BACKGROUND:It has been proved clinically that adhesion of fibrous scar with the dura mater or nerve root after lumbar operation is an important factor for postoperative symptoms,such as postoperative pain and numbness. OBJECTIVE:To verify the inhibitory effect of autologous ligamentum flavum on the formation of epidural fibrous scar after lumbar surgery and explore the possible molecular biological mechanism. METHODS:Forty-eight Japanese white rabbits(6-8 months old)were randomly divided into three groups:a ligamentum flavum preservation group,a ligamentum flavum non-preservation group,and an autologous fat reposition group.A lumbar laminectomy model was established in all the three groups of rabbits,and rabbit epidural tissues were collected at 3 and 6 weeks after modeling.Hematoxylin-eosin staining was used to observe histological changes and the number and density of fibroblasts,VG staining was used to observe the percentage of collagen fiber area,and immunohistochemistry was used to observe the expression of transforming growth factor β1 and Smad3 proteins. RESULTS AND CONCLUSION:Hematoxylin-eosin staining results revealed that fibroblasts in the ligamentum flavum preservation group were few and loosely arranged,while the cells in the ligamentum flavum non-preservation and autologous fat reposition groups were more numerous and closely arranged.The number density of fibroblasts in the ligamentum flavum preservation group was lower than that in the ligamentum flavum non-preservation and autologous fat reposition groups at 3 and 6 weeks after surgery(P＜0.05);however,there was no significant difference between the latter two groups.VG staining results showed that the collagen fibers in the ligamentum flavum preservation group were sparse and distributed unevenly,while a lot of red collagen fibers were gathered in the ligamentum flavum non-preservation and autologous fat reposition groups.The area percentage of collagen fibers in the ligamentum flavum preservation group was lower than that in the ligamentum flavum non-preservation and autologous fat reposition groups at 3 and 6 weeks after surgery(P＜0.05),but there was no significant difference between the latter two groups.The results of immunohistochemistry showed that the degree of positive staining of retained histone the ligamentum flavum preservation group was significantly lower than that of the other two groups.The absorbance value of transforming growth factor β1 and Smad3 in the ligamentum flavum preservation group was significantly lower than that in the other two groups at 3 and 6 weeks after surgery(P＜0.05),but there was no significant difference between the latter two groups.To conclude,there are different degrees of epidural fibrous scar formation after lumbar surgery.If the ligamentum flavum is preserved,it can help to reduce the number of epidural fibroblasts as well as the formation of collagen fibers,thus reducing the adhesion of the fibrous scar tissue to the dural sac and nerve root.The mechanism is not only a purely mechanical blockade,but also to reduce the formation of epidural fibrous scar by interfering with the transforming growth factor β1/Smad3 signaling pathway.

Aim To investigate the protective and reparative effect of empagliflozin on oxidized-low density lipo-protein(ox-LDL)-induced injury in human umbilical vein endothelial cells(HUVEC)and its mechanism of action.Methods Primary HUVEC were cultured in vitro.ox-LDL was used to induce HUVEC injury model,and the cell sur-vival rate was measured by CCK-8 assay.EDU method was used to detect cell proliferation.Western blot was used to detect the protein levels of Ki-67,Bcl-2,cleaved Caspase-3,Bax,endothelial nitric oxide synthase(eNOS),intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule 1(VCAM-1)and epidermal growth factor receptor(EGFR)in HUVEC.RT-qPCR was used to detect the mRNA expression levels of interleukin-6(IL-6)and tumor necro-sis factor-α(TNF-α)in HUVEC.Using Swiss targets,GeneCards databases,gene ontology(GO)and Kyoto encyclope-dia of genes and genomes(KEGG),protein-protein interaction(PPI)network analysis,and ClickDocking(https://mcule.com/apps/1-click-docking/)to predict the target of empagliflozin.Results CCK-8 results showed that 0.025 μmol/L empagliflozin significantly alleviated ox-LDL-induced HUVEC injury(P＜0.01).EDU results showed that ox-LDL treatment for 24 h significantly inhibited the proliferation of HUVEC(P＜0.01),while empagliflozin treatment sig-nificantly alleviated the inhibition of cell proliferation(P＜0.01).The results of Western blot showed ox-LDL treatment significantly decreased the protein expression levels of Ki-67,Bcl-2,and eNOS,and increased the protein expression levels ofcleaved Caspase-3,Bax,ICAM-1,and VCAM-1 in HUVEC(all P＜0.05).However,empagliflozin treatment reversed these changes(all P＜0.05).RT-qPCR results showed that ox-LDL treatment increased the mRNA expression levels of IL-6 and TNF-α in HUVEC(P＜0.01),while empagliflozin treatment decreased their expression levels(P＜0.05).However,after adding EGFR agonist NSC 228155,the protective effect of empagliflozin against ox-LDL-mediated HUVEC injury was significantly reversed(P＜0.05).Conclusion Empagliflozin can significantly reduce ox-LDL-in-duced HUVEC injury,which may be related to EGFR signaling pathway.

Aim To investigate the protective and reparative effect of empagliflozin on oxidized-low density lipo-protein(ox-LDL)-induced injury in human umbilical vein endothelial cells(HUVEC)and its mechanism of action.Methods Primary HUVEC were cultured in vitro.ox-LDL was used to induce HUVEC injury model,and the cell sur-vival rate was measured by CCK-8 assay.EDU method was used to detect cell proliferation.Western blot was used to detect the protein levels of Ki-67,Bcl-2,cleaved Caspase-3,Bax,endothelial nitric oxide synthase(eNOS),intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule 1(VCAM-1)and epidermal growth factor receptor(EGFR)in HUVEC.RT-qPCR was used to detect the mRNA expression levels of interleukin-6(IL-6)and tumor necro-sis factor-α(TNF-α)in HUVEC.Using Swiss targets,GeneCards databases,gene ontology(GO)and Kyoto encyclope-dia of genes and genomes(KEGG),protein-protein interaction(PPI)network analysis,and ClickDocking(https://mcule.com/apps/1-click-docking/)to predict the target of empagliflozin.Results CCK-8 results showed that 0.025 μmol/L empagliflozin significantly alleviated ox-LDL-induced HUVEC injury(P＜0.01).EDU results showed that ox-LDL treatment for 24 h significantly inhibited the proliferation of HUVEC(P＜0.01),while empagliflozin treatment sig-nificantly alleviated the inhibition of cell proliferation(P＜0.01).The results of Western blot showed ox-LDL treatment significantly decreased the protein expression levels of Ki-67,Bcl-2,and eNOS,and increased the protein expression levels ofcleaved Caspase-3,Bax,ICAM-1,and VCAM-1 in HUVEC(all P＜0.05).However,empagliflozin treatment reversed these changes(all P＜0.05).RT-qPCR results showed that ox-LDL treatment increased the mRNA expression levels of IL-6 and TNF-α in HUVEC(P＜0.01),while empagliflozin treatment decreased their expression levels(P＜0.05).However,after adding EGFR agonist NSC 228155,the protective effect of empagliflozin against ox-LDL-mediated HUVEC injury was significantly reversed(P＜0.05).Conclusion Empagliflozin can significantly reduce ox-LDL-in-duced HUVEC injury,which may be related to EGFR signaling pathway.

Objective: To evaluate the differences of serum total light chain(sTLC), urine total light chain(uTLC) and serum free light chain(sFLC) in different stages of chronic kidney disease(CKD) and their correlation with renal function indexes. To investigate the predictive value of light chain indexes in CKD staging. Methods: 292 patients with CKD were analyzed retrospectively, and plasma cell diseases, acute kidney injury and tumor diseases were excluded. According to the estimated glomerular filtration rate(eGFR), CKD patients were divided into five groups from CKD 1 stage to CKD 5 stage. The levels of sTLC, uTLC, sFLC and corresponding biochemical indexes of CKD patients were detected, and the differences and correlations among the indexes of each group were compared. The receiver operating curve(ROC curve) was used to analyze the predictive value of each light chain index in CKD stage, with CKD1-2 stage combined as control group and CKD3-5 stage combined as case group. Results: There was no significant difference in sTLC κ, sTLC λ, sTLC κ/λ and sFLC κ/λ among CKD1-5 stage(P>0.05). There were significant differences between sFLC κ, sFLC λ and uTLC κ, uTLC λ among CKD1-5 stage(P<0.05), which increased with the increase of CKD staging. The correlation between sFLC κ, sFLC λ and serum creatinine(Scr), blood urea nitrogen(BUN), eGFR were better than uTLC κ, uTLC λ(P<0.001). The sTLC κ, sTLC λ, sTLC κ/λ and sFLC κ/λ had no correlation with renal function indexes(P>0.05). The best critical points of sFLC κ and sFLC λ for predicting CKD3-5 stage were 35.4 mg/L and 52.8 mg/L, and AUC was 0.916(0.883-0.949) and 0.915(0.881-0.949), which were higher than uTLC κ and uTLC λ,AUC was 0.811(0.754-0.869) and 0.787(0.728-0.846), respectively. Conclusion With the increase of CKD staging, the levels of sFLC and uTLC gradually increase. The sFLC and uTLC can effectively predict patients with CKD3 and above, which has an important reference value in stratified management of patients with CKD.

Objective To investigate the effects of non-Newtonian properties on hemodynamic characteristics of Fontan procedure in computational simulation. Methods A Fontan vascular model was reconstructed based on patient-specific medical images. The boundary conditions were set according to velocity profiles measured by real-time echocardiography. The Newtonian model and two non-Newtonian (Casson and Carreau) models were applied to analyze the hemodynamic parameters, including flow ratio (FR), energy loss (EL), wall shear stress (WSS) as well as non-Newtonian importance factor, so as to compare flow differences between the Newtonian model and non-Newtonian models. Results The rheological models had small effects on the FR. The EL of non-Newtonian models was higher than that of the Newtonian model, and the EL of Casson model was the highest. Flow recirculation and flow disturbance accompanied with low WSS were observed in inferior vena cava (IVC). At low inflow velocity, flow disturbance in IVC of Newtonian model was more obvious. The calculations of non-Newtonian importance factor suggested significant non-Newtonian viscosity in IVC. Conclusions Non-Newtonian viscosity is significant in IVC where low velocity and flow recirculation are observed. Non-Newtonian properties of the blood should be considered in patient-specific hemodynamic simulation of Fontan procedure.

This article reviewed and summarized the experimental researches on the treatment of gouty arthritis (GA) with traditional Chinese medicine in recent years, which showed that the traditional or modified animal models of disease were widely used, and also concerned about the the model of integrating the disease and symptoms. However, few are about the application of combined disease and syndromes model. The mechanism research result shows that, single Chinese herb, component extract of Chinese herbs and Chinese herbal compound all play an important role in inhibiting inflammation, regulating signal pathway, anti-oxidation, reducing uric acid, increasing feeling of pain and regulating body metabolism.

Objective: To investigate the association between the preterm birth and low birth weight and parental thalassemia. Methods: Pregnant women and their husbands receiving prenatal examination in local hospitals or maternal and child health centers in Jingxi and Debao in Guangxi from January to December 2017 were selected as study subjects. A total of 758 pregnant women with pregnancy outcomes and their husbands, who were both or alone diagnosed with thalassemia through thalassemia gene detection, were selected as case group and 758 pregnant women with pregnancy outcomes and their husbands, who were negative in thalassemia gene detection and hemoglobin electrophoresis test were selected as control groups. The case group were further divided into mother group, father group and both mother and farther group. Clinical and pregnancy outcome data of the study subjects were collected for the analysis on the association between parental thalassaemia and preterm birth or low birth weight by the independent sample t test, χ² test and Cox regression analysis. Results: The incidence of preterm birth in case group and control group was about 6.5% and 1.6% and the incidence of low birth weight in case group and control group was about 7.3% and 0.8%. After adjusting for possible confounding factors, Cox regression analysis results showed that mother suffering from thalassemia (aRR=3.45, 95%CI: 1.35-8.81, P=0.010), fathers suffering from thalassemia (aRR=4.93, 95%CI: 2.16-11.21, P<0.001) and both mother and farther suffering from thalassemia (aRR=5.13, 95%CI: 2.62-10.04, P<0.001) were associated with preterm birth. Mother suffering from thalassemia (aRR=12.98, 95%CI: 4.91-34.30, P<0.001), fathers suffering from thalassemia (aRR=9.40, 95%CI: 3.40-25.95, P<0.001) and both mother and farther suffering from thalassemia (aRR=10.74, 95%CI: 4.44-26.00, P<0.001) were associated with low birth weight. The newborn whose parent all suffered from thalassemia had higher risks for preterm birth (χ²=22.72, P<0.001)and low birth weight (χ²=34.03, P<0.001) compared with those only with mother or father suffering from thalassemia. Conclusion Parental thalassaemia, including both sides and single side, might increase the risks of preterm birth and low birth weight for newborn, and the risks might be higher in newborn with both mother and father suffering from thalassaemia.

One patient with chronic refractory wound in right lower leg was admitted to our department in June 2017, which experienced repeated ulceration for 4 years. On 4 days post admission, two bamboo sticks were taken out from the deep muscle of the right lower leg. The wound was repaired by perforator flap of posterior tibial artery in the right lower leg. The donor site was covered with split-thickness skin in the upper leg of the same side. On 7 days post operation, the flap and skin graft survived. During follow-up of 12 months, the flap had good appearance. This case suggests that the first thing for the treatment of chronic refractory wound is to find out the cause of wound.

Objective To study the clinic significance of allergen serum immunoglobulin E (IgE) detection for the flying personnel with allergic rhinitis.Methods One hundred and twentyeight flying personnel with clinically suspected allergic rhinitis were drawn 2 ml venous blood.Serum tIgE (total IgE) and 14 allergen sIgE (specific IgE) including 7 aspiration allergens and 7 food allergens were detected with antibody kit.Strong positive reaction rates of the flying personnel with aspiration allergens and food allergens were compared as well as the correlation of serum tIgE and positive reaction rate of allergen sIgE was analyzed.Results Positive reaction rate of tIgE in 128 flying personnel with allergic rhinitis was 85.9 ％ (110/128) and positive reaction rate of sIgE was 91.4％ (117/128).The top 3 positive reaction rates of aspiration allergens were dust mite (66.4％),tree combination (32.8％) and house dust (23.4％).The top 3 positive reaction rates of food allergens were fruit combination (mango/pineapple/apple/peach/strawberry) (18.0％),seafood combination (shrimp/crab/scallop) (16.4％) and fish combination (ling/trout/weever) (13.3％).Positive response rate of the flying personnel with both aspiration and food allergens was 12.5 ％ (16/128).The aspiration allergens mainly reflected as strong positive reaction while the food allergens mainly expressed as weakly positive reaction.The strong positive reaction showed significance between aspiration and food allergens.(x2=16.881,P＜0.05).The strong positive reaction of allergen serum had the positive correlation to tIgE value (r=0.517,P＜0.01).Conclusions The allergen serum IgE detection have shown its objective,accurate and noninvasive advantages and are with less age,disease,medication,manipulation and other external limitations.The test results can be quantitatively or semi-quantitatively expressed and can determine tIgE level within the detection.So it has certain clinical significance on diagnosis,treatment,evaluation and prevention for the flying personnel with allergic rhinitis.

Objective To study the clinic significance of allergen serum immunoglobulin E (IgE) detection for the flying personnel with allergic rhinitis.Methods One hundred and twentyeight flying personnel with clinically suspected allergic rhinitis were drawn 2 ml venous blood.Serum tIgE (total IgE) and 14 allergen sIgE (specific IgE) including 7 aspiration allergens and 7 food allergens were detected with antibody kit.Strong positive reaction rates of the flying personnel with aspiration allergens and food allergens were compared as well as the correlation of serum tIgE and positive reaction rate of allergen sIgE was analyzed.Results Positive reaction rate of tIgE in 128 flying personnel with allergic rhinitis was 85.9 ％ (110/128) and positive reaction rate of sIgE was 91.4％ (117/128).The top 3 positive reaction rates of aspiration allergens were dust mite (66.4％),tree combination (32.8％) and house dust (23.4％).The top 3 positive reaction rates of food allergens were fruit combination (mango/pineapple/apple/peach/strawberry) (18.0％),seafood combination (shrimp/crab/scallop) (16.4％) and fish combination (ling/trout/weever) (13.3％).Positive response rate of the flying personnel with both aspiration and food allergens was 12.5 ％ (16/128).The aspiration allergens mainly reflected as strong positive reaction while the food allergens mainly expressed as weakly positive reaction.The strong positive reaction showed significance between aspiration and food allergens.(x2=16.881,P＜0.05).The strong positive reaction of allergen serum had the positive correlation to tIgE value (r=0.517,P＜0.01).Conclusions The allergen serum IgE detection have shown its objective,accurate and noninvasive advantages and are with less age,disease,medication,manipulation and other external limitations.The test results can be quantitatively or semi-quantitatively expressed and can determine tIgE level within the detection.So it has certain clinical significance on diagnosis,treatment,evaluation and prevention for the flying personnel with allergic rhinitis.