Knee osteoarthritis (KOA) is a prevalent degenerative joint disease characterized by synovial inflammation, cartilage loss. Often manifesting as joint pain and limited mobility, it severely affects the quality of life of patients. Traditional treatment methods such as pharmacological injections and surgical interventions primarily aim to alleviate symptoms but have limited effects on cartilage repair. Human umbilical cord mesenchymal stem cells (hUC-MSCs), due to their anti-inflammatory and chondrogenic capabilities, is considered a new hope for the treatment of KOA. This article synthesizes the latest research findings from both domestic and international sources to discuss the theoretical basis for the clinical application of hUC-MSCs in treating KOA, clinical study design, and efficacy evaluation. It also addresses the challenges in the clinical application of hUC-MSCs and explores future directions, in the hope of providing feasible theoretical support for the treatment of KOA with hUC-MSCs.

BACKGROUND:Cervical disc herniation can cause pain in the neck and shoulder area,as well as radiating pain in the upper limbs.The incidence rate is increasing year by year and tends to affect younger individuals.Fully understanding the biomechanical characteristics of the cervical spine in adolescents is of great significance for preventing and delaying the onset of cervical disc herniation in this age group. OBJECTIVE:To reconstruct cervical spine models for both healthy adolescents and adolescent patients with cervical disc herniation utilizing finite element analysis techniques,to analyze the motion range of the C1-T1 cervical vertebrae as well as the biomechanical characteristics of the annulus fibrosus,nucleus pulposus,endplates,and the cartilage of the small joints. METHODS:A normal adolescent's cervical spine and an adolescent patient with cervical disc herniation were selected in this study.The continuous scan cervical spine CT raw image data were imported into Mimics 21.0 in DICOM format.The C1-T1 vertebrae were reconstructed separately.Subsequently,the established models were imported into the 3-Matic software for disc reconstruction.The perfected models were then imported into Hypermesh software for meshing of the vertebrae,nucleus pulposus,annulus fibrosus,and ligaments,creating valid geometric models.After assigning material properties,the final models were imported into ABAQUS software to observe the joint motion range of the C1-C7 cervical vertebrae segments under different conditions,and to analyze the biomechanical characteristics of the annulus fibrosus,nucleus pulposus,endplates,and small joint cartilage of each cervical spine segment. RESULTS AND CONCLUSION:(1)In six different conditions,the joint motion range of the C1 vertebra in the cervical spine models of both normal adolescent and adolescent patient with cervical disc herniation was higher than that of the other vertebrae.Additionally,the joint motion range of each cervical spine segment in normal adolescent was greater than that in adolescent patient with cervical disc herniation.(2)In the cervical spine model of normal adolescent,the maximum stress values in the annulus fibrosus and nucleus pulposus were found on the left side during C2-3 flexion conditions(0.43 MPa and 0.17 MPa,respectively).In the cervical spine model of adolescent patient with cervical disc herniation,the maximum stress values were found on the left side during C7-T1 flexion conditions(0.54 MPa and 0.18 MPa,respectively).(3)In the cervical spine model of normal adolescent,the maximum stress value on the endplate was found on the left side of the upper endplate of C3 during flexion conditions(1.46 MPa).In the model of adolescent patient with cervical disc herniation,the maximum stress value on the endplate was found on the left side of the lower endplate of C7 during flexion conditions(1.32 MPa).(4)In the cervical spine model of normal adolescent,the maximum stress value in the small joint cartilage was found in the C2-3 left rotation conditions(0.98 MPa).In adolescent patient with cervical disc herniation,the stress in the small joint cartilage significantly increased under different conditions,especially in C1-2,with the maximum stress found during left flexion(3.50 MPa).(5)It is concluded that compared to normal adolescent,adolescent patient with cervical disc herniation exhibits altered cervical curvature and a decrease in overall joint motion range in the cervical spine.In adolescent with cervical disc herniation,there is a significant increase in stress on the annulus fibrosus,nucleus pulposus,and endplates in the C7-T1 segment.The stress on the left articular cartilage of the C1-2 is notable.Abnormal cervical curvature may be the primary factor causing these stress changes.

Objective To investigate the correlation between serum levels of microRNA(miR)-489-3p and miR-214-3p in patients with Psoriasis and the severity of disease.Methods From March 2022 to January 2024,138 Psoriasis patients who visited Zhangjiakou First Hospital were regarded as the study subjects(disease group).According to the psoriasis area and severity index(PASI)score,the 138 Psoriasis patients were separated into mild group(n=46),moderate group(n=54)and severe group(n=38).112 healthy individuals who underwent physical examinations in Zhangjiakou First Hospital during the same period were included in the control group.Real-time fluorescence quantitative PCR(RT-qPCR)method was applied to determine the serum levels of miR-489-3p and miR-214-3p in the subjects.The serum levels of miR-489-3p and miR-214-3p were compared between the disease group and the control group,and among patients with different degrees of disease.Spearman correlation analysis was applied to explore the relationship between serum miR-489-3p,miR-214-3p levels and disease severity in Psoriasis patients.Logistic regression analysis was performed to analyze the related factors affecting the severity of Psoriasis.Receiver operating characteristic(ROC)curve was applied to investigate the diagnostic value of serum miR-489-3p and miR-214-3p levels for severe Psoriasis.Results The serum levels of miR-489-3p(0.81±0.23)and miR-214-3p(0.79±0.22)in the disease group were lower than those in the control group(1.05±0.28,1.02±0.25),and the differences were statistically significant(t=7.441,7.732,all P<0.05).Serum miR-489-3p in mild,moderate and severe Psoriasis groups(0.93±0.24,0.80±0.23,0.69±0.22),miR-214-3p levels(0.91±0.24,0.77±0.22,0.66±0.21)decreased gradually,and the differences were statistically significant(F=12.423,13.168,all P<0.05).Spearman's results showed that serum levels of miR-489-3p and miR-214-3p were negatively correlated with the severity of Psoriasis in patients(r=-0.490,-0.463,all P<0.05).Serum miR-489-3p and miR-214-3p were independent protective factors for the severity of Psoriasis patients(Wald χ2=5.751,8.753,all P<0.05).ROC curve results showed that the area under the curve(AUC)of serum miR-489-3p and miR-214-3p for diagnosing severe Psoriasis alone was 0.785 and 0.792,with sensitivity of 78.9%and 73.7%,specificity of 49.9%and 54.7%,respectively.The AUC of the combined diagnosis for severe Psoriasis was 0.931,the sensitivity and specificity were 71.7%,71.1%,respectively,and the combined diagnostic efficacy of the two was better than that of miR-489-3p and miR-214-3p alone,and the differences were statistically significant(Z=3.018,2.773,all P<0.05).Conclusion The serum levels of miR-489-3p and miR-214-3p in patients with Psoriasis are both reduced,and both are negatively correlated with the severity of the disease in Psoriasis patients.The combined determination of the two has high efficacy in the diagnosis of severe Psoriasis.

Aim To clarify the mechanism by which Qishen Yixin Granules improved microcirculation vas-cular endothelial dysfunction(VED)in mice,through activating the Nrf2/HO-1 signaling pathway to regulate oxidative stress.Methods C57 mice were randomly divided into six groups:blank group,model group,pos-itive drug group,and low-,medium-,and high-dose groups of Qishen Yixin Granules.The VED model was established by long-term infusion of Ang Ⅱ combined with a high-fat diet.Each treatment group received the corresponding drug intervention.After four weeks of drug intervention,cardiac function was assessed by echocardiography.Carstairs staining was used to ob-serve the formation of microthrombi in myocardial tis-sue.The micro vascular ischemia was evaluated by Hei-denhain staining.The ultrastructure of endothelial cells was observed by electron microscopy.The levels of EMPs,ROS,NO,ET-1,TF,TM,VWF,and TXA2 in serum were measured by ELISA.The expression levels of MDA,SOD,and GSH-Px in mouse heart tissue were determined by chemical methods.Cardiac microvascu-lar density and the expression of Nrf2,Keap1,and HO-1 proteins were detected by Immunohistochemical stai-ning.The protein expressions of Keap1,cytoplasmic Nrf2,nuclear Nrf2,and HO-1 in myocardial tissue were detected by Western blot.Results Qishen Yixin Granules could effectively improve the cardiac function of mice,alleviate the damage of endothelial cells and endothelial function.They could up-regulate serum NO levels and the activities of antioxidant enzymes SOD and GSH-Px,while down-regulating the expression of ROS and vascular inflammatory injury factors such as ET-1,VWF,TXA2,TF,TM,and EMPs.Qishen Yixin Granules also increased the positive counts of CD34,Nrf2,and HO-1,as well as microvessel density.Fur-thermore,they inhibited the expression of MDA,Keap1,and cytoplasmic Nrf2 protein in myocardial tis-sue,while increasing the expression of nuclear proteins HO-1 and Nrf2.Conclusions Qishen Yixin Granules may inhibit oxidative stress and inflammatory response by regulating the Nrf2/HO-1 signaling pathway,thereby improving vascular endothelial damage and cardiac function in VED mice.

Objective To develop a novel method for measuring the Hounsfield Unit(HU)value of the surface carbon fiber material of the Varian Exact IGRT Couch,and to establish a treatment couch model in the treatment planning system(TPS)for correcting the attenuation of radiation dose caused by the treatment couch.Methods Two different field combinations were used to measure the radiation dose attenuation at the thin end and the middle medium-thickness part of the Varian Exact IGRT Couch.Dose deviations were measured when radiation passed through the treatment couch or not.Multiple sets of different HU values for the couch surface materials were defined in the TPS,and the dose difference between with and without couch was calculated under the same conditions as the measurements.The HU value of the treatment couch material corresponding to the actual measurements was found by data comparison and analysis.Results The attenuation for two interpenetrating fields was-2.49%to-1.69%at the thin end,and-3.43%to-2.23%at the medium-thickness part.The attenuation for multiple oblique incident fields ranged from-3.12%to-2.17%at the thin end,and that was-3.59%to-2.86%at the medium-thickness part.When the HU values of the couch model's surface and internal materials in the TPS were defined as-500 and-960,for two interpenetrating fields,the attenuation was-2.57%to-1.53%at the thin end,and-3.28%to-2.18%at the medium-thickness part;while for multiple oblique incident fields,the attenuation was-3.12%to-2.21%at the thin ends,and-3.42%to-2.43%at the medium-thickness part.These calculated results were consistent with the actual measurement values.For 40 verification plans,the average point dose difference between measurement and calculation in TPS were 0.90%and 0.89%at the thin end and medium-thickness part,respectively.Conclusion This novel measurement method can measure the HU value of the surface carbon fiber material and internal foam material of Exact IGRT Couch.Defining the HU values of these two materials of the couch model in the TPS as-500 and-960 can correct the radiation dose attenuation caused by the treatment couch,thereby improving the dose accuracy of the target volume and organs-at-risk.

AIM To investigate the promotional effects of esculin combined with bone marrow mesenchymal stem cells(BM-MSCs)transplantation on the repair of spinal cord injury(SCI)in rats.METHODS The rats were randomly divided into the sham operation group,the model group,the esculin group for gavage of 20 mg/kg esculin,the BM-MSCs group for tail vein injection of 1 mL of 1×106/mL BM-MSCs,and the combinaiton treatment group.The SCI rat model was established using Allen's method,followed by the 14 days consecutive corresponding drug administration starting from the 2nd day after modeling.On days 3,7 and 14 of drug administration,the rats had their hind limbs motor function evaluated by the BBB scoring;and their footprint experiment conducted on the 14th day after modeling.After 14 days of administration,the rats had their morphological changes of spinal cord tissue observed with HE staining and Nissl staining;their activities of SOD and GSH,and level of MDA in spinal cord tissue detected by kits;their expressions of MAP2,GAP43 and GFAP in spinal cord tissue detected by immunofluorescence;and their expressions of NQO-1,Nrf-2,Bcl-2 and Bax proteins in spinal cord tissue detected by Western blot.RESULTS Compared with the model group,the groups interved with esculin,or BM-MSCs,or the combination treatment showed improvements in hind limb function and spinal cord tissue morphology(P＜0.05);decreased MDA levels(P＜0.05);increased SOD and GSH activities(P＜0.05);increased MAP2 and GAP43 fluorescence intensity(P＜0.05);decreased GFAP fluorescence intensity(P＜0.05);increased NQO-1,Nrf-2 and Bcl-2 protein expressions(P＜0.05);and decreased Bax protein expression(P＜0.05).And the combination treatment group was observed with an even better effects(P＜0.05).CONCLUSION The combination of esculin and BM-MSCs transplantation can effectively improve the spinal cord tissue damage and hind limb function in SCI rats.This effect may be achieved by activating the Nrf-2/NQO-1 signaling pathway to inhibit oxidative stress response,thereby reducing neuronal apoptosis,blocking glial scar formation,and promoting stem cell differentiation to rebuild neurons.

AIM To establish LC-MS and GC-MS method and analyze the chemical constituents of Dendrobium huoshanense C.Z.Tang & S.J.Cheng flowers.METHODS LC-MS was performed on a Zorbax Eclipse C18 column(2.1 mm×100 mm,1.8 μm),with the mobile phase comprising of water(containing 0.1％formic acid)-acetonitrile flowing at 0.3 mL/min,and electrospray ionization was operated in both positive and negative ion modes.The GC-MS employed headspace solid-phase microextraction for sample preparation,and the analysis was performed on an HP-5MS column(30 m×0.25 mm,0.25 μm),with the following temperature program:initial temperature 50 ℃(held for 2 min),increased at 5 ℃/min to 180 ℃(held for 5 min),then raised at 10 ℃/min to 250 ℃(held for 5 min),and electron impact ion source was employed.RESULTS A total of 62 compounds were identified by LC-MS,including 35 flavonoids,4 coumarins,6 alkaloids,6 terpenoids,3 amino acids,2 polyphenols,2 ketones and 4 others.A total of 101 volatile components were identified by GC-MS,including ketones,aldehydes,alcohols,esters,ethers,and acid.CONCLUSION This method can comprehensively analyze the chemical constituents of D.huoshanense flowers,and provide a scientific basis for elucidating its pharmacodynamic material basis.

OBJECTIVE To explore the application of autoregressive integrated moving average model(ARIMA)in prediction of prevalence trends of carbapenem-resistant Klebsiella pneumoniae(CRKP)in intensive care unit(ICU)so as to provide scientific bases for formulating prevention strategies for CRKP infection in ICU.METHODS The number of CRKP strains that were monthly isolated from the ICU patients of Jiangnan University Affiliated Hospital between Jan.2021 and Jan.2024 was collected,the duplicate samples from the same patient were excluded,and totally 555 strains of CRKP were finally enrolled in the study.The time series differencing was performed by using R statistical software,the ARIMA model was established,the parameters of the model were determined by means of autocorrelation function(ACF)and partial autocorrelation function(PACF)images.The optimal model was screened out by Akaike information criterion(AIC)and root-mean-square error(RMSD),the robustness of the residual sequences was assessed by Box-Ljung test.The data that were detected from Sep.2023 to Jan.2024 were assigned as the validation set,the prediction accuracy of the model was assessed,and the dy-namic trend of the CRKP strains from Feb.2024 to Apr.2024 was predicted.RESULTS The isolation rate of CRKP strains in ICU showed dynamic change from 2021 to 2023(x2=66.906,P=0.001),sputum and midstream urine were the major sources.The minimal AIC of the optimal ARIMA model(8,1,10)was 222.1,with RMSE 3.67.Box-Ljung(x2=0.104,P=0.746)test indicated that there was no autocorrelation among the residual se-quences.Both the actual CRKP and the predictive value firstly rose then descended from Sep.2023 to Jan.2024,and the average relative error of the model was 9.62％for prediction.The number of isolated CRKP strains predic-ted by the model might reached to the lowest point in Feb.2024 and then showed an upward trend,and it might reach to a high peak in Apr.CONCLUSION ARIMA model is effective for short-term prediction and dynamic anal-ysis of prevalence trend of CRKP strains in the ICU so as to provide theoretical basis for early warning of hospital-associated infection and take corresponding prevention measures.

This study was aimed at understanding the resistance status of dairy cow-derived Streptococcus strains in China,and providing scientific guidance for the rational use of antimicrobials and the development of new antimicrobials.Meta-analysis was used to explore the resistance of Streptococcus strains to 20 antimicrobials between 2000 and 2023.A total of 67 articles de-scribing 3 154 strains were included after a literature search,and a meta-analysis was conducted on the overall collection area according to time subgroups for 20 antimicrobials.Streptococci of dairy origin in China showed varying resistance rates(≥30％),as follows:penicillin(60％,95％CI=0.48-0.72),streptomycin(57％,95％CI=0.46-0.68),cotrimoxazole(56％,95％CI=0.28-0.82),lincomycin(51％,95％CI=0.26-0.76),tetracycline(49％,95％CI=0.40-0.59),doxycyc-line(42％,95％CI=0.24-0.60),clindamycin(41％,95％CI=0.28-0.54),ampicillin(39％,95％CI=0.27-0.52),e-rythromycin(37％,95％CI=0.28-0.45),kanamycin(36％,95％CI=0.20-0.54),and amoxicillin(30％,95％CI=0.10-0.53).On the basis of findings in the collection area,the resistance rates of dairy cow-derived Streptococcus to antimicrobials in Northeast China and Southwest China was generally high.The resistance rates of Streptococcus from dairy cattle to antimi-crobial drugs such as tetracycline,doxycycline,and lincomycin increased significantly over time.However,the resistance rates to antimicrobial drugs such as streptomycin,gentamicin,and enrofloxacin showed a significant decreasing trend.Dairy cow-de-rived Streptococcus had high resistance to some antimicrobials,and the resistance varied by region,because of differences in breeding and management.Monitoring of antimicrobial resistance rates,enhancing research on resistance mechanisms,and reg-ulating the use of antimicrobials remain necessary.

This study aims to investigate the epidemic variation of porcine circovirus type2(PCV2)and its distribution in swine farms in Henan Province from 2022 to 2023.In this study,1 206 pig blood samples from 18 urban scale swine farms,and 318 pigs and environmental samples from 2 PCV2-positive swine farms in Henan Province were detected by fluorescence quantitative PCR.ORF2 gene sequencing and genetic evolution analysis were performed on the positive samples.The results showed that the positive rate of PCV2 was 7.05％(85/1 206)in Henan Province,11.15％in western Henan Province and 3.03％in southern Henan Province.The positive rate of PCV2 in spring was 11.60％(67/576).A total of 31 ORF2 gene sequences were obtained,of which 23 were PCV2d(74.19％),6 were PCV2a(19.35％),one was PCV2b(3.23％)and one was PCV2c(3.23％).The results of amino acid sequence comparison showed that the mutation sites mainly concentrated on amino acids at positions 40-68 and 180-209.The total positive rate of pig farm sam-ples was 37.42％(119/318),and the positive rate of pig samples from different types of pig houses was 60.71％(34/56),45.83％(11/24),35.09％(20/57),and 33.33(3/9)in order from high to low.The positive rate of environmental samples from high to low was 56.36％(31/55)in feeding system,46.67％(7/15)in feces system,12.50(1/8)in decontamination area,11.11％(2/18)in living area,and no PCV2 was detected in ventilation system.The highest positive rate was 45.00％(9/20)for the tools in the house,7.14％(1/14)for the surface and sole of the clothes after leaving the house,and no PCV2 was detected on the surface and sole of the clothes before entering the house.In this study,the epidemiological investigation of PCV2 in Henan Province and its distribu-tion in swine farms were carried out,and the main circulating strains,seasons,regions and gene mutations of PCV2 in H enan Province were identified.The distribution and transmission routes of PCV2 in positive pig farms were preliminarily analyzed and summarized,which provided data basis and reference for effective prevention and control of PCV and the establishment of accurate bio-safety prevention and control measures.