Objective To investigate the ameliorative effect and the related mechanism of rotating magnetic fields(RMF)on sevoflurane(SEV,a commonly used inhalational anesthetics in clinics)-induced cognitive impairments in elderly rats.Methods The cognitive functions of 24 elderly male SD rats which were allocated into 3 experimental groups(Control group,SEV group,and SEV+RMF group;n=8 per group)were assessedviawater maze testing,and the damage and repair of hippocampal neurons were detected using ELISA and Western blotting assays.Water maze testing was also conducted on additional 24 elderly male SD rats which were randomized into 3 groups(SEV group,SEV+RMF group,and SEV+autophagy inhibitor+RMF group;n=8 per group)for assessing their cognitive functions.Results Compared with SEV group,RMF intervention significantly reduced the escape latency and swimming distance in water maze test(P<0.01),while increasing the number of platform crossovers(P<0.001).RMF downregulated the serum levels of tumor necrosis factor-α,interleukin-1β,and interleukin-6 in SEV-treated rats(P<0.001),and led to remarkable reductions in both serum neuron-specific enolase and β-amyloid protein levels(P<0.001).Moreover,RMF upregulated the expressions of nerve growth factor and brain-derived neurotrophic factor in hippocampal neurons(P<0.001),suppressed the expression of apoptotic protein caspase-3 and autophagy related protein p62 in the hippocampus,and upregulate the expression of autophagy related protein Beclin-1(P<0.001).However,the administration of autophagy inhibitor 3-MA abolished the ameliorative effects of RMF on SEV-induced cognitive impairments in elderly rats(P<0.001).Conclusion RMF can effectively improves SEV-induced cognitive dysfunction in elderly rats,and this neuroprotective effect is mediated by the autophagy activation in hippocampal neurons.

AIM:To investigate the role of lectin-like oxidized low-density lipoprotein receptor-1(LOX-1)in hypoxia-induced autophagy and apopto-sis in endothelial cells.METHODS:Human umbili-cal vein endothelial cells(HUVECs)were exposed to hypoxia(1％O2)for varying durations(0,6,12,24 h)to evaluate autophagy and apoptosis levels.LOX-1 was further intervened to explore its effects on autophagy and apoptosis.GFP-LC3B adenovirus in-fection was observed under fluorescence microsco-py to assess LC3B expression.Autophagosomes were detected by transmission electron microscopy(TEM).LOX-1 mRNA levels were measured using re-al-time PCR.Protein expression of LOX-1,LC3Ⅱ/Ⅰ,Beclin-1,Atg5,cleaved-caspase 3,Bax,and Bcl-2 was analyzed by Western blot.Reactive oxygen spe-cies(ROS)levels were quantified using the DCFH-DA fluorescent probe.Apoptosis was assessed via Hoechst staining and flow cytometry(Annexin V-PI double staining).RESULTS:Hypoxia(1％O2,24 h)significantly increased LC3Ⅱ puncta under fluores-cence microscopy,upregulated LC3Ⅱ/Ⅰ protein ex-pression,and induced autophagosome formation observed by TEM.Hypoxia elevated ROS produc-tion and promoted apoptosis.LOX-1 mRNA and protein expression were upregulated in hypoxic HU-VECs.LOX-1 siRNA intervention markedly reversed hypoxia-induced autophagy,downregulating au-tophagy-related proteins(Beclin-1,Atg5,LC3Ⅱ/Ⅰ).LOX-1 siRNA also suppressed ROS generation and inhibited apoptosis,as evidenced by decreased ex-pression of cleaved-caspase 3 and Bax,and in-creased Bcl-2 levels.CONCLUSION:Hypoxia in-duced upregulation of LOX-1 expression to produce ROS,thereby promoting autophagy and apoptosis in endothelial cells.

Objective To explore the change of nucleoplasm distribution of glucocorticoid receptor alpha(GRα)in peripheral blood of children with primary nephrotic syndrome(PNS)during the course of the disease,aiming at evaluating the correlation between nuclear transport abnormality and different GC responses.Methods A total of 45 children with PNS were enrolled as subjects in this prospective study,and divided into steroid-sensitive nephrotic syndrome(SSNS,n=36)and steroid-resistant nephrotic syndrome(SRNS,n=9)groups,according to their response to GC.The SSNS group was further subclassified into non-frequently relapsing nephrotic syndrome(NFRNS,n=21)and frequently relapsing nephrotic syndrome(FRNS,n=15)based on relapse frequency during 12-month follow-up.Peripheral blood samples were collected before GC treatment,6-week and 6-month after GC treatment.GRα nuclear localization was detected by immunofluorescence assay,and their correlations with clinical-laboratory indicators were analyzed.Results Before the GC treatment,the average fluorescence intensity showed no significantly difference among different groups(P＞0.05),the GRαin the three groups were localized mainly in cytoplasm,and the nucleocytoplasmic ratio showed no significantly difference among the three groups(P＞0.05).6-week after the GC treatment,the average fluorescence intensity showed no significantly difference among the three groups(P＞0.05),the GRα in SSNS group were localized mainly in nucleus,while those in SRNS group were localized mainly in cytoplasm.Furthermore,nucleocytoplasmic ratio in NFRNS group and SRNS group demonstrated significant differences,while those in NFRNS group and FRNS group showed no significant difference(P＞0.05).6-month after the GC treatment,the average fluorescence intensity in NFRNS group and FRNS group showed no significant difference(P＞0.05),GRα in the two groups were localized mainly in nucleus,and their nucleocytoplasmic ratio had significantly differences(P＜0.05).The GRα nucleocytoplasmic ratio in children with PNS was negatively correlated with 24-hour urine protein(24 h-UTP),TNF-α,while positively correlated with serum albumin(Alb).Conclusion There are differences in nuclear transport ability among PNS children of SRNS,NFRNS and FRNS groups,and these differences are correlated with the differency of GC responses.

Objective:To translate the Moyamoya Health Behavior Scale for Adolescent Patients into Chinese and to test its reliability and validity.Methods:Based on the Brislin translation model, the scale was forward-translated, back-translated, cross-culturally adapted, and pretested to develop the Chinese version of the Moyamoya Health Behavior Scale for Adolescent Patients. A convenience sampling method was used to recruit 220 adolescent inpatients with moyamoya disease from the Department of Neurosurgery, Zhongnan Hospital of Wuhan University, between January 2023 and December 2024. Reliability and validity analyses were conducted on the scale.Results:A total of 220 questionnaires were distributed, and 206 valid questionnaires were returned, yielding a valid response rate of 93.64%. The Chinese version of the scale comprised 12 items. The item-level content validity index ranged from 0.875 to 1.000, and the scale-level content validity index was 0.917. Exploratory factor analysis extracted three common factors: treatment implementation for moyamoya disease, health-promoting behaviors for moyamoya disease, and health coping behaviors for moyamoya disease, with a cumulative variance contribution of 69.741%. Confirmatory factor analysis showed that the overall model fit was acceptable. The Cronbach's α coefficient for the total scale was 0.872, with subscale Cronbach's α coefficients ranging from 0.810 to 0.871. The test-retest reliability coefficient for the total scale was 0.983, and the split-half reliability coefficient was 0.766.Conclusions:The Chinese version of the Moyamoya Health Behavior Scale for Adolescent Patients demonstrated good reliability and validity and can be used as an assessment tool for health behaviors in this patient population.

Objective To investigate the ameliorative effect and the related mechanism of rotating magnetic fields(RMF)on sevoflurane(SEV,a commonly used inhalational anesthetics in clinics)-induced cognitive impairments in elderly rats.Methods The cognitive functions of 24 elderly male SD rats which were allocated into 3 experimental groups(Control group,SEV group,and SEV+RMF group;n=8 per group)were assessedviawater maze testing,and the damage and repair of hippocampal neurons were detected using ELISA and Western blotting assays.Water maze testing was also conducted on additional 24 elderly male SD rats which were randomized into 3 groups(SEV group,SEV+RMF group,and SEV+autophagy inhibitor+RMF group;n=8 per group)for assessing their cognitive functions.Results Compared with SEV group,RMF intervention significantly reduced the escape latency and swimming distance in water maze test(P<0.01),while increasing the number of platform crossovers(P<0.001).RMF downregulated the serum levels of tumor necrosis factor-α,interleukin-1β,and interleukin-6 in SEV-treated rats(P<0.001),and led to remarkable reductions in both serum neuron-specific enolase and β-amyloid protein levels(P<0.001).Moreover,RMF upregulated the expressions of nerve growth factor and brain-derived neurotrophic factor in hippocampal neurons(P<0.001),suppressed the expression of apoptotic protein caspase-3 and autophagy related protein p62 in the hippocampus,and upregulate the expression of autophagy related protein Beclin-1(P<0.001).However,the administration of autophagy inhibitor 3-MA abolished the ameliorative effects of RMF on SEV-induced cognitive impairments in elderly rats(P<0.001).Conclusion RMF can effectively improves SEV-induced cognitive dysfunction in elderly rats,and this neuroprotective effect is mediated by the autophagy activation in hippocampal neurons.

BACKGROUND:Needle-knife release of the ligamentum flavum can effectively improve symptoms in patients with lumbar degeneration,and ultrasound guidance can increase the precision of needle-knife release;however,the specific effects of needle-knife release of the ligamentum flavum on the degenerated intervertebral discs and the possible mechanisms remain to be clarified. OBJECTIVE:To investigate the effect of ultrasound-guided needle-knife release of the ligamentum flavum. METHODS:Twenty-four New Zealand rabbits were randomized into control(n=6)and model(n=18)groups.A rabbit model of lumbar disc degeneration model was established in the model group by cutting the supraspinous and interspinous ligaments of the L5/6 and L6/7 segments to maintain a standing posture and apply axial load to the lumbar spine.After successful modeling,the model rabbits were subdivided into a control group,a model group,an ultrasonic needle-knife group,and a sham needle-knife group according to a random number table method,with six animals in each group.The ultrasonic needle-knife group underwent ultrasound-guided needle-knife release of the right yellow ligament of L7/S1,once every week,for a total of four times.The needle-knife approach in the sham needle-knife group was the same as that in the ultrasound needle-knife group,but the ligamentum flavum was not released.At 30 days after the intervention,MRI was used to observe the changes in the signal intensity of the nucleus pulposus within the L7/S1 segment.Hematoxylin-eosin staining was used to observe the morphological changes of the L7/S1 segment.Immunohistochemical staining was used to detect the expression of type I and II collagen in the nucleus pulposus of the L7/S1 segment.RT-PCR and western blot were used to detect the expression of integrin α5 and β1,p38,and nuclear factor κB in the L7/S1 segment. RESULTS AND CONCLUSION:MRI findings indicated that the nucleus pulposus of the intervertebral disc of rabbits in the model group was gray-black in color,and the gray value of the nucleus pulposus was significantly lower than that of the control group(P<0.01).The brightness of the nucleus pulposus of the intervertebral disc of the rabbits in the ultrasonic needle-knife group was elevated compared with that of the model group,and the gray value of the nucleus pulposus was higher than that of the model group(P<0.01).Results from hematoxylin-eosin staining showed that in the model group,the shape of the nucleus pulposus was irregular,the number of nucleus pulposus cells was reduced,the extracellular matrix was compressed,the fibrous ring was ruptured,the structure and boundary of the end plate were unclear,and the chondrocytes were arranged disorderly.Compared with the model group,the ultrasonic needle-knife group showed an increase in the number of the nucleus pulposus,an improvement in the rupture of the fibrous ring,and more regular arrangement of cartilage endplate cells.Results from immunohistochemical staining showed an increase in positive expression of type I collagen(P<0.01)and a decrease in positive expression of type II collagen in the nucleus pulposus of the model group compared with the control group as well as a decrease in positive expression of type I collagen and an increase in positive expression of type II collagen in the nucleus pulposus of the ultrasonic needle-knife group compared with the model group(P<0.01).RT-PCR and western blot assays showed that the mRNA and protein expression of integrin α5,integrin β1,p38,and nuclear factor κB in the intervertebral discs of rabbits in the model group were increased compared with that in the control group(P<0.01);the mRNA and protein expression of integrin α5,integrin β1,p38,and nuclear factor κB in the intervertebral discs of rabbits in the ultrasonic needle-knife group was decreased compared with that in the model group(P<0.01).To conclude,ultrasound-guided needle-knife release of the ligamentum flavum can improve the degree of lumbar disc degeneration in rabbits,which may be related to the inhibition of p38 and nuclear factor-κB expression by modulating integrin α5 and β1 expression.

OpenSim is an open source, free motion simulation and gait analysis software, which can be used to dynamically simulate and analyze the complex motion of the human body, and is widely used in human biomechanical research. Since OpenSim can analyze multi-dimensional motion data such as muscle strength, joint torque, and muscle synergistic activation during human movement, it can be used to study the biomechanical mechanism of musculoskeletal imbalance diseases and various treatment methods in TCM orthopedics, and has a broad application prospect in the field of TCM orthopedics. By the analysis of the basic characteristics, elements, analysis process, and application prospects of OpenSim, it is concluded that OpenSim musculoskeletal model has a large application space in the field of traditional Chinese medicine orthopedic, which is helpful to explain the pathogenesis and mechanism of diseases, and promote the precision diagnosis and treatment of orthopedics diseases;the application of OpenSim musculoskeletal model can solve the problem that the previous research paid attention to the bone malalignment and not enough attention to the tendon, and provide a new method for the research of orthopedic diseases. At present, there are still problems in the promotion and application of OpenSim, such as large equipment requirements and high operation threshold. Therefore, multidisciplinary cooperation, clinical research, and data sharing are the basic research strategies in this field.
Humans ; Biomechanical Phenomena ; Orthopedics ; Traumatology ; Software ; Medicine, Chinese Traditional ; Musculoskeletal System ; Models, Biological

OBJECTIVE: To investigate the short-to-medium-term clinical efficacy of total hip arthroplasty(THA) with Pinnacle ES constrained liner in the treatment of femoral neck fractures(FNF) associated with lower limb neuromuscular disorders. METHODS: A retrospective analysis was conducted on 16 patients who underwent primary THA using Pinnacle ES constrained liner for FNF with lower limb neuromuscular disorders and had complete follow-up data, treated between January 2020 and January 2023. There were 7 males and 9 females, with a mean age of (68.42±3.58) years old ranging from 61 to 75 years old. Among them, 10 cases had left-sided fractures and 6 had right-sided fractures;based on the Garden classification, 11 cases were type Ⅲ and 5 cases were type Ⅳ. The affected limbs were complicated with sequelae of poliomyelitis (2 cases), Parkinson's disease (2 cases), and sequelae of cerebral infarction (12 cases). All operations were performed via a posterolateral approach. Prosthesis position was evaluated using imaging data. Hip function was assessed by the Harris hip score(HHS) and Merle D'Aubigne hip score. During the follow-up period, the occurrence of complications such as prosthetic dislocation, loosening, and infection was recorded. RESULTS: One patient died of advanced tumor 2 years after surgery, and the remaining 15 patients were followed up for 24 to 64 months with a mean of (34.8±5.5) months. The operation time ranged from 50 to 90 minutes with a mean of (75.56±8.15) minutes, and the blood loss ranged from 150 to 200 ml with a mean of (170.32±12.56) ml. All patients achieved primary wound healing after surgery. Intraoperatively, femoral calcar splitting occurred in 2 cases, which were treated with titanium cable binding;no neurovascular injuries were observed in any case. The mean HHS increased from (18.95±2.25) preoperatively to (88.02±2.42) at the last follow-up, and the mean Merle D'Aubigne Score increased from (3.05±0.06) preoperatively to (16.65±0.93) at the last follow-up. Postoperative follow-up X-rays showed good prosthetic position, and no complications such as dislocation, prosthetic loosening, periprosthetic fracture, or deep infection occurred during the follow-up period. CONCLUSION Total hip arthroplasty with Pinnacle ES constrained liner is effective in the treatment of femoral neck fractures associated with lower limb neuromuscular disorders. It can significantly improve hip function, reduce the postoperative prosthetic dislocation rate, provide good initial stability, and achieve satisfactory short-to-medium-term clinical efficacy.
Humans ; Male ; Female ; Middle Aged ; Aged ; Arthroplasty, Replacement, Hip/methods* ; Femoral Neck Fractures/complications* ; Retrospective Studies ; Neuromuscular Diseases/surgery* ; Lower Extremity ; Treatment Outcome

BACKGROUND:Cartilaginous endplate stromal homeostasis is closely related to intervertebral disc degeneration.Acupotomy that releases posterior wall ligamentum flavum of the interforaminal orifice can improve the symptoms of patients with lumbar disc degeneration.Whether the mechanism of action is related to the regulation of cartilaginous endplate stromal homeostasis remains to be clarified.OBJECTIVE:To investigate the effect of ultrasound-guided needle-knife relaxation of the internal orifice of the rabbit L7/S1 intervertebral foramina on the matrix homeostasis of the rabbit cartilage endplate.METHODS:A total of 24 male New Zealand rabbits were randomly divided into a control group(n=6)and a modeling group(n=18).Lumbar disc degeneration modeling was performed by intermittent standing after transection of the supraspinous interspinous ligament for 12 weeks.After modeling,the modeling group was randomly divided into model group,needle-knife group and fake needle knife group,with 6 rabbits in each group.In the needle-knife group,the ultrasound-guided needle-knife released the ligamentum flavum posterior wall of the right intervertebral foramina,while in the fake needle-knife group,the needle-knife only reached the surface of the posterior wall ligamentum flavum of the intervertebral foramina,with a total of four interventions,each time at an interval of 1 week.No intervention was performed in the control and model groups.Thirty days after the intervention,the disc degeneration was observed by MRI.The morphology of L7/S1 intervertebral disc cartilaginous endplate,nucleus pulposus and annulus fibrosus were observed with hematoxylin-eosin and safranin O-fast green staining and was then scored.The expressions of type II collagen,proteoglycan and matrix metalloproteinase-13 in nucleus pulposus and cartilage endplate of L7/S1 intervertebral disc were detected by immunohistochemistry.RESULTS AND CONCLUSION:MRI results showed that the relative gray value of L7/S1 nucleus pulposus was significantly lower in the model group than in the control group(P<0.01),and higher in the needle-knife group than in the model group and the fake needle-knife group(P<0.05).Hematoxylin-eosin and safranin O-fast green staining showed obvious degeneration of the nucleus pulposus and annulus fibrosus,thinning of the cartilaginous endplate,and obvious calcification at the junction with bone endplate in the model group.The morphology of the cartilaginous endplate and degeneration of the nucleus pulposus were improved in the needle-knife group compared with the model group.The morphological scores of the model group,needle-knife group and fake needle-knife group were significantly higher than those of control group(P<0.01).The morphological score of the needle-knife group was significantly lower than that of the model group and fake needle-knife group(P<0.01).Immunohistochemistry results showed that compared with the control group,the expressions of type II collagen and Aggrecan in the nucleus pulposus and cartilage endplate in the model group and fake needle-knife group were significantly decreased(P<0.01),while the expression of matrix metalloproteinase-13 was significantly increased(P<0.01).Compared with the model group and fake needle-knife group,the expressions of type II collagen and Aggrecan in the nucleus pulposus and cartilage endplate were increased in the needle-knife group(P<0.05),while the expression of matrix metalloproteinase-13 was decreased significantly(P<0.01).In conclusion,the relaxation of the interforaminal orifice by needle knife can regulate the matrix homeostasis of the rabbit cartilage endplate and improve the degeneration of the intervertebral disc.

Objective:To translate the Moyamoya Health Behavior Scale for Adolescent Patients into Chinese and to test its reliability and validity.Methods:Based on the Brislin translation model, the scale was forward-translated, back-translated, cross-culturally adapted, and pretested to develop the Chinese version of the Moyamoya Health Behavior Scale for Adolescent Patients. A convenience sampling method was used to recruit 220 adolescent inpatients with moyamoya disease from the Department of Neurosurgery, Zhongnan Hospital of Wuhan University, between January 2023 and December 2024. Reliability and validity analyses were conducted on the scale.Results:A total of 220 questionnaires were distributed, and 206 valid questionnaires were returned, yielding a valid response rate of 93.64%. The Chinese version of the scale comprised 12 items. The item-level content validity index ranged from 0.875 to 1.000, and the scale-level content validity index was 0.917. Exploratory factor analysis extracted three common factors: treatment implementation for moyamoya disease, health-promoting behaviors for moyamoya disease, and health coping behaviors for moyamoya disease, with a cumulative variance contribution of 69.741%. Confirmatory factor analysis showed that the overall model fit was acceptable. The Cronbach's α coefficient for the total scale was 0.872, with subscale Cronbach's α coefficients ranging from 0.810 to 0.871. The test-retest reliability coefficient for the total scale was 0.983, and the split-half reliability coefficient was 0.766.Conclusions:The Chinese version of the Moyamoya Health Behavior Scale for Adolescent Patients demonstrated good reliability and validity and can be used as an assessment tool for health behaviors in this patient population.