Objective:This study introduces a novel segmented and layered thoracic laminoplasty technique for the treatment of thoracic spinal stenosis (TSS) caused by ossification of the posterior longitudinal ligament (OPLL) and ligamentum flavum (OLF). The goal is to simplify the surgical procedure, improve safety, reduce iatrogenic injuries, and validate its clinical outcomes through follow-up.Methods:A retrospective analysis was conducted on 23 patients (10 males, 13 females; mean age 58.83±12.01 years) treated at Taizhou People's Hospital Affiliated to Nanjing Medical University from January 2018 to December 2023. Transverse grooves were created at the superior and inferior vertebral pedicle levels, utilizing the intervertebral ligamentum flavum as a segmental demarcation reference. Partial removal of the distal lamina and medial of the inferior articular process was performed through a cortical window. Under direct visualization, complete removal of ossified ligamentum flavum, proximal portion of lamina, superior articular process. The treatment effect was evaluated by clinical symptoms, signs, Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS), imaging results (CT and MRI) and complications before or after surgery.Results:All 23 procedures were successfully completed with a mean operative duration of 180(150, 220) min, the surgical time for 71 segments were 67.5(53.8, 120.0) minutes and intraoperative blood loss of 200(100, 300) ml, demonstrating a low intraoperative dural tear rate of 8.70% (2/23). Postoperative imaging (CT/MRI) confirmed adequate decompression in all cases, with significant symptom improvement at final follow-up 21(9, 39) months: 47% (7/15) of patients achieved marked relief of lower limb numbness, 82% (14/17) showed substantial motor recovery, and 54% (7/13) exhibited improved gait stability. Functional outcomes revealed significant enhancements, with JOA scores increasing from 8(6, 8) preoperatively to 9(8, 10) postoperatively ( P<0.05; 43.80% improvement rate) and VAS scores decreasing from 6(5, 7) to 2(1, 4) ( P<0.05). The complications were two dural tears and one suture reaction. Conclusions:Ultrasonic osteotome-assisted segmented layered laminectomy is a safe, effective, and straightforward technique for treating thoracic spinal stenosis caused by OPLL and OLF. It offers shorter operative times, minimal complications, and significant clinical improvement, making it a promising technique for broader clinical adoption.

OBJECTIVE To establish skin contamination models with sulfur mustard analogue 1-chloro-2-ethylsulfanyl ethane(CEES),and evaluate the therapeutic efficacy of reactive skin decontamination lotion kit(RSDL).METHODS ①Kunming,BALB/c,BALB/c-nu,and C57BL/6N were contaminted with CEES 75 μL·kg-1 using exposed method and covered method for 10 min on the dorsal skin.Wound healing times and areas were assessed to determine the stock of mice and exposure method.② BALB/c mice were exposed to a gradient of CEES at the doses of 75,150,250,350 and 500 μL·kg-1(10 min)using the covered method.Wound healing times,areas and Kaplan-Meier survival curves were used to determine the optimal dose.③ BALB/c mice were exposed to CEES 150 μL·kg-1 for varying durations(5,10 and 20 min)using the covered method.Wound healing times,areas and Kaplan-Meier survival curves were analyzed to determine the optimal exposure time.④ BALB/c mice were divided into four groups:control(exposed with the covered method at 150 μL·kg-1,10 min),treatment(20 μL RSDL treatment after exposure,as the control group),5 min treatment(20 μL RSDL treatment after 5 min of exposure,followed by 5 min of coverage)and immediate-treatment(exposed with the exposed method at 150 μL·kg-1,immediately treated with 20 μL RSDL,followed by 10 min of coverage).The therapeutic efficacy was evaluated based on the wound area,subcutaneous microvesicle count,epidermal thick-ness,and inflammatory cytokine(IL-6 and TNF-α)expressions.RESULTS ① The covered method caused more severe and prolonged wounds than the exposed method.BALB/c mice exhibited a high sensitivity to CEES with delayed wound healing and were therefore selected as the model animal.② Survival rates in BALB/c mice dropped below 50%at doses of 250,350 and 500 μL·kg-1,whereas an 83.3%survival rate was observed at 150 μL·kg-1.③ The mice exposed to CEES(150 μL·kg-1,20 min)died within 3 days.The wound area was consistently smaller in the 5 min covered group than in the 10 min covered group.④CEES-induced skin injury led to epidermal nuclear pyknosis,follicular disrup-tion,inflammatory infiltration,and microvesicle formation in both treatment and poisoned control groups.As more immediate treatment,the wound area significantly decreased.While the IL-6 expres-sion showed no significant intergroup difference,the TNF-α expression was significantly higher in the treatment group.CONCLUSION A CEES-induced skin contamination model has been established in BALB/c mice using the covered method(150 μL·kg-1,10 min covered).However,RSDL should be ad-ministered in 10 min post-contamination.

Objective:This study introduces a novel segmented and layered thoracic laminoplasty technique for the treatment of thoracic spinal stenosis (TSS) caused by ossification of the posterior longitudinal ligament (OPLL) and ligamentum flavum (OLF). The goal is to simplify the surgical procedure, improve safety, reduce iatrogenic injuries, and validate its clinical outcomes through follow-up.Methods:A retrospective analysis was conducted on 23 patients (10 males, 13 females; mean age 58.83±12.01 years) treated at Taizhou People's Hospital Affiliated to Nanjing Medical University from January 2018 to December 2023. Transverse grooves were created at the superior and inferior vertebral pedicle levels, utilizing the intervertebral ligamentum flavum as a segmental demarcation reference. Partial removal of the distal lamina and medial of the inferior articular process was performed through a cortical window. Under direct visualization, complete removal of ossified ligamentum flavum, proximal portion of lamina, superior articular process. The treatment effect was evaluated by clinical symptoms, signs, Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS), imaging results (CT and MRI) and complications before or after surgery.Results:All 23 procedures were successfully completed with a mean operative duration of 180(150, 220) min, the surgical time for 71 segments were 67.5(53.8, 120.0) minutes and intraoperative blood loss of 200(100, 300) ml, demonstrating a low intraoperative dural tear rate of 8.70% (2/23). Postoperative imaging (CT/MRI) confirmed adequate decompression in all cases, with significant symptom improvement at final follow-up 21(9, 39) months: 47% (7/15) of patients achieved marked relief of lower limb numbness, 82% (14/17) showed substantial motor recovery, and 54% (7/13) exhibited improved gait stability. Functional outcomes revealed significant enhancements, with JOA scores increasing from 8(6, 8) preoperatively to 9(8, 10) postoperatively ( P<0.05; 43.80% improvement rate) and VAS scores decreasing from 6(5, 7) to 2(1, 4) ( P<0.05). The complications were two dural tears and one suture reaction. Conclusions:Ultrasonic osteotome-assisted segmented layered laminectomy is a safe, effective, and straightforward technique for treating thoracic spinal stenosis caused by OPLL and OLF. It offers shorter operative times, minimal complications, and significant clinical improvement, making it a promising technique for broader clinical adoption.

As the longest and most widely distributed pair of nerves in the brain,the vagus nerve is involved in the regulation of many systems and organs.Recent studies have found that the vagus nerve may be involved in the occurrence of a variety of neuropsychiatric diseases by regulating the release of neurotransmitters(such as norepinephrine,5-hydroxytryptamine,gamma-aminobutyric acid and acetylcholine)and regulating the immune system and gut-brain axis.This article focuses on the regulatory mechanisms of the vagus nerve on neurotransmitters,immune system function,and the gut-brain axis,as well the therapeutic advances in vagus nerve stimulation for neurological and psychi-atric diseases such as epilepsy,depression and anxiety disorders.

As the longest and most widely distributed pair of nerves in the brain,the vagus nerve is involved in the regulation of many systems and organs.Recent studies have found that the vagus nerve may be involved in the occurrence of a variety of neuropsychiatric diseases by regulating the release of neurotransmitters(such as norepinephrine,5-hydroxytryptamine,gamma-aminobutyric acid and acetylcholine)and regulating the immune system and gut-brain axis.This article focuses on the regulatory mechanisms of the vagus nerve on neurotransmitters,immune system function,and the gut-brain axis,as well the therapeutic advances in vagus nerve stimulation for neurological and psychi-atric diseases such as epilepsy,depression and anxiety disorders.

OBJECTIVE To establish skin contamination models with sulfur mustard analogue 1-chloro-2-ethylsulfanyl ethane(CEES),and evaluate the therapeutic efficacy of reactive skin decontamination lotion kit(RSDL).METHODS ①Kunming,BALB/c,BALB/c-nu,and C57BL/6N were contaminted with CEES 75 μL·kg-1 using exposed method and covered method for 10 min on the dorsal skin.Wound healing times and areas were assessed to determine the stock of mice and exposure method.② BALB/c mice were exposed to a gradient of CEES at the doses of 75,150,250,350 and 500 μL·kg-1(10 min)using the covered method.Wound healing times,areas and Kaplan-Meier survival curves were used to determine the optimal dose.③ BALB/c mice were exposed to CEES 150 μL·kg-1 for varying durations(5,10 and 20 min)using the covered method.Wound healing times,areas and Kaplan-Meier survival curves were analyzed to determine the optimal exposure time.④ BALB/c mice were divided into four groups:control(exposed with the covered method at 150 μL·kg-1,10 min),treatment(20 μL RSDL treatment after exposure,as the control group),5 min treatment(20 μL RSDL treatment after 5 min of exposure,followed by 5 min of coverage)and immediate-treatment(exposed with the exposed method at 150 μL·kg-1,immediately treated with 20 μL RSDL,followed by 10 min of coverage).The therapeutic efficacy was evaluated based on the wound area,subcutaneous microvesicle count,epidermal thick-ness,and inflammatory cytokine(IL-6 and TNF-α)expressions.RESULTS ① The covered method caused more severe and prolonged wounds than the exposed method.BALB/c mice exhibited a high sensitivity to CEES with delayed wound healing and were therefore selected as the model animal.② Survival rates in BALB/c mice dropped below 50%at doses of 250,350 and 500 μL·kg-1,whereas an 83.3%survival rate was observed at 150 μL·kg-1.③ The mice exposed to CEES(150 μL·kg-1,20 min)died within 3 days.The wound area was consistently smaller in the 5 min covered group than in the 10 min covered group.④CEES-induced skin injury led to epidermal nuclear pyknosis,follicular disrup-tion,inflammatory infiltration,and microvesicle formation in both treatment and poisoned control groups.As more immediate treatment,the wound area significantly decreased.While the IL-6 expres-sion showed no significant intergroup difference,the TNF-α expression was significantly higher in the treatment group.CONCLUSION A CEES-induced skin contamination model has been established in BALB/c mice using the covered method(150 μL·kg-1,10 min covered).However,RSDL should be ad-ministered in 10 min post-contamination.

Neuropsychiatric disorders such as Parkinson disease,Alzheimer disease,and schizo-phrenia may induce hallucinations,delusions,and other psychiatric symptoms during the course of disease development.These symptoms are highly prevalent and difficult to cure,and have a impact on the lives of patients.Classical antipsychotic drugs such as chlorpromazine,sulpiride and perphenazine can con-trol related symptoms,but they can also cause uncontrollable extrapyramidal system reactions and side effects such as hyperprolactinemia.In recent years,it has been found that non-classical antipsy-chotics such as olanzapine,clozapine,risperidone and pimovanserin can treat hallucinatory symptoms in neuropsychiatric disorders by antagonising the 5-hydroxytryptamine 2A(5-HT2A)receptor,or by antago-nising both the 5-HT2A receptor(strong)and the dopamine 2(D2)receptor(weak).In preclinical studies,non-classical antipsychotic drugs have shown great therapeutic effects against hallucination induced by multiple factors.Clinical studies have confirmed that these drugs improve psychotic symptoms(mainly hallucinations and delusions)significantly.In patients who are insensitive or tolerant to clozapine and risperidone,pimavanserin still shows therapeutic effects.At the same time,the incidence and severity of adverse reactions to non-classical antipsychotic drugs are reduced,and they are well tolerated.This article reviews the research progress in the role of 5-HT2A receptor antagonists in attenuating hallucino-genic symptoms so as to provide reference for the design and development of new therapeutic drugs.

Human beings are inevitably exposed to toxic substances as a result of influences of potential contamination factors in the environment,food and medicines,which poses a threat to human health.In order to effectively screen and prevent the exposure or intake of such substances,it is neces-sary to develop in vitro assays for the detection and toxicity evaluation of toxic substances.High content screening(HCS)has been recognized as an important tool for toxicity testing and risk assessment of compounds due to its high throughput and automation advantages,and has been widely used in in vitro toxicology research.In this review,we described the system components of HCS and its workflow in toxicity screening and toxicity evaluation by focusing on cases of their application in toxicity detection and evaluation studies,including the cytotoxicity,hepatotoxicity,nephrotoxicity,genotoxicity,neurotox-icity,cardiotoxicity,and developmental toxicity.In addition,the applications and developments of machine learning in HCS were explored,especially to the advantages of supervised and unsupervised machine learning strategies for high throughput image screening and data analysis.Finally,the future applications of HCS in toxicity screening and evaluation are outlined,especially in terms of binding new models and gene editing technology.

Objective: To investigate the effect of three-dimensional conformal radiotherapy (3D-CRT) combined with PC chemotherapy (paclitaxel + carboplatin) on non-small cell lung cancer (NSCLC) patients and the serum levels of CA125, tissue inhibitor of metalloproteinase-1 (TIMP-1), serum amyloid A (SAA) and T-lymphocyte subsets. Methods: A total of 100 patients with NSCLC treated in Affiliated Hospital of Guangdong Medical University from May 2015 to December 2017 were selected as the study subjects. They were divided into control group and observation group according to random number table method, with 50 cases in each group. The observation group was treated with 3D-CRT combined with PC chemotherapy, while the control group was treated with PC chemotherapy. The two groups were treated for 4 cycles. The therapeutic effect, serum CA125, TIMP-1, SAA, T-lymphocyte subsets and adverse reactions were compared between the two groups. Results: Four cases were lost to follow-up both in the two groups. The overall response rate in the observation group (43.48%, 20/46) was higher than that in the control group (23.91%, 11/46; χ²=3.941, P=0.047). The serum levels of CA125, TIMP-1 and SAA of the two groups had no significant difference before treatment, and the levels of these indexes decreased after treatment. The serum levels of CA125, TIMP-1 and SAA in the observation group after treatment were (12.31±1.13) U/ml, (275.31±13.69) pg/ml and (47.21±7.21) mg/L, which were lower than those in the control group [(30.36±1.98) U/ml, (320.36±17.23) pg/ml, (65.92±8.36) mg/L], with significant differences (t=53.699, P<0.001; t=13.884, P<0.001; t=11.495, P<0.001). The levels of CD3⁺ , CD4⁺ , CD8⁺ and CD4⁺ /CD8⁺ of the two groups had no significant difference before treatment, and the levels of these indexes decreased after treatment. The levels of CD3⁺ , CD4⁺ , CD8⁺ and CD4⁺ /CD8⁺ in the observation group were (35.27±10.31)%, (20.27±6.72)%, (15.89±3.37)% and 0.91±0.37, which were higher than those in the control group [(30.77±9.27)%, (15.27±5.73)%, (12.02±2.69)% and 0.75±0.39], with significant differences (t=2.201, P=0.030; t=3.840, P<0.001; t=6.087, P<0.001; t=2.019, P=0.047). There were no significant differences in the adverse reactions such as nausea and vomiting [63.04% (29/46) vs. 43.48% (20/46); χ²=3.537, P=0.060], phlebitis [6.52% (3/46) vs. 4.35% (2/46); χ²=0.000, P>0.999], abnormal liver function [6.52% (3/46) vs. 2.17% (1/46); χ²=0.261, P=0.609] and myelosuppression [8.70% (4/46) vs. 6.52% (3/46); χ²=0.000, P>0.999] between the observation group and the control group. Conclusion For patients with NSCLC, 3D-CRT combined with PC chemotherapy can improve the overall response rate, decrease the levels of serum CA125, TIMP-1 and SAA, and improve the immune function of patients. The therapeutic effect is remarkable and the safety is good. The therapeutic scheme is suitable for the treatment of NSCLC.

Objective To observe the correlation between CD4+ CD29+ T cells and metastasis and radiotherapy for patients with pulmonary adenocarcinoma. Method Seventy-one patients with lung adenocarcinoma, 93 patients with lung adenocarcinoma ,76 cases of chronic obstructive pulmonary disease (COPD),63 cases of healthy volunteers were enrolled. Frequencies of blood CD4+ CD29+ T cells and their intracellular necrosis factor alpha(TNF-α)and interleukin 1(IL-1)were compared. Compare TNF-α,IL-1,integrin beta 1 and vascular endothelial growth factor(VEGF)levels in the patients with transferred pulmonary adenocarcinoma or with non-transferred pulmonary adenocarcinoma and their changes with the treatment of radiotherapy. Results the patients with lung adenocarcinoma and non lung adenocarcinoma were significantly higher than that of COPD and health group,and patients with lung adenocarcinoma is significantly higher than patients with non lung adenocarcinoma (P<0.05);Integrin beta 1,VEGF and CD4+CD29+T cells,TNF-αand IL-1 level in patients with lung adeno-carcinoma metastasis were significantly higher than non-transferred group(P < 0.05);After radiotherapy,CD4+CD29+T cells,TNF-αand IL-1 in patients with lung adenocarcinoma were significantly lower than before(P<0.05);CD4+ CD29+ T cells,TNF alpha and IL-1 with integrin beta 1 and VEGF had significantly positive correlations. Conclusion CD4+CD29+T cells and cytokines increase significantly in the blood of patients with lung adenocarci-noma,and are related to the prognosis of metastasis and radiation therapy,which has important clinical significance.