1.Effect of Acupuncture at Neiguan (PC6) on Improving Autism by Promoting Myelination Through The METTL14/m⁶A/PTEN Axis Based on “Xuanfu-Suiqiao” Theory
Wei-Li DANG ; Lü-Yuan LIANG ; Yu-Xin LI ; Zhi-Yao LI ; Sai-Dan LIU ; Jia-Lei CAO ; Rong-Ze MA ; Yun-Kai WANG ; Xiao-Qing YANG ; Bing-Qi WEI ; Bing-Xiang MA
Progress in Biochemistry and Biophysics 2026;53(5):1165-1177
ObjectiveTo clarify whether METTL14 mediates the core role of acupuncture at Neiguan (PC6) in promoting myelination and improving behavior in young autistic rats through gene intervention technology. MethodsThe ASD model was established by intraperitoneal injection of valproic acid (VPA) in pregnant rats. Male offspring were intracerebroventricularly injected with adenovirus-packaged METTL14 shRNA (sh-METTL14) or its control (sh-NC) on postnatal day 1, with a model group set as well. Subsequently, the juvenile rats were divided into model group, acupuncture group, acupuncture+sh-NC group, and acupuncture+sh-METTL14 group. The acupuncture group received acupuncture at Neiguan (PC6) from postnatal day 7, once daily for 21 consecutive days. Neurobehavioral changes were evaluated by behavioral tests; METTL14 knockdown efficiency and the expression of METTL14, METTL3, and PTEN were detected by quantitative real-time PCR (qRT-PCR) and Western blot (WB); PTEN m6A levels were measured by RNA immunoprecipitation-qPCR (RIP-qPCR); myelin ultrastructure, expression of myelin basic protein (MBP) and neurofascin 155 (NF155), and dendritic spine density were observed using transmission electron microscopy (TEM), enzyme-linked immunosorbent assay (ELISA), immunofluorescence, qRT-PCR, and primary neuron culture. ResultsBehaviorally, knockdown of METTL14 significantly counteracted the beneficial effects of acupuncture in improving self-grooming, open field exploration, three-chamber social interaction, and Morris water maze learning and memory (P<0.05, P<0.01). Compared with the acupuncture+sh-NC group, the acupuncture+sh-METTL14 group showed significantly decreased mRNA and protein expression of hippocampal METTL14 (P<0.01), and the upregulating effects of acupuncture on METTL3 and PTEN expression were reversed (P<0.01). Meanwhile, knockdown of METTL14 significantly inhibited the acupuncture-induced increase in PTEN m6A levels (P<0.01). Morphologically, knockdown of METTL14 attenuated the improvement of myelin structure by acupuncture, reversed the downregulation of MBP and upregulation of NF155 induced by acupuncture, and blocked the increase in dendritic spine density (P<0.05, P<0.01). ConclusionMETTL14 is a key molecule mediating the therapeutic effect of acupuncture at Neiguan. Acupuncture at Neiguan upregulates METTL14, thereby enhancing m6A methylation modification of PTEN mRNA to stabilize its expression, ultimately promoting myelin development and improving behavioral symptoms in ASD juvenile rats. This preliminarily reveals the modern biological connotation of “opening Xuanfu and dredging myelin”.
2.Effect of Acupuncture at Neiguan (PC6) on Improving Autism by Promoting Myelination Through The METTL14/m⁶A/PTEN Axis Based on “Xuanfu-Suiqiao” Theory
Wei-Li DANG ; Lü-Yuan LIANG ; Yu-Xin LI ; Zhi-Yao LI ; Sai-Dan LIU ; Jia-Lei CAO ; Rong-Ze MA ; Yun-Kai WANG ; Xiao-Qing YANG ; Bing-Qi WEI ; Bing-Xiang MA
Progress in Biochemistry and Biophysics 2026;53(5):1165-1177
ObjectiveTo clarify whether METTL14 mediates the core role of acupuncture at Neiguan (PC6) in promoting myelination and improving behavior in young autistic rats through gene intervention technology. MethodsThe ASD model was established by intraperitoneal injection of valproic acid (VPA) in pregnant rats. Male offspring were intracerebroventricularly injected with adenovirus-packaged METTL14 shRNA (sh-METTL14) or its control (sh-NC) on postnatal day 1, with a model group set as well. Subsequently, the juvenile rats were divided into model group, acupuncture group, acupuncture+sh-NC group, and acupuncture+sh-METTL14 group. The acupuncture group received acupuncture at Neiguan (PC6) from postnatal day 7, once daily for 21 consecutive days. Neurobehavioral changes were evaluated by behavioral tests; METTL14 knockdown efficiency and the expression of METTL14, METTL3, and PTEN were detected by quantitative real-time PCR (qRT-PCR) and Western blot (WB); PTEN m6A levels were measured by RNA immunoprecipitation-qPCR (RIP-qPCR); myelin ultrastructure, expression of myelin basic protein (MBP) and neurofascin 155 (NF155), and dendritic spine density were observed using transmission electron microscopy (TEM), enzyme-linked immunosorbent assay (ELISA), immunofluorescence, qRT-PCR, and primary neuron culture. ResultsBehaviorally, knockdown of METTL14 significantly counteracted the beneficial effects of acupuncture in improving self-grooming, open field exploration, three-chamber social interaction, and Morris water maze learning and memory (P<0.05, P<0.01). Compared with the acupuncture+sh-NC group, the acupuncture+sh-METTL14 group showed significantly decreased mRNA and protein expression of hippocampal METTL14 (P<0.01), and the upregulating effects of acupuncture on METTL3 and PTEN expression were reversed (P<0.01). Meanwhile, knockdown of METTL14 significantly inhibited the acupuncture-induced increase in PTEN m6A levels (P<0.01). Morphologically, knockdown of METTL14 attenuated the improvement of myelin structure by acupuncture, reversed the downregulation of MBP and upregulation of NF155 induced by acupuncture, and blocked the increase in dendritic spine density (P<0.05, P<0.01). ConclusionMETTL14 is a key molecule mediating the therapeutic effect of acupuncture at Neiguan. Acupuncture at Neiguan upregulates METTL14, thereby enhancing m6A methylation modification of PTEN mRNA to stabilize its expression, ultimately promoting myelin development and improving behavioral symptoms in ASD juvenile rats. This preliminarily reveals the modern biological connotation of “opening Xuanfu and dredging myelin”.
3.Construction of evaluation index system of infectious disease prevention and control ability in colleges and universities
Chinese Journal of School Health 2025;46(3):438-442
Objective:
To construct a scientific and perfect evaluation index system of infectious disease prevention and control ability in colleges and universities, so as to provide reference tools for colleges and universities to effectively respond to infectious disease.
Methods:
The initial framework of the evaluation index system of infectious disease prevention and control ability in colleges and universities was constructed by using literature analysis method. Experts familiar with infectious disease prevention and control or school health work were selected to conduct two rounds( n =16,18) of Delphi expert consultation for determining the evaluation index system. Analytical hierarchy process was used to calculate the index weights and combined weights. About 198 prevention and control personnel were conveniently selected from 3 universities in Inner Mongolia Autonomous Region to comprehensively evaluate the evaluation indicators by using fuzzy comprehensive evaluation method.
Results:
After two rounds of Delphi consultation questionnaire, the effective recovery rates were 80.0% and 90.0%, the expert authority levels were 0.89 and 0.86, the expert harmony coefficients for Kendall W were 0.166 and 0.310, and the variation coefficient of each index was <0.25. Finally, the evaluation index system of infectious disease prevention and control ability of colleges and universities included 4 first level indicators, 14 second level indicators and 75 third level indicators. The weights of prevention and monitoring and early warning, organizational system guarantee, emergency management, rehabilitation and summary were 0.176, 0.476, 0.268 and 0.080, respectively. The top 3 weights of the secondary indexes were 0.623 for infectious disease surveillance and early warning, 0.595 for loss assessment and 0.370 for emergency response. The score of fuzzy comprehensive evaluation of the index system of infectious disease prevention and control ability in colleges and universities was 79.148, suggesting a high level.
Conclusion
The established evaluation index system of infectious disease prevention and control ability in colleges and universities is scientific and reasonable, which is conducive to provide tool reference for the evaluation of infectious disease prevention and control ability in colleges and universities.
4.Mechanism of acupuncture on cerebral ischemia-reperfusion injury via p53/SLC7A11/GPX4 signaling pathway in rat models.
Qi WANG ; Ziwen HOU ; Yaoyao LIU ; Dan WEI ; Qingjie KONG ; Xia CHEN
Chinese Acupuncture & Moxibustion 2025;45(8):1099-1110
OBJECTIVE:
To explore the neuroprotective effect and underlying mechanism of Xingnao Kaiqiao acupuncture (acupuncture for regaining consciousness and opening orifices) in the rat models of cerebral ischemia-reperfusion injury (CIRI) based on the p53 protein (p53)/solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) signaling pathway.
METHODS:
Of 102 male Wistar rats, 20 rats were randomly collected as a sham-operation group. Using a modified external carotid artery filament insertion method, CIRI models were prepared by occluding the middle cerebral artery in the rest rats. After modeling and excluding 1 non-successfully modeled rat and 1 dead one, the other modeled rats were randomized into a model group, an agonist group, an acupuncture group, and an acupuncture + agonist group, 20 rats in each one. Xingnao Kaiqiao acupuncture therapy was delivered in the rats of the acupuncture group and the acupuncture + agonist group. The acupoints included "Shuigou" (GV26), bilateral "Neiguan" (PC6), and "Sanyinjiao" (SP6) on the affected side. Electroacupuncture was attached to "Neiguan" (PC6) and "Sanyinjiao" (SP6) on the affected side, with dense-disperse wave, a frequency of 2 Hz/15 Hz and intensity of 1 mA. The intervention was delivered twice daily, 20 min each time and for 7 consecutive days. In the agonist group and acupuncture+agonist group, p53 agonist, COTI-2 was intraperitoneally injected (15 mg/kg), once daily for 7 consecutive days. Neurological deficit was evaluated using Zausinger's six-point scale. Cerebral infarction volume was quantified by triphenyl tetrazolium chloride (TTC) staining. Histopathological changes were observed using hematoxylin-eosin (HE) staining. Iron deposition was assessed by Prussian blue staining. Mitochondrial ultrastructure in the ischemic cortex was examined under transmission electron microscopy (TEM). Serum iron (Fe2+) was measured with chromometry. Malondialdehyde (MDA) and glutathione (GSH) levels in the ischemic hippocampus were determined using thiobarbituric acid and microplate assays, respectively. The mean fluorescence intensity of reactive oxygen species (ROS) in the ischemic cortex was analyzed by flow cytometry. The mRNA and protein expression of GPX4, SLC7A11, and p53 in the ischemic hippocampus were evaluated using quantitative real-time PCR (qRT-PCR) and Western blotting, respectively.
RESULTS:
Compared with the sham-operated group, the model group exhibited the decrease in neurological deficit score (P<0.01), and the increase in cerebral infarction volume percentage (P<0.01). The changes of brain tissue were presented in extensive cellular necrosis, pyknotic and deeply-stained nuclei, and vacuolar degeneration. The iron deposition was elevated in cortex and hippocampus (P<0.01), mitochondrial membrane density increased, the cristae was broken or reduced, and the outer membrane ruptured. The levels of Fe2+ and MDA, as well as the mean flourscence intensity of ROS were elevated (P<0.01) and the level of GSH was reduced (P<0.01). The mRNA and protein expression of GPX4 and SLC7A11 was reduced (P<0.01), while that of p53 rose (P<0.01). When compared with the model group, in the agonist group, the neurological deficit score was reduced (P<0.05), the percentage of infarction volume was higher (P<0.01), the histopathological damage was further exacerbated, and the percentage of iron deposition increased in the cortex and hippocampus (P<0.01). The mitochondrial quantity decreased, the membrane density increased, the mitochondrial cristae were broken or reduced, and the outer membrane was ruptured. The levels of Fe2+ and MDA, as well as the mean flourscence intensity of ROS were higher (P<0.01, P<0.05) and the level of GSH was reduced (P<0.05). The mRNA and protein expression of GPX4 and SLC7A11 decreased (P<0.01, P<0.05), while that of p53 was elevated (P<0.01). Besides, in comparison with the model group, the neurological deficit score was higher in the acupuncture group and the acupuncture + agonist group (P<0.01, P<0.05), the percentage of cerebral infarction volume was lower in the acupuncture group (P<0.01), the pathological damage of brain tissue was alleviated in the acupuncture group and the acupuncture + agonist group, and the percentage of iron depositiondecreased in the cortex and hippocampus (P<0.01). The mitochondrial structure was relatively clear, the mitochondrial cristae were fractured or reduced mildly in the acupuncture group and the acupuncture + agonist group. The levels of Fe2+ and MDA, as well as the mean flourscence intensity of ROS were lower (P<0.01) and the level of GSH was higher (P<0.01) in the acupuncture group. The mean fluorescence intensity of ROS were dropped (P<0.01) in the acupuncture + agonist group. The mRNA expression of GPX4 and SLC7A11 was elevated (P<0.01) and that of p53 was reduced (P<0.01, P<0.05) in either the acupuncture group or the acupuncture + agonist group; the protein expression of GPX4 and SLC7A11 rose (P<0.05, P<0.01) and that of p53 was dropped (P<0.01) in the acupuncture group; and the protein expression of p53 was also lower in the acupuncture + agonist group (P<0.05). When compared with the agonist group, in the acupuncture + agonist group, neurological deficit score increased (P<0.01), the percentage of cerebral infarction volume decreased (P<0.01), the pathological brain tissue damage was reduced, the percentage of iron deposition in cortex and hippocampus decreased (P<0.01), the mitochondrial structure was relatively clear and the cristae broken or reduced slightly; the levels of Fe2+ and MDA, as well as the mean fluorescence intensity of ROS were dropped (P<0.01), while the level of GSH increased (P<0.05); the mRNA and protein expression of GPX4 and SLC7411 was elevated (P<0.01, P<0.05), and that of p53 reduced (P<0.01). In comparison with the acupuncture + agonist group, in the acupuncture group, the neurological deficit score increased (P<0.05), the percentage of cerebral infarction volume decreased (P<0.05), the pathological brain tissue damage was alleviated, the percentage of iron deposition in cortex and hippocampus decreased (P<0.01), the mitochondrial structure was normal in tendency; the levels of Fe2+ and MDA, as well as the mean fluorescence intensity of ROS were reduced (P<0.05), while the level of GSH rose (P<0.01); the mRNA and protein expression of GPX4 and SLC7411 was elevated (P<0.01, P<0.05), and that of p53 reduced (P<0.01, P<0.05).
CONCLUSION
Xingnao Kaiqiao acupuncture can alleviate neurological damage in CIRI rats, which is obtained probably by inhibiting ferroptosis through p53/SLC7A11/GPX4 pathway.
Animals
;
Reperfusion Injury/metabolism*
;
Male
;
Acupuncture Therapy
;
Rats
;
Tumor Suppressor Protein p53/genetics*
;
Brain Ischemia/metabolism*
;
Rats, Wistar
;
Signal Transduction
;
Humans
;
Phospholipid Hydroperoxide Glutathione Peroxidase/genetics*
;
Disease Models, Animal
;
Acupuncture Points
;
Amino Acid Transport System y+/genetics*
5.Alzheimer's disease diagnosis among dementia patients via blood biomarker measurement based on the AT(N) system.
Tianyi WANG ; Li SHANG ; Chenhui MAO ; Longze SHA ; Liling DONG ; Caiyan LIU ; Dan LEI ; Jie LI ; Jie WANG ; Xinying HUANG ; Shanshan CHU ; Wei JIN ; Zhaohui ZHU ; Huimin SUI ; Bo HOU ; Feng FENG ; Bin PENG ; Liying CUI ; Jianyong WANG ; Qi XU ; Jing GAO
Chinese Medical Journal 2025;138(12):1505-1507
6.Anti-radiation effects of gene CCND1 activated by low-dose radiation
Dan CAI ; Ying FAN ; Yunqi MO ; Ruixue LIU ; Lei WU ; Jianan MA ; Qi WANG ; Zhenhua QI ; Zhidong WANG
Chinese Journal of Radiological Medicine and Protection 2025;45(9):840-850
Objective:To select low-dose radiation-activated genes with intrinsic radiation protection by developing a model for adaptive responses to low-dose ionizing radiation, in order to explore the mechanisms behind the radiation resistance of the candidate genes.Methods:The cells were divided into adaptive response induction group and whole transcriptome sequencing group. The level of DNA damage was assessed using the γ-H2AX immunofluorescence assay. The low-dose radiation-activated candidate genes with radiation protection were selected through whole transcriptome sequencing and quantitative reverse transcription PCR (RT-qPCR)-based validation. The anti-radiation effect of candidate gene CCND1 was assessed based on CCK-8 cell proliferation and γ-H2AX immunofluorescence assay. After up- and down-regulation of CCND1 expression, the anti-radiation mechanism of CCND1 was preliminarily explored through transcriptome sequencing analysis.Results:A model for low-dose ionizing radiation-induced adaptive responses of lymphocytes was constructed. Using this model, six candidate genes with radiation protection, including CCND1, ZMAT3, MGAT3, DFFB, CYP4F2, ITGA6, were selected. Compared to the control group, overexpressed CCND1 led to significantly enhanced proliferation ability of AHH-1 cells ( t = 7.92-14.76, P < 0.05) and distinctly lowered level of DNA damage ( t = 2.79-9.68, P < 0.05) after 2 Gy of X-ray irradiation. Furthermore, compared to the control group, the CCND1 knockdown caused significantly decreased cell proliferation ability ( t = 13.58-26.25, P < 0.05) and notably elevated level of DNA damage of cells ( t = 2.87-7.61, P < 0.05). Transcriptome sequencing revealed that up- and down-regulation of CCND1 expression resulted in the activation of pathways related to cell growth, death, and damage repair. Conclusions:By selecting six low-dose-activated candidate genes with radiation protection and revealing the function of CCND1 in radiation protection, this study provides a new perspective for the development of radiation protection agents from the perspective of adaptive responses to low-dose radiation.
7.Prevalence and risk factors of insomnia in Air Force servicemen deployed to highland areas
Jin WANG ; Jiajia LIU ; Xuemin LIAO ; Jin ZHOU ; Huai JIANG ; Dan HE ; Jianlin QI
Chinese Mental Health Journal 2025;39(11):962-969
Objective:To explore the prevalence and risk factors of insomnia in Chinese Air Force servicemen deployed to highland areas.Methods:A total of 718 Air Force servicemen deployed to Qinghai-Tibetan plateau were recruited at May 2024.Sleep quality was assessed with the Pittsburgh Sleep Quality Index.Social-demograph-ic,military service,and psychological characteristics were measured with a self-administered general question-naire.Bivariable and multivariable logistic regressions were performed to identify independent risk factors.Missing data were handled by the multiple imputation.Results:The average sleep duration was(6.9±1.2)h and the aver-age PSQI score was(5.9±4.1).Totally 53.8%of participants experienced clinically significant insomnia.The multivariable analysis revealed that age≥35(aOR=4.07,95%CI=1.11-17.76),stressful event(aOR=3.27,95%CI=2.00-5.49),dysfunctional sleep beliefs and attitudes(aOR=2.59,95%CI=1.75-3.85),and caffeine product usage(aOR=1.69,95%CI=1.17-2.43)were risk factors for insomnia,while Tibetan-indigenous ethnic(aOR=0.44,95%CI=0.20-0.91),higher perceived social support(aOR=0.96,95%CI=0.96-0.99),and positive coping style(aOR=0.96,95%CI=0.93-0.99)were protective factors.Conclusion:Air force service-men deployed to highland areas have sufficient sleep time,but reduced sleep quality.Age,exposed to stress event during deployment,dysfunctional sleep beliefs and attitudes,and caffeine product usage are risk factors for insomni-a,while Tibetan-indigenous ethnic,higher perceived social support and positive coping style act as protective fac-tors.
8.Prevalence and risk factors of insomnia in Air Force servicemen deployed to highland areas
Jin WANG ; Jiajia LIU ; Xuemin LIAO ; Jin ZHOU ; Huai JIANG ; Dan HE ; Jianlin QI
Chinese Mental Health Journal 2025;39(11):962-969
Objective:To explore the prevalence and risk factors of insomnia in Chinese Air Force servicemen deployed to highland areas.Methods:A total of 718 Air Force servicemen deployed to Qinghai-Tibetan plateau were recruited at May 2024.Sleep quality was assessed with the Pittsburgh Sleep Quality Index.Social-demograph-ic,military service,and psychological characteristics were measured with a self-administered general question-naire.Bivariable and multivariable logistic regressions were performed to identify independent risk factors.Missing data were handled by the multiple imputation.Results:The average sleep duration was(6.9±1.2)h and the aver-age PSQI score was(5.9±4.1).Totally 53.8%of participants experienced clinically significant insomnia.The multivariable analysis revealed that age≥35(aOR=4.07,95%CI=1.11-17.76),stressful event(aOR=3.27,95%CI=2.00-5.49),dysfunctional sleep beliefs and attitudes(aOR=2.59,95%CI=1.75-3.85),and caffeine product usage(aOR=1.69,95%CI=1.17-2.43)were risk factors for insomnia,while Tibetan-indigenous ethnic(aOR=0.44,95%CI=0.20-0.91),higher perceived social support(aOR=0.96,95%CI=0.96-0.99),and positive coping style(aOR=0.96,95%CI=0.93-0.99)were protective factors.Conclusion:Air force service-men deployed to highland areas have sufficient sleep time,but reduced sleep quality.Age,exposed to stress event during deployment,dysfunctional sleep beliefs and attitudes,and caffeine product usage are risk factors for insomni-a,while Tibetan-indigenous ethnic,higher perceived social support and positive coping style act as protective fac-tors.
9.Consistency of claudin 18.2 expression with antibodies of different clones in gastric adenocarcinoma
Chaoshan WANG ; Dan ZHANG ; Xin ZHANG ; Fangcen LIU ; Qianyun SHI ; Hongyan WU ; Hongping XIA ; Qi SUN ; Lin LI
Chinese Journal of Pathology 2025;54(11):1144-1149
Objective:To explore the consistency of claudin 18.2 immunohistochemistry (IHC) using 4 different clone antibodies in gastric adenocarcinoma.Methods:A total of 226 gastric adenocarcinomas diagnosed and treated at the Drum Tower Hospital Affiliated to Nanjing University Medical College between January 2022 to March 2023 were included in this study. The cohort consisted of 165 males and 61 females, with a mean age of (61.3±12.1) years. Tumor tissues from radical resection specimens were collected for tissue microarrays. IHC detection of claudin 18.2 was performed using the EnVision method, utilizing 4 clones of antibody: OTIR157B5, 43-14A, EPR19202 and D313D22. The results were interpreted based on both the intensity of staining on tumor cell membranes and the percentage of positive tumor cells relative to the total tumor cells.Results:The positive cutoff value was set as moderately to strongly linear membrane staining in ≥75% of all viable invasive tumor cells, and clone OTIR157B5 demonstrated the highest positive expression rate at 52.2% (118/226). Additionally, the clones OTIR157B5, 43-14A, and EPR19202 were consistently and strongly positive, with all agreement rates of Cohen κ exceeding 0.8. In gastric adenocarcinoma and its three Lauren subtypes, OTIR157B5 exhibited clear membranous localization.Conclusions:Clone OTIR157B5 of claudin 18.2 antibody shows the highest rate of moderately to strongly linear membrane-positive staining, accounting for ≥75% of all viable invasive tumor cells, and clones 43-14A and EPR19202 show strong consistency and high sensitivity.
10.The efficacy of different surgical approaches in full-endoscopic treatment for degenerative lumbar lateral recess stenosis:A propensity score-matched cohort study
Ran LIU ; Dan CHEN ; Yingzhao QI ; Jiayu WANG ; Zhixin LIU
The Journal of Practical Medicine 2025;41(22):3544-3551
Objective To compare the clinical efficacy of the transforaminal endoscopic lumbar discectomy(TELD)approach with that of the interlaminar endoscopic lumbar discectomy(IELD)approach,both performed using a single-channel spinal endoscope,in the treatment of L4-L5 degenerative lumbar lateral recess stenosis(DLLRS).Methods A retrospective analysis was conducted on 78 patients with L4-L5 DLLRS who underwent single-channel endoscopic spinal surgery at our institution between March 2020 and March 2024.Patients were classified into the TELD group(lateral transforaminal approach,n=34)and the IELD group(interlaminar approach,n=44).Propensity score matching(PSM)was performed in a 1∶1 ratio using age,sex,body mass index(BMI),and duration of symptoms as covariates,yielding 25 matched pairs for final comparative analysis.Perioperative outcomes were systematically compared between groups.Visual analog scale(VAS)scores for low back pain and leg pain,as well as the Oswestry Disability Index(ODI),were evaluated preoperatively and at 3 days,3 months,6 months,and 1 year postoperatively.Lumbar computed tomography(CT)scans obtained 3 days after surgery were used to measure the lateral recess angle(LRA)and assess the extent of decompression.Spinal stability was evaluated using dynamic lumbar radiographs at 3 months postoperatively.Clinical outcomes were assessed 1 year after surgery based on the modified MacNab criteria.Results Both groups showed significant reductions in VAS scores for low back and leg pain,as well as in ODI scores,at all postoperative time points compared to baseline values(P<0.05).However,no statistically significant differences were observed between the two groups(P>0.05).Lumbar CT scans performed on postoperative day 3 demonstrated a significant increase in LRA in both groups relative to preoperative measurements(P<0.05).Although the magnitude of increase was greater in the IELD group,the intergroup difference did not reach statistical significance(P>0.05).At 3 months postoperatively,dynamic lumbar radiographs revealed no deterioration in spinal stability in either group compared to preoperative conditions,with no significant difference between groups(P>0.05).According to the modified MacNab criteria at 1 year postoperatively,the excellent and good outcome rate was 88.0%in the TELD group and 92.0%in the IELD group,with no statistically significant difference between the groups(P>0.05).Conclusions Both the TELD and IELD techniques are safe and effective for managing L4-L5 DLLRS,yielding comparable clini-cal outcomes.The selection of surgical approach should be guided by the anatomical location of ventral disc protru-sions,as well as the degree of facet joint hypertrophy and neural compression.


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