BACKGROUND:Traditional surgery for lumbar disc herniation involves extensive excision of tissue surrounding the nerve for decompression and removal of protruding lumbar intervertebral discs,which poses various risks and complications such as nerve damage causing paralysis,lumbar instability,herniation recurrence,intervertebral space infection,and adjacent vertebral diseases. OBJECTIVE:To propose the symmetrically adduction of lumbar decompression induced resorption of herniated nucleus pulpous technique for lumbar spine symmetrically decompression,showing the induced resorption of herniated nucleus pulpous phenomenon and early clinical efficacy,and then analyze its decompression mechanism. METHODS:214 patients with lumbar disc herniation at Department of Orthopedics,First Affiliated Hospital of Zhengzhou University from March 2021 to May 2023 were enrolled in this study.Among them,81 patients received conservative treatment as the control group,and 133 patients received symmetrically adduction of lumbar decompression induced resorption of herniated nucleus pulpous treatment as the trial group.Before surgery,immediately after surgery(7-14 days),and early after surgery(over 1 year),MRI images were used to measure the volume changes of lumbar disc herniation.CT images were used to measure the posterior displacement distance of the lumbar spinous process ligament complex,as well as the width and height of the lateral recess.Japanese Orthopaedic Association scores were used to evaluate the patient's neurological function recovery. RESULTS AND CONCLUSION:(1)Control group:81 patients with lumbar disc herniation were treated conservatively,with a total of 171 herniated lumbar discs.The average follow-up time was(22.7±23.1)months.The first and second MRI measurements of 171 herniated lumbar discs showed herniated lumbar disc volumes of(551.6±257.9)mm3 and(792.2±330.4)mm3,respectively,with an average volume increase rate of(53.2±44.4)%,showing statistically significant differences(P<0.001).Out of 171 herniated lumbar discs,4 experienced natural shrinkage,with an absorption ratio of 2.3%(4/171)and an absorption rate of(24.5±9.9)%.(2)Trial group:133 patients with lumbar disc herniation had a total of 285 herniated lumbar discs.(1)Immediately after surgery:All patients were followed up immediately after surgery.229 out of 285 herniated lumbar discs experienced retraction,with an absorption ratio of 80.3%(229/285)and an average absorption rate of(21.5±20.9)%,with significant and complete absorption accounting for 6.5%.There were a total of 70 herniated lumbar discs in the upper lumbar spine,with an absorption ratio of 85.7%(60/70),an average absorption rate of(23.1±19.5)%,and a maximum absorption rate of 86.6%.There were 215 herniated lumbar discs in the lower lumbar spine,with an absorption ratio of 78.6%(169/215),an average absorption rate of(21.0±21.3)%,and a maximum absorption rate of 83.2%.Significant and complete absorption of the upper and lower lumbar vertebrae accounted for 5.7%and 6.5%,respectively,with no statistically significant difference(P>0.05).The average distance of posterior displacement of the spinous process ligament complex immediately after surgery was(5.2±2.8)mm.There were no significant differences in the width and height of the left and right lateral recess before and immediately after surgery(P>0.05).The Japanese Orthopaedic Association score immediately after surgery increased from(10.1±3.4)before surgery to(17.0±4.8),and the immediate effective rate after surgery reached 95.6%.(2)Early postoperative period:Among them,46 patients completed the early postoperative follow-up.There were 101 herniated lumbar discs,with an absorption ratio of 94%(95/101)and an average absorption rate of(36.9±23.7)%.Significant and complete absorption accounted for 30.6%,with a maximum absorption rate of 100%.Out of 101 herniated lumbar discs,3 remained unchanged in volume,with a volume invariance rate of 2.97%(3/101).Out of 101 herniated lumbar discs,3 had an increased volume of herniated lumbar discs,with an increase ratio of 2.97%(3/101)and an increase rate of(18.5±18.4)%.The Japanese Orthopaedic Association score increased from preoperative(9.3±5.1)to(23.5±4.0),with an excellent and good rate of 93.4%.(3)The early postoperative lumbar disc herniation absorption ratios of the control group and trial group were 2.3%and 85.9%,respectively,with statistically significant differences(P<0.001).(4)Complications:There were two cases of incision exudation and delayed healing in the trial group.After conservative treatment such as dressing change,no nerve injury or death occurred in the incision healing,and no cases underwent a second surgery.(5)It is concluded that symmetrically adduction of lumbar decompression induced resorption of herniated nucleus pulpous is a new method for treating lumbar disc herniation that can avoid extensive excision of the"ring"nerve and achieve satisfactory early clinical efficacy.It does not damage the lumbar facet joints or alter the basic anatomical structure of the lateral recess,fully preserves the herniated lumbar discs,and can induce significant or even complete induced resorption of herniated nucleus pulpous.Symmetrically adduction of lumbar decompression induced resorption of herniated nucleus pulpous provides a new basis and method for the clinical treatment of lumbar disc herniation.

Objective: To address the relation among pelvic inflammatory disease (PID), genetic vulnerability and ovarian cancer (OC) risk, we assessed the association between PID and OC risk, alongside the interplay with germline homologous recombination repair (gHR) mutation, utilizing the UK Biobank. Methods: We conducted a prospective cohort study in the UK Biobank by tracking OC incidences between individuals with and without a PID history. Identification of gHR mutations (BRCA1, BRCA2, RAD51C, RAD51D, BRIP1) carriers were accomplished through paired whole-exome sequencing data. We used Cox’s regression models to evaluate the hazard ratios (HRs) for OC risks under PID. Results: In the large prospective cohort study, the adjusted HR for OC in patients with PID was 1.45 (95% confidence interval [CI]=0.90, 2.32) compared with those with non-PID.Intriguingly, age-stratified analysis unveiled a positive association between PID history and OC risk in those aged under 55 years (HR=1.92; 95% CI=1.02, 3.63). Moreover, individuals aged younger than 55 years harboring both a history of PID and gHR mutations exhibited the highest risk of OC (HR=7.40; 95% CI=1.03, 53.10). Conclusion An association between PID and OC risk emerged, notably in the subgroup aged younger than 55 years old. Individuals with both a PID history and gHR mutations exhibited the highest risk of OC. These findings imply PID as a potential precursor for OC, underscoring the importance of early intervention, particularly in the younger population with gHR mutations.

Objective:To investigate the diagnostic value of serum Aspergillus fumigatus immunoglobulin G (IgG), bronchoalveolar lavage fluid (BALF) galactomannan antigen test (GM test) and combined detection of the two methods in chronic pulmonary aspergillosis (CPA). Methods:A total of 310 patients with suspected CPA who were hospitalized in Wuhan Pulmonary Hospital from January 2020 to December 2022 were screened. BALF-GM test and serum Aspergillus fumigatus IgG were detected. According to the inclusion and exclusion criteria, 151 confirmed or clinically diagnosed CPA patients were enrolled and 60 non-CPA cases were included as controls. The underlying diseases, clinical symptoms and imaging findings of the two groups were analyzed using case-control study. Statistical comparison was performed by chi-square test. The efficacies of BALF-GM test, serum Aspergillus fumigatus IgG test, and their combined detection for CPA were analyzed by receiver operating characteristic curve. Results:There were 130 confirmed cases and 21 clinically diagnosed cases among 151 patients with CPA, including 106 males (70.2%) with age of (54.6±15.5) years. The age of 60 non-CPA patients was (53.6±17.8) years, including 42 males (70.0%). The proportions of pulmonary tuberculosis, bronchiectasis and chronic obstructive pulmonary disease, and the incidence of hemoptysis in CPA group were 79.47%(120/151), 86.09%(130/151), 26.49%(40/151) and 43.71%(66/151), respectively, which were all higher than those in non-CPA group (10.00%(6/60), 25.00%(15/60), 8.33%(5/60) and 11.67%(7/60), respectively), and the differences were statistically significant ( χ2=86.14, 74.56, 8.44 and 19.48, respectively, all P<0.05). The proportion of interstitial lung disease in non-CPA group was 28.33%(17/60), which was higher than that in CPA group (2.65%, 4/151), and the difference was statistically significant ( χ2=31.61, P<0.001). The common imaging findings of CPA patients were pulmonary cavity (70.86%, 107/151), cavity inclusions (41.72%, 63/151) and lung damage (33.77%, 51/151). The specificity and sensitivity of serum Aspergillus fumigatus IgG for CPA diagnosis were 81.7% and 68.9%, respectively, and the area under the curve (AUC) was 0.753 (95% confidence interval (95% CI) 0.681 to 0.825, P< 0.001). The specificity and sensitivity of BALF-GM test were 76.7% and 67.5%, respectively, and the AUC was 0.724 (95% CI 0.649 to 0.800, P<0.001). The specificity and sensitivity of the two methods in series combined detection were 95.0% and 44.4%, respectively, and those of the two methods in parallel detection were 60.3% and 94.5%, respectively. The AUC of the combined diagnosis of CPA by the two methods was 0.843 (95% CI 0.783 to 0.903, P<0.001). Conclusions:Serum Aspergillus fumigatus IgG combined with BALF-GM test has a good diagnostic efficacy for CPA. The detection of serum Aspergillus fumigatus IgG is non-invasive and highly specific, which is beneficial to the early diagnosis and treatment of CPA.

BACKGROUND:Mechanical stimulation has been confirmed to promote osteogenic differentiation of bone marrow stromal stem cells,but the mechanism is unknown.Primary cilia are important mechanoreceptors and regulate various signaling pathways such as TGF-β1/BMP-2/SMAD.They are likely to be important targets for mechanical regulation of bone marrow stromal stem cells. OBJECTIVE:To investigate the effect and mechanism of fluid shear stress on osteogenic differentiation of bone marrow stromal stem cells. METHODS:Rat bone marrow stromal stem cells were divided into control group,mechanical stimulation group(fluid shear mechanics intervention by shaking table),mechanical stimulation + IFT88 silencing group(mechanical stimulation + silencing IFT88 expression with siRNA).After 24 hours of intervention,qRT-PCR was utilized to determine the expression of transforming growth factor β1 and bone morphogenetic protein 2.Western blot assay was used to detect the expression of phosphorylated SMAD2/3 protein.Immunofluorescent staining of primary cilia was conducted and morphology was analyzed. RESULTS AND CONCLUSION:Shear stress stimulation could promote the transcriptional activity of transforming growth factor β1 and bone morphogenetic protein 2 genes,and increase the expression of phosphorylated SMAD2/3 protein.After siRNA interfered with primary cilia,this mechanical response effect was significantly reduced.There was a Spearman correlation between the change ratio of the primary cilium area of bone marrow stromal stem cells and the increased ratio of transforming growth factor β1 and bone morphogenetic protein 2 gene transcription.These findings indicate that primary cilia/intraflagellar transport mediates the activation of fluid shear stress-responsive transforming growth factor β1/bone morphogenetic protein 2/SMAD signaling pathway and promotes osteogenic differentiation of bone marrow stromal stem cells.

Objective:To establish UPLC specific chromatogram method and content determination method of Dryopteridis Crassirhizomatis Rhizoma; To comprehensively evaluate the Dryopteridis Crassirhizomatis Rhizoma from different producing areas.Methods:UPLC method was used to establish the specific chromatogram of 15 batches of Dryopteridis Crassirhizomatis Rhizoma from different producing areas. The quality was evaluated by cluster analysis and partial least square analysis. The content of total flavonoids was determined by ultraviolet spectrophotometry.Results:The established specific chromatogram identified a total of 21 common peaks, and identified 4 components through comparison with control samples. The clustering and partial least squares analysis showed that the samples from Anshan City in Liaoning Province, Yanbian Korean Autonomous Prefecture in Jilin Province, Jiamusi City in Heilongjiang Province, Jilin City in Jilin Province had a certain consistency. The results of total flavone content determination showed that the content of samples from different producing areas was different.Conclusion:The established UPLC characteristic chromatogram and content determination method of total flavone content of Dryopteridis Crassirhizomatis Rhizoma can reflect the quality of Dryopteridis Crassirhizomatis Rhizoma in different places. The quality of samples from different origins is similar, but the contents of the three producing areas fluctuated greatly.

Objective: To investigate the effects of long-term hyperglycemia induced ultrastructure of left ventricular myocardium in streptozotocin-induced type 1 diabetes mellitus(T1 DM) cynomolgus monkeys. Methods: The T1 DM cynomolgus monkeys were induced by intravenous administration of streptozotocin as the model group. The normal cynomolgus monkeys were distributed to the control group. Ultrastructural morphometric features of left ventricular myocardium in the model group and the control group were obtained using transmission electron microscope and quantitatively analyzed. Results: Ultrastructural observations indicated that the numbers of mitochondrion(P<0.01), the relative electron density of mitochondrion(P<0.000 1), the volume density(P<0.001) and the surface area density(P<0.05) of mitochondrion were observed to decrease in the cytoplasm of left ventricular cardiomyocytes of the model group compared to the control group. The ration surface and the average area of mitochondrion showed no difference between two groups. Massive lipid droplets were identified in the cytoplasm of left ventricular cardiomyocytes of the model group. Thickening of basement membrane(P<0.000 1) and decreasing of pinocytotic vesicles(P<0.000 1) were observed in the capillary endothelial cells in left ventricular myocardium of the model group compared to the control group. Conclusion The results indicate that long-term hyperglycemia induces left ventricular cardiomyocytes and capillary endothelial cells ultrastructural damage in TIDM cynomolgus monkeys.

Objective:To observe the weight,fat distribution,pesistent low-grade inflammation and insulin sensitivity of SD female rats in neonatal,adolescent and adult periods,which were exposed with intrauterine high androgen.Methods:Fifteen offspring female rats which were exposed to high level of intrauterine testosterone in late pregnancy were obtained by subcutaneous injection of 2 mg testosterone into pregnant SD rats at 18-20 d of gestation. They were ascribed to the intrauterine testosterone group. At the same time, fifteen female offspring obtained from the pregnant SD rats injected with the same volume saline were as control group. The weight and body fat content were observed in neonatal stage (4 d), adolescent stage (15 d) and adult stage (35 d) of offspring female rats. Tumor necrosis factor (TNF)-α and monocyte chemotactic factor (MCP)-1 were tested by enzyme-linked immunosorbent assay (ELISA). The expression of CD16 in peritoneal adipose tissue was detected by immune fluorescence staining. Intraperitoneal glucose tolerance test (IGTT) was performed in adolescent and adult female rats.Results:1) The weight of neonatal and adolescent female offspring in intrauterine testosterone group were significantly increased compared with control group [(101.17±9.19) g vs. (71.59±7.56) g, P<0.001; (211.61±11.94) g vs. (189.85±6.97) g, P=0.003]. Similarly, there was a significant difference in the ratio of fat and weight between the two groups (0.16±0.18 vs. 0.11±0.17, P=0.002; 0.27±0.18 vs. 0.21±0.18, P=0.006), while there were no obvious significance in adult offspring between the two groups ( P>0.05). 2) The body fat and muscle ratio of female offspring in intrauterine testosterone group were higher than those in control group during neonatal, adolescent and adult periods (0.05±0.04 vs. 0.08±0.05, P=0.031; 0.08±0.05 vs. 0.13±0.07, P=0.007; 0.12±0.04 vs. 0.18±0.06, P=0.005). 3) The serum TNF-α and MCP-1 levels in intrauterine testosterone group were higher than those in control group ( P<0.001, P=0.004),and the expression of CD16 in peritoneal adipose tissue was significantly increased ( P=0.018, P=0.031, P=0.004). 4) Following IGTT, compared with control group, the intrauterine testosterone group in puberty showed significantly higher 120 min glucose level [(165.00±58.68) mg/dL vs. (123.90±65.16) mg/dL, P=0.028] and the adulthood showed higher 60 min [(189.73±69.87) mg/dL vs. (136.67±37.14) mg/dL, P=0.035] and 120 min [(170.18±32.66) mg/dL vs. (102.56±12.27) mg/dL, P=0.008] glucose level. Conclusion:The hyperandrogen exposure at late-geastation can lead to the excessive androgen and centripetal obesity of female offspring from newborn to adolescence, but the adverse effect on muscle formation can extent to adulthood. The intrauterine high testosterone environment facilitated to promote macro-phage to M1-subtype and maintain chronic low-degree inflammation. In addition, the insulin sensitivity decreased from puberty to adulthood, which was even worsen in adulthood.

Objective:To observe the weight,fat distribution,pesistent low-grade inflammation and insulin sensitivity of SD female rats in neonatal,adolescent and adult periods,which were exposed with intrauterine high androgen.Methods:Fifteen offspring female rats which were exposed to high level of intrauterine testosterone in late pregnancy were obtained by subcutaneous injection of 2 mg testosterone into pregnant SD rats at 18-20 d of gestation. They were ascribed to the intrauterine testosterone group. At the same time, fifteen female offspring obtained from the pregnant SD rats injected with the same volume saline were as control group. The weight and body fat content were observed in neonatal stage (4 d), adolescent stage (15 d) and adult stage (35 d) of offspring female rats. Tumor necrosis factor (TNF)-α and monocyte chemotactic factor (MCP)-1 were tested by enzyme-linked immunosorbent assay (ELISA). The expression of CD16 in peritoneal adipose tissue was detected by immune fluorescence staining. Intraperitoneal glucose tolerance test (IGTT) was performed in adolescent and adult female rats.Results:1) The weight of neonatal and adolescent female offspring in intrauterine testosterone group were significantly increased compared with control group [(101.17±9.19) g vs. (71.59±7.56) g, P<0.001; (211.61±11.94) g vs. (189.85±6.97) g, P=0.003]. Similarly, there was a significant difference in the ratio of fat and weight between the two groups (0.16±0.18 vs. 0.11±0.17, P=0.002; 0.27±0.18 vs. 0.21±0.18, P=0.006), while there were no obvious significance in adult offspring between the two groups ( P>0.05). 2) The body fat and muscle ratio of female offspring in intrauterine testosterone group were higher than those in control group during neonatal, adolescent and adult periods (0.05±0.04 vs. 0.08±0.05, P=0.031; 0.08±0.05 vs. 0.13±0.07, P=0.007; 0.12±0.04 vs. 0.18±0.06, P=0.005). 3) The serum TNF-α and MCP-1 levels in intrauterine testosterone group were higher than those in control group ( P<0.001, P=0.004),and the expression of CD16 in peritoneal adipose tissue was significantly increased ( P=0.018, P=0.031, P=0.004). 4) Following IGTT, compared with control group, the intrauterine testosterone group in puberty showed significantly higher 120 min glucose level [(165.00±58.68) mg/dL vs. (123.90±65.16) mg/dL, P=0.028] and the adulthood showed higher 60 min [(189.73±69.87) mg/dL vs. (136.67±37.14) mg/dL, P=0.035] and 120 min [(170.18±32.66) mg/dL vs. (102.56±12.27) mg/dL, P=0.008] glucose level. Conclusion:The hyperandrogen exposure at late-geastation can lead to the excessive androgen and centripetal obesity of female offspring from newborn to adolescence, but the adverse effect on muscle formation can extent to adulthood. The intrauterine high testosterone environment facilitated to promote macro-phage to M1-subtype and maintain chronic low-degree inflammation. In addition, the insulin sensitivity decreased from puberty to adulthood, which was even worsen in adulthood.

Objective:To analyze the clinical characteristics of intestinal tuberculosis improving the diagnosis rate of intestinal tuberculosis.Methods:From January 2014 to June 2018, at Wuhan Pulmonary Hospital, the data of clinical symptoms, laboratory examination, imaging, endoscopy, surgery and pathological examination of 205 patients with intestinal tuberculosis were retrospectively analyzed. Descriptive analysis was performed for statistical analysis.Results:Among 205 patients with intestinal tuberculosis, 145 cases were male and 60 cases were female, aged 14 to 85 years old. A total of 189 cases (92.2%) were complicated with lung tuberculosis, of which 151 cases (79.9%) were positive for sputum acid fast staining. A total of 126 cases were tested for feces acid fast staining, of which 83 cases (65.9%) were positive. A total of 60 cases (29.3%) were tested for GeneXpert Mycobacterium tuberculosis/rifampicintablet (GeneXpert MTB/RIP), of which 49 cases (81.7%) were positive. A total of 44 cases of intestinal tuberculosis were diagnosed by biopsy under electronic enteroscopy, and 21 cases were pathologically diagnosed with intestinal tuberculosis after surgical resection. The 21 patients were tested for GeneXpert MTB/RIP, of which 19 cases (90.5%) were positive and 10 cases (47.6%) were positive for tuberculin test. Six patients were clinically diagnosed with intestinal tuberculosis after effective treatment of antituberculosis drugs. Conclusions:Combination of clinical symptoms and laboratory, imaging, endoscopic and pathological examination, as well as the therapeutic effect of diagnostic antituberculosis treatment could make comprehensive diagnosis of intestinal tuberculosis. The GeneXpert MTB/RIP examination is of great value in the diagnosis of intestinal tuberculosis.

Exosome, a membranous vesicle with biological activity, not only transmits active substances between cells but also transfers information between cells to participate in cell communication. Epithelial-mesenchymal transition (EMT) is a process by which epithelial cells acquire migratory and invasive properties to become mesenchymal stem cells. EMT is essential for the development of a spectrum of diseases. Studies have shown that exosomes have dual effects on EMT to, on the one hand, promote EMT and tumor cell invasion and metastasis and accelerate angiogenesis and tumor growth; on the other hand, exosomes can suppress tumor cell invasion, inhibit fibrosis of the heart, liver and kidney, and improve myocardial infarction by inhibiting EMT. Exosomes modulate EMT-related signaling pathways by carrying EMT-related proteins or miRNA to exert their bi-directional regulatory effects.
Epithelial-Mesenchymal Transition ; Exosomes ; Humans ; MicroRNAs ; Neoplasms ; Signal Transduction