prescription could reduce the expression of key lipid metabolism genes of PTGS1,PLA2G4A,and SPHK1(P<0.001,P<0.01,P<0.05).Conclusion Huoxue Rongluo Prescription can down-regulate the expressions of PTGS1,PLA2G4A,SPHK1,exert molecular functions such as oxidoreductase activity,iron ion binding,heme binding,and mediate arachidonic acid metabolism,phospholipase D signaling pathway,and VEGF signaling pathway.It participates in the process of lipid metabolism regulation,fatty acid metabolism,and fatty acid derivative metabolism,increases the number of Nissl bodies,improves the symptoms of neurological deficits,and exerts neuroprotective effects.

Objective:To determine the efficacy and influencing factors of thymectomy for bulbar myasthenia gravis.Methods:The clinical data of 120 patients with bulbar myasthenia gravis admitted to the Myasthenia Gravis Comprehensive Diagnosis and Treatment Center of Henan Provincial People's Hospital from March 2018 to June 2023 were collected, with 61 males and 59 females. There were 66 patients with thymoma and 54 patients with non-thymoma. The duration of bulbar muscle involvement before operation ranged from 11 days to 108 months. Preoperative AChR-Ab was positive in 105 cases and negative in 15 cases. There were 28 cases with bulbar muscle involvement as the initial symptom and 92 cases as the non-initial symptom. There were 7 cases with crisis and 113 cases without crisis in the past. The postoperative efficacy was evaluated according to the Myasthenia Gravis post-treatment status evaluation program of the American Myasthenia Gravis Society. Univariate analysis and logistic regression analysis were used to analyze the factors that may affect the surgical efficacy. Results:All 120 patients successfully underwent extended thymectomy, there was no perioperative death. The follow-up time was 3-57 months, with a median of 24 months. Twenty-two patients (18.33%) achieved complete durable remission, 1 patient (0.83%) maintained remission, 65 patients (54.17%) had minimal symptoms, and 20 patients (16.70%) improved. No change in 8 cases (6.67%), no aggravation cases (0), deterioration in 2 cases (1.67%), and death in 2 cases (1.67%). 23 cases(19.17%) achieved clinical remission and 85 cases (70.83%) achieved partial remission. Univariate analysis showed that positive AChR-Ab before operation and duration of bulbar muscle involvement before operation were the influencing factors of surgical efficacy in patients with bulbar MG, and the difference was statistically significant ( P<0.05). Logistic regression analysis showed that positive AChR-Ab before operation and the duration of bulbar muscle involvement before operation were independent influencing factors of surgical efficacy. Conclusion:Thymectomy can effectively relieve the symptoms of bulbar myasthenia gravis. Patients with positive AChR-Ab before surgery and shorter duration of bulbar muscle involvement may benefit more from thymectomy.

The frenulum is a bridge structure between the prepuce and the ventral side of glans, which is highly sensitive and fragile. Lesions of frenulum are easy to cause male genital discomfort, negatively affecting their reproductive health. The plastic operation of frenulum is a safe and simple surgery. At present, it is widely used to treat skin-type downward curvature of penis and premature ejaculation caused by short frenulum and in frenulum reconstruction of hypospadias, including frenuloplasty, frenulum reconstruction and many other surgical method. This article summarizes the anatomy, physiology and embryonic development of frenulum. In addition, it reviews the indications and method of frenulum plastic surgery, with a purpose to providing references for future clinical work.

Adjacent segment disease(ASD) refers to the degeneration of adjacent segments after lumbar fusion surgery, including intervertebral disc herniation, stress vertebral fractures, slippage, segmental scoliosis, spinal canal stenosis, and facet joint degeneration, which can lead to corresponding clinical symptoms such as lumbosacral pain, root lower limb pain, or intermittent claudication. The treatment of different pathological types of ASD varies. The patients with mild symptoms require conservative treatment and patients with severe symptoms require surgical treatment. In the past, open fusion surgery with posterior approach or intervertebral foramen approach was commonly used for surgical treatment, which had definite therapeutic effects. However, there were drawbacks such as large surgical trauma, excessive intraoperative blood loss, and slow postoperative recovery. With the booming development of minimally invasive spinal surgery technology in recent years, spinal surgeons actively use minimally invasive surgery for the treatment of ASD. It has advantages such as less bleeding, short hospital stay, fast recovery, and fewer complications (such as deep vein thrombosis and pulmonary embolism), but its indications are limited. Therefore, this article provides a reference for the choice of ASD treatment by reviewing the treatment modalities of ASD with different pathological types.

The frenulum is a bridge structure between the prepuce and the ventral side of glans, which is highly sensitive and fragile. Lesions of frenulum are easy to cause male genital discomfort, negatively affecting their reproductive health. The plastic operation of frenulum is a safe and simple surgery. At present, it is widely used to treat skin-type downward curvature of penis and premature ejaculation caused by short frenulum and in frenulum reconstruction of hypospadias, including frenuloplasty, frenulum reconstruction and many other surgical method. This article summarizes the anatomy, physiology and embryonic development of frenulum. In addition, it reviews the indications and method of frenulum plastic surgery, with a purpose to providing references for future clinical work.

Objective To evaluate the effectiveness of different nursing techniques of traditional Chinese medicine (TCM) on post-stroke sleep disorders (PSSD). Methods A systematic search for RCTs(randomized controlled trial) on effects of TCM-based nursing techniques was conducted online through the databases of CNKI,WanFang Data,VIP Data,CBM,PubMed,The Cochrane Library and EMBASE from the inception of the databases to December 2022. Two reviewers independently screened the retrieved literature,assessed the risk of bias in the included studies,and extracted relevant data. A network meta-analysis was then performed using Stata 17.0 software to analyse the data. Results A total of 11 RCTs involving 962 stroke patients cared with 8 TCM-based nursing techniques were included. The 8 techniques comprised acupoint massage,Guasha+auricular acupoint pressing,acupoint plaster therapy,moxibustion,Tuina,five elements music+auricular acupoint pressing,auricular acupoint pressing,and routine nursing care. The regular meta-analysis demonstrated that the therapeutic effects of the 7 nursing techniques relieved PSSD of the patients[OR=3.18,95％CI (2.15,4.70),P<0.001]. The best probability ranking of the therapeutic effects showed by network meta-analysis was:acupoint massage>Guasha+auricular acupoint pressing>acupoint plaster therapy>moxibustion>Tuina>five elements music+auricular acupoint pressing>auricular acupoint pressing>routine care. Conclusion Acupoint massage is recommend as a priority option to alleviate the symptoms of PSSD. Further high-quality studies are necessary to verify this conclusion due to the limitations on quality and quantity of the included RCTs.

Objective To evaluate the effectiveness of different nursing techniques of traditional Chinese medicine (TCM) on post-stroke sleep disorders (PSSD). Methods A systematic search for RCTs(randomized controlled trial) on effects of TCM-based nursing techniques was conducted online through the databases of CNKI,WanFang Data,VIP Data,CBM,PubMed,The Cochrane Library and EMBASE from the inception of the databases to December 2022. Two reviewers independently screened the retrieved literature,assessed the risk of bias in the included studies,and extracted relevant data. A network meta-analysis was then performed using Stata 17.0 software to analyse the data. Results A total of 11 RCTs involving 962 stroke patients cared with 8 TCM-based nursing techniques were included. The 8 techniques comprised acupoint massage,Guasha+auricular acupoint pressing,acupoint plaster therapy,moxibustion,Tuina,five elements music+auricular acupoint pressing,auricular acupoint pressing,and routine nursing care. The regular meta-analysis demonstrated that the therapeutic effects of the 7 nursing techniques relieved PSSD of the patients[OR=3.18,95％CI (2.15,4.70),P<0.001]. The best probability ranking of the therapeutic effects showed by network meta-analysis was:acupoint massage>Guasha+auricular acupoint pressing>acupoint plaster therapy>moxibustion>Tuina>five elements music+auricular acupoint pressing>auricular acupoint pressing>routine care. Conclusion Acupoint massage is recommend as a priority option to alleviate the symptoms of PSSD. Further high-quality studies are necessary to verify this conclusion due to the limitations on quality and quantity of the included RCTs.

The frenulum is a bridge structure between the prepuce and the ventral side of glans, which is highly sensitive and fragile. Lesions of frenulum are easy to cause male genital discomfort, seriously affecting their reproductive health. The plastic operation of frenulum is a safe and simple surgery. At present, it is widely used to treat skin type downward curvature of penis and premature ejaculation caused by short frenulum and in frenulum reconstruction of hypospadias, including frenuloplasty, frenulum reconstruction and many other surgical method. This article summarizes the anatomy, physiology and embryonic development of frenulum, and reviews the indications and method of frenulum plastic surgery, with a view to providing references for future clinical work.