Objective:To explore the differences in clinical efficacy between Co-Cr-Mo guided multidirectional sliding growing rod technology (CMSG) and traditional growing rod in the treatment of neurofibromatosis type 1 dysplastic early-onset scoliosis.Methods:A retrospective analysis was conducted on the data of 20 patients with neurofibromatosis type 1 dysplastic early-onset scoliosis who underwent surgical treatment in the Scoliosis Department of Zhengzhou Orthopaedic Hospital Affiliated to Henan University from January 2010 to July 2022. There were 10 patients in the traditional rod group (treated with traditional growing rod surgery) and 10 patients in the CMSG group (treated with CMSG technology). All patients were ≤10 years old and had a Cobb angle ≥45°. The number of surgeries and the occurrence of complications were recorded. The Cobb angle of the main scoliotic curve, the Cobb angle of kyphosis from T 5 to T 12, and the height from T 1 to S 1 were measured from the imaging data to evaluate the correction of deformity and spinal growth. Results:There were no significant differences in age, gender, follow - up time, preoperative Cobb angle, and preoperative Cobb angle of kyphosis from T 5-T 12 between the CMSG group and the TGR group ( P>0.05). The number of surgeries 1.3±0.67 and the total medical cost 91, 100±34, 700 yuan in the CMSG group were lower than those in the TGR group (5.3±1.77 times and 155, 800±45, 900 yuan], and the differences were statistically significant ( t=6.687, P<0.001; t=3.558, P=0.002). The Cobb angles of the main curve before surgery, after the first surgery, and at the last follow - up in the CMSG group were 69.7°±17.8°, 19.8°±9.7°, and 24.4°±9.0° respectively, while those in the TGR group were 62.0°±11.1°, 32.1°±11.4°, and 33.3°±11.6° respectively. The differences in Cobb angles after the first surgery and at the last follow-up between the two groups were statistically significant ( t=2.633, P=0.017; t=2.313, P=0.033). The Cobb angles of kyphosis from T 5 to T 12 before surgery, after the first surgery, and at the last follow - up in the CMSG group were 40.0°±24.2°, 21.0°±6.0°, and 33.6°±9.3° respectively, while those in the TGR group were 31.3°±14.5°, 26.3°±10.5°, and 32.3°±17.2° respectively. There were no significant differences in the Cobb angles of kyphosis from T 5 to T 12 after the first surgery and at the last follow-up between the two groups ( t=1.383, P=0.184; t=0.243, P=0.811). The heights from T 1 to S 1 before surgery, after the first surgery, and at the last follow-up in the CMSG group were 30.5±3.4 cm, 33.7±3.3 cm, and 37.9±4.8 cm respectively, with an annual increase of 1.18±0.39 cm. The heights from T 1 to S 1 in the TGR group were 29.1±3.0 cm, 31.4±2.9 cm, and 36.3±3.5 cm respectively, with an annual increase of 1.25±0.23 cm. There was no significant difference in the annual growth height of T 1-S 1 between the two groups ( t=1.367, P=0.189). During the follow-up period, 3 patients in the CMSG group had 3 complications: 1 case of coronal plane trunk decompensation, 1 case of rod fracture, and 1 case of distal junctional kyphosis. In the TGR group, 7 patients had 8 complications: 2 cases of wound rupture, 3 cases of screw loosening, 1 case of distal addition phenomenon, 1 case of proximal addition phenomenon, and 1 case of rod fracture. Conclusion:The Co-Cr-Mo guided multidirectional sliding growing rod technique is safe and effective in treating type 1 neurofibromatosis with malnutrition type early-onset scoliosis. It can effectively control the progression of spinal deformities,preserve the growth ability of the spine, and have a low overall incidence of complications.

Objective:To explore the differences in clinical efficacy between Co-Cr-Mo guided multidirectional sliding growing rod technology (CMSG) and traditional growing rod in the treatment of neurofibromatosis type 1 dysplastic early-onset scoliosis.Methods:A retrospective analysis was conducted on the data of 20 patients with neurofibromatosis type 1 dysplastic early-onset scoliosis who underwent surgical treatment in the Scoliosis Department of Zhengzhou Orthopaedic Hospital Affiliated to Henan University from January 2010 to July 2022. There were 10 patients in the traditional rod group (treated with traditional growing rod surgery) and 10 patients in the CMSG group (treated with CMSG technology). All patients were ≤10 years old and had a Cobb angle ≥45°. The number of surgeries and the occurrence of complications were recorded. The Cobb angle of the main scoliotic curve, the Cobb angle of kyphosis from T 5 to T 12, and the height from T 1 to S 1 were measured from the imaging data to evaluate the correction of deformity and spinal growth. Results:There were no significant differences in age, gender, follow - up time, preoperative Cobb angle, and preoperative Cobb angle of kyphosis from T 5-T 12 between the CMSG group and the TGR group ( P>0.05). The number of surgeries 1.3±0.67 and the total medical cost 91, 100±34, 700 yuan in the CMSG group were lower than those in the TGR group (5.3±1.77 times and 155, 800±45, 900 yuan], and the differences were statistically significant ( t=6.687, P<0.001; t=3.558, P=0.002). The Cobb angles of the main curve before surgery, after the first surgery, and at the last follow - up in the CMSG group were 69.7°±17.8°, 19.8°±9.7°, and 24.4°±9.0° respectively, while those in the TGR group were 62.0°±11.1°, 32.1°±11.4°, and 33.3°±11.6° respectively. The differences in Cobb angles after the first surgery and at the last follow-up between the two groups were statistically significant ( t=2.633, P=0.017; t=2.313, P=0.033). The Cobb angles of kyphosis from T 5 to T 12 before surgery, after the first surgery, and at the last follow - up in the CMSG group were 40.0°±24.2°, 21.0°±6.0°, and 33.6°±9.3° respectively, while those in the TGR group were 31.3°±14.5°, 26.3°±10.5°, and 32.3°±17.2° respectively. There were no significant differences in the Cobb angles of kyphosis from T 5 to T 12 after the first surgery and at the last follow-up between the two groups ( t=1.383, P=0.184; t=0.243, P=0.811). The heights from T 1 to S 1 before surgery, after the first surgery, and at the last follow-up in the CMSG group were 30.5±3.4 cm, 33.7±3.3 cm, and 37.9±4.8 cm respectively, with an annual increase of 1.18±0.39 cm. The heights from T 1 to S 1 in the TGR group were 29.1±3.0 cm, 31.4±2.9 cm, and 36.3±3.5 cm respectively, with an annual increase of 1.25±0.23 cm. There was no significant difference in the annual growth height of T 1-S 1 between the two groups ( t=1.367, P=0.189). During the follow-up period, 3 patients in the CMSG group had 3 complications: 1 case of coronal plane trunk decompensation, 1 case of rod fracture, and 1 case of distal junctional kyphosis. In the TGR group, 7 patients had 8 complications: 2 cases of wound rupture, 3 cases of screw loosening, 1 case of distal addition phenomenon, 1 case of proximal addition phenomenon, and 1 case of rod fracture. Conclusion:The Co-Cr-Mo guided multidirectional sliding growing rod technique is safe and effective in treating type 1 neurofibromatosis with malnutrition type early-onset scoliosis. It can effectively control the progression of spinal deformities,preserve the growth ability of the spine, and have a low overall incidence of complications.

Nuclear receptor corepressor (NCoR1) interacts with various nuclear receptors and regulates the anabolism and catabolism of lipids. An imbalance in lipid/energy homeostasis is also an important factor in obesity and metabolic syndrome development. In this study, we found that the deletion of NCoR1 in intestinal epithelial cells (IECs) mainly activated the nuclear receptor PPARα and attenuated metabolic syndrome by stimulating thermogenesis. The increase in brown adipose tissue thermogenesis was mediated by gut-derived tricarboxylic acid cycle intermediate succinate, whose production was significantly enhanced by PPARα activation in the fed state. Additionally, NCoR1 deletion derepressed intestinal LXR, increased cholesterol excretion, and impaired duodenal lipid absorption by decreasing bile acid hydrophobicity, thereby reversing the possible negative effects of intestinal PPARα activation. Therefore, the simultaneous regulatory effect of intestinal NCoR1 on both lipid intake and energy expenditure strongly suggests that it is a promising target for developing metabolic syndrome treatment.

Objective:To investigate the expression of soluble T cell immunoglobulin and mucin domain-3 (Tim-3) in peripheral blood of patients with pancreatic cancer and its diagnostic value in combination with serum Carbohydrate antigen 19-9 (CA19-9) .Methods:106 newly diagnosed pancreatic cancer patients and 65 age and sex matched healthy individuals were enrolled. Tim-3 concentration was quantitatively determined by enzyme-linked immunosorbent assay (ELISA). According to the expression levels of soluble Tim-3 and serum CA19-9, a binary logistic regression model of receiver operating characteristic (ROC) curve was established to compare the diagnostic effects of serum CA19-9 and soluble Tim-3 alone or combined with the two tests.Results:The levels of soluble Tim-3 in the pancreatic cancer group were significantly higher than those in the healthy control group ( P<0.001). The expression level of soluble Tim-3 was significantly higher in patients with stage III-IV pancreatic cancer than in patients with stage I-II ( P=0.003). The AUC of soluble Tim-3 diagnosis for stage I-II pancreatic cancer was 0.856 (95%CI: 0.765 to 0.992 P<0.001), Serum CA19-9 The AUC used for the stage I-II pancreatic cancer diagnosis was 0.862 (95%CI: 0.772 to 0.926 P<0.001), The AUC for the combined diagnosis was 0.949 (95%CI: 0.880 - 0.985 P<0.001) ; In a healthy population and in patients with stage III-IV pancreatic cancer, the AUC of soluble T I I-IV pancreatic cancer in stage III was 0.927 (95%CI: 0.873 to 0.963 P<0.001), the AUC of serum CA19-9 used for the diagnosis of stage III-IV pancreatic cancer was 0.933 (95%CI: 0.881 to 0.968 P<0.001), the AUC for the combined diagnosis was 0.989 (95%CI: 0.956 to 0.999 P<0.001) . Conclusions:The combination of soluble Tim-3 and serum CA19-9 can improve the diagnostic rate of pancreatic cancer patients.