1.Current awareness and optimization recommendations regarding the pneumonia with unknown etiology surveillance system among healthcare professionals in Shanghai
Qiwen FANG ; Chenyan JIANG ; Xin CHEN ; Huanyu WU ; Bihong JIN ; Xiaohuan GONG ; Shenghua MAO ; Qi QIU ; Ruobing HAN ; Huilin SHI ; Wenbin DONG ; Xin HU ; Jian CHEN ; Yaxu ZHENG
Shanghai Journal of Preventive Medicine 2026;38(6):482-487
ObjectiveTo investigate the current awareness and optimization recommendations on pneumonia with unknown etiology (PUE) surveillance among Shanghai healthcare professionals, and to provide evidence for the improvement of the surveillance system. MethodsIn December 2024, healthcare professional participants from diverse medical and health institutions were randomly selected within each stratum using a stratified cluster sampling method in all 16 districts of Shanghai for questionnaire surveys on their knowledge and suggestions for optimization of the PUE surveillance system. Descriptive statistics analyses, multivariate logistic regressions, and content analyses were used for data analyses. ResultsA total of 385 survey subjects were involved in the study, including 119 professional staffs from disease prevention and control centers and 266 from medical institutions. Those who understood the case definition for PUE correctly accounted for 67.01% (258/385). Multivariate regression model analyses showed that female gender (aOR=2.22, 95%CI: 1.36‒3.66), professionals from disease control institutions (aOR=2.02, 95%CI: 1.12‒3.72), and those who self-assessed as being familiar with the monitoring system (aOR=2.18, 95%CI:1.23‒3.89) had better understanding of the definition. Overall, 89.61% (345/385) of the survey subjects acknowledged the necessity of the surveillance system. Small number of cases meeting the case definition (54.46%, 214/379), insufficient diagnostic awareness (39.84%, 151/379), and lack of incentives for case reporting (29.29%, 111/379) were major problems for the current surveillance system, with variations observed across different types of institutions. Suggested segments for optimizing the surveillance system included monitoring purpose, case definition, form of monitoring and reporting procedure, organization mechanism, and epidemiological investigation and response. ConclusionThe necessity of PUE surveillance is commonly recognized among healthcare workers. However, the existing system falls short in terms of mastery of case definition and overall surveillance adaptability. There is an urgent need for optimization and improvement to enhance the capacity for preventing and controlling emerging and sudden respiratory infectious diseases.
2.Effect of Heat-Sensitive Moxibustion on Apoptosis of Gastric Mucosal Tissue in Chronic Atrophic Gastritis Model Rats:Based on PI3K/Akt Signaling Pathway
Qi ZHANG ; Yanping ZHOU ; Qide WANG ; Shujuan CHEN ; Yu SUN ; Fang LI ; Hongbin GONG ; Mingjun XIE ; Hui LIU ; Haifeng ZHANG
Journal of Traditional Chinese Medicine 2026;67(15):1650-1658
ObjectiveTo investigate the potential mechanism of heat-sensitive moxibustion on chronic atrophic gastritis (CAG) through the phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) signaling pathway. MethodsFifty-eight SD rats were randomly divided into blank group (n=14) and modeling group (n=44). Rats in the blank group were fed routinely, while the rats in the modeling group received drinking water containing 1-methyl-3-nitro-1-nitrosoguanidine (MNNG) at a concentration of 140 μg/ml, combined with irregular fasting and feeding for 12 weeks to establish CAG model. After successful modeling, the rats were randomly divided into model group (n=10), inhibitor group (n=10) and moxibustion group (n=20). After 40 minutes of suspended moxibustion at "Zhongwan" (CV 12) daily, the rats in the moxibustion group were divided into heat-sensitive moxibustion group (n=10) and non-heat-sensitive moxibustion group (n=9) according to the change of tail temperature during moxibustion. The inhibitor group was bound for 40 minutes daily, and then administered with PI3K/Akt signaling pathway inhibitor, rapamycin solution, by gavage at a dose of 1 mg/kg. The model group received intragastric administration of 1 ml/kg normal saline after 40 minutes of restraint stress each day. All interventions were administered once daily for 28 consecutive days, while the blank group received no intervention. After the intervention finished, the body weight of rats in each group was compared. HE staining was used to observe the histopathological changes of gastric mucosa. The apoptosis-positive rate of gastric mucosal cells was detected by TUNEL assay. Immunohistochemistry was performed to determine the protein levels of matric metalloproteinase-7 (MMP7), vascular endothelial growth factor A (VEGFA) and epidermal growth factor receptor (EGFR) in gastric mucosa. The mRNA expression levels of PI3K, Akt and mammalian target of rapamycin (mTOR) in gastric mucosal tissues were detected by qPCR. The protein levels of phosphorylated Akt (p-Akt) and phosphorylated mTOR (p-mTOR) in rat gastric mucosal tissues were measured by Western Blotting. ResultsCompared to the blank group, rats in all other groups exhibited decreased body weight, significantly increased gastric mucosal cell apoptosis-positive rates, elevated protein levels of MMP7, VEGFA and EGFR in gastric mucosa, increased mRNA expression levels of PI3K, Akt and mTOR, and enhanced protein expression levels of p-Akt and p-mTOR (P<0.05 or P<0.01). Histopathological examination revealed thinning of the gastric mucosa, glandular disorganization and atrophy, accompanied by intestinal metaplasia.Compared to the model group, the heat-sensitive moxibustion group, the non-heat-sensitive moxibustion group and the inhibitor group all showed significant improvements in the above-mentioned indicators (P<0.05 or P<0.01). Compared to the heat-sensitive moxibustion group, the non-heat-sensitive moxibustion group and the inhibitor group exhibited increased positive rates of gastric mucosal cell apoptosis; the non-heat-sensitive moxibustion group showed increased protein levels of MMP7, VEGFA and EGFR, as well as mRNA expression levels of PI3K, Akt and mTOR, and protein expressions of p-Akt and p-mTOR; the inhibitor group exhibited elevated protein expression level of EGFR (P<0.05 or P<0.01). Histopathological examination showed that the gastric mucosal glands in the heat-sensitive moxibustion group were arranged more regularly, with an approximately normal structural appearance. ConclusionHeat-sensitive moxibustion can improve the body weight of CAG rats and repair gastric mucosal injury. Its therapeutic effects may be mediated by inhibiting excessive activation of gastric mucosal PI3K/Akt signaling pathway, thereby reducing gastric mucosal cell apoptosis.
3.Effect of Heat-Sensitive Moxibustion on Apoptosis of Gastric Mucosal Tissue in Chronic Atrophic Gastritis Model Rats:Based on PI3K/Akt Signaling Pathway
Qi ZHANG ; Yanping ZHOU ; Qide WANG ; Shujuan CHEN ; Yu SUN ; Fang LI ; Hongbin GONG ; Mingjun XIE ; Hui LIU ; Haifeng ZHANG
Journal of Traditional Chinese Medicine 2026;67(15):1650-1658
ObjectiveTo investigate the potential mechanism of heat-sensitive moxibustion on chronic atrophic gastritis (CAG) through the phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) signaling pathway. MethodsFifty-eight SD rats were randomly divided into blank group (n=14) and modeling group (n=44). Rats in the blank group were fed routinely, while the rats in the modeling group received drinking water containing 1-methyl-3-nitro-1-nitrosoguanidine (MNNG) at a concentration of 140 μg/ml, combined with irregular fasting and feeding for 12 weeks to establish CAG model. After successful modeling, the rats were randomly divided into model group (n=10), inhibitor group (n=10) and moxibustion group (n=20). After 40 minutes of suspended moxibustion at "Zhongwan" (CV 12) daily, the rats in the moxibustion group were divided into heat-sensitive moxibustion group (n=10) and non-heat-sensitive moxibustion group (n=9) according to the change of tail temperature during moxibustion. The inhibitor group was bound for 40 minutes daily, and then administered with PI3K/Akt signaling pathway inhibitor, rapamycin solution, by gavage at a dose of 1 mg/kg. The model group received intragastric administration of 1 ml/kg normal saline after 40 minutes of restraint stress each day. All interventions were administered once daily for 28 consecutive days, while the blank group received no intervention. After the intervention finished, the body weight of rats in each group was compared. HE staining was used to observe the histopathological changes of gastric mucosa. The apoptosis-positive rate of gastric mucosal cells was detected by TUNEL assay. Immunohistochemistry was performed to determine the protein levels of matric metalloproteinase-7 (MMP7), vascular endothelial growth factor A (VEGFA) and epidermal growth factor receptor (EGFR) in gastric mucosa. The mRNA expression levels of PI3K, Akt and mammalian target of rapamycin (mTOR) in gastric mucosal tissues were detected by qPCR. The protein levels of phosphorylated Akt (p-Akt) and phosphorylated mTOR (p-mTOR) in rat gastric mucosal tissues were measured by Western Blotting. ResultsCompared to the blank group, rats in all other groups exhibited decreased body weight, significantly increased gastric mucosal cell apoptosis-positive rates, elevated protein levels of MMP7, VEGFA and EGFR in gastric mucosa, increased mRNA expression levels of PI3K, Akt and mTOR, and enhanced protein expression levels of p-Akt and p-mTOR (P<0.05 or P<0.01). Histopathological examination revealed thinning of the gastric mucosa, glandular disorganization and atrophy, accompanied by intestinal metaplasia.Compared to the model group, the heat-sensitive moxibustion group, the non-heat-sensitive moxibustion group and the inhibitor group all showed significant improvements in the above-mentioned indicators (P<0.05 or P<0.01). Compared to the heat-sensitive moxibustion group, the non-heat-sensitive moxibustion group and the inhibitor group exhibited increased positive rates of gastric mucosal cell apoptosis; the non-heat-sensitive moxibustion group showed increased protein levels of MMP7, VEGFA and EGFR, as well as mRNA expression levels of PI3K, Akt and mTOR, and protein expressions of p-Akt and p-mTOR; the inhibitor group exhibited elevated protein expression level of EGFR (P<0.05 or P<0.01). Histopathological examination showed that the gastric mucosal glands in the heat-sensitive moxibustion group were arranged more regularly, with an approximately normal structural appearance. ConclusionHeat-sensitive moxibustion can improve the body weight of CAG rats and repair gastric mucosal injury. Its therapeutic effects may be mediated by inhibiting excessive activation of gastric mucosal PI3K/Akt signaling pathway, thereby reducing gastric mucosal cell apoptosis.
4.Association of life skills and psychological resilience with subjective well-being among primary and secondary school students
Chinese Journal of School Health 2026;47(7):962-965
Objective:
To explore the relationship between life skills, psychological resilience and subjective well-being among primary and secondary school students, so as to provide evidence for targeted adolescent mental health education.
Methods:
From September to November, 2025, a total of 5 831 primary and secondary school students from five cities (Beijing, Guangzhou, Shenzhen, Chongqing, Urumqi) were selected by convenience sampling. The Adolescent Subjective Well being Scale, School based Adolescents Life Skills Scale, and Adolescent Psychological Resilience Scale were used for investigation. Data were analyzed using t-tests, one way ANOVA, and linear regression.
Results:
The total mean score of students subjective well being was (5.46± 0.91) ; the total mean score of life skills was (3.69±0.64); the total mean score of psychological resilience was (3.66±0.69). Statistically significant differences in subjective well being scores were found among students grouped by gender, grade, school stage, residential city, living with parents or living with siblings ( t/F =4.14, 53.92, 14.53, 49.99, 13.49, 2.18, all P <0.01). Stratified regression analyses were performed by gender (adjusting for school stage, residential city and living arrangement) and by school stage (adjusting for gender, residential city and living arrangement), the regression results indicated that life skills of boys, girls, primary school students and junior high school students( β =0.54, 0.53, 0.50, 0.57) and their psychological resilience ( β = 0.56 , 0.60, 0.56, 0.60) were positively associated with subjective well being (all P <0.01).
Conclusions
Life skills and psychological resilience may be important protective factors for subjective well being among primary and secondary school students. School based mental health education should emphasize life skills training and resilience building to promote students subjective well being.
5.Therapeutic Study on The Inhibition of Neuroinflammation in Ischemic Stroke by Induced Regulatory T Cells
Tian-Fang KANG ; Ai-Qing MA ; Li-Qi CHEN ; Han GONG ; Jia-Cheng OUYANG ; Fan PAN ; Hong PAN ; Lin-Tao CAI
Progress in Biochemistry and Biophysics 2025;52(4):946-956
ObjectiveNeuroinflammation plays a crucial role in both the onset and progression of ischemic stroke, exerting a significant impact on the recovery of the central nervous system. Excessive neuroinflammation can lead to secondary neuronal damage, further exacerbating brain injury and impairing functional recovery. As a result, effectively modulating and reducing neuroinflammation in the brain has become a key therapeutic strategy for improving outcomes in ischemic stroke patients. Among various approaches, targeting immune regulation to control inflammation has gained increasing attention. This study aims to investigate the role of in vitro induced regulatory T cells (Treg cells) in suppressing neuroinflammation after ischemic stroke, as well as their potential therapeutic effects. By exploring the mechanisms through which Tregs exert their immunomodulatory functions, this research is expected to provide new insights into stroke treatment strategies. MethodsNaive CD4+ T cells were isolated from mouse spleens using a negative selection method to ensure high purity, and then they were induced in vitro to differentiate into Treg cells by adding specific cytokines. The anti-inflammatory effects and therapeutic potential of Treg cells transplantation in a mouse model of ischemic stroke was evaluated. In the middle cerebral artery occlusion (MCAO) model, after Treg cells transplantation, their ability to successfully migrate to the infarcted brain region and their impact on neuroinflammation levels were examined. To further investigate the role of Treg cells in stroke recovery, the changes in cytokine expression and their effects on immune cell interactions was analyzed. Additionally, infarct size and behavioral scores were measured to assess the neuroprotective effects of Treg cells. By integrating multiple indicators, the comprehensive evaluation of potential benefits of Treg cells in the treatment of ischemic stroke was performed. ResultsTreg cells significantly regulated the expression levels of both pro-inflammatory and anti-inflammatory cytokines in vitro and in vivo, effectively balancing the immune response and suppressing excessive inflammation. Additionally, Treg cells inhibited the activation and activity of inflammatory cells, thereby reducing neuroinflammation. In the MCAO mouse model, Treg cells were observed to accumulate in the infarcted brain region, where they significantly reduced the infarct size, demonstrating their neuroprotective effects. Furthermore, Treg cell therapy notably improved behavioral scores, suggesting its role in promoting functional recovery, and increased the survival rate of ischemic stroke mice, highlighting its potential as a promising therapeutic strategy for stroke treatment. ConclusionIn vitro induced Treg cells can effectively suppress neuroinflammation caused by ischemic stroke, demonstrating promising clinical application potential. By regulating the balance between pro-inflammatory and anti-inflammatory cytokines, Treg cells can inhibit immune responses in the nervous system, thereby reducing neuronal damage. Additionally, they can modulate the immune microenvironment, suppress the activation of inflammatory cells, and promote tissue repair. The therapeutic effects of Treg cells also include enhancing post-stroke recovery, improving behavioral outcomes, and increasing the survival rate of ischemic stroke mice. With their ability to suppress neuroinflammation, Treg cell therapy provides a novel and effective strategy for the treatment of ischemic stroke, offering broad application prospects in clinical immunotherapy and regenerative medicine.
6.miR-27a-3p promotes the proliferation of human hypertrophic scar fibroblasts by regulating mitogen-activated protein kinase signaling pathway
Jun LI ; Jingjing GONG ; Guobin SUN ; Rui GUO ; Yang DING ; Lijuan QIANG ; Xiaoli ZHANG ; Zhanhai FANG
Chinese Journal of Tissue Engineering Research 2025;29(8):1609-1617
BACKGROUND:Multiple studies have confirmed that mitogen-activated protein kinase(MAPK)signaling pathway is involved in cell proliferation,and microRNA(miR)is involved in the occurrence and development of hypertrophic scars.Therefore,the role of miR-27a-3p and MAPK signaling pathways in pathological scar formation has been further explored. OBJECTIVE:To explore the effect of miR-27a-3p on the proliferation of human hypertrophic scar fibroblasts through the MAPK signaling pathway. METHODS:The primary fibroblasts were isolated and collected from the skin samples.The primary fibroblasts were observed by inverted microscope and verified by immunofluorescence.The relative expression level of miR-27a-3p in tissues was detected by qRT-PCR.The target genes of hsa-miR-27a-3p were predicted using the database,and then the predicted target genes were enriched by gene ontology function analysis and biological pathway enrichment analysis of the Kyoto Encyclopedia of Genes and Genomes.There were seven groups:blank control,negative control,miR-27a-3p mimic,miR-27a-3p inhibitor,miR-27a-3p mimic+p38 MAPK inhibitor,miR-27a-3p mimic+extracellular regulated protein kinase inhibitor,miR-27a-3p mimic+c-Jun N-terminal kinase inhibitor.Western blot was used to detect the levels of extracellular regulated protein kinase,c-Jun N-terminal kinase inhibitor.and p38 kinase and their phosphorylation levels.Cell counting kit-8 and EdU were used to detect cell proliferation. RESULTS AND CONCLUSION:Compared with normal skin fibroblasts,hypertrophic scar fibroblasts had stronger proliferative activity(P<0.05)and faster proliferation level(P<0.001).Compared with normal skin,miR-27a-3p was highly expressed in hypertrophic scars(P<0.001).Compared with the negative control group,overexpression of miR-27a-3p could promote cell proliferation activity(P<0.001)and proliferation levels(P<0.001).Compared with the negative control group,knockdown of miR-27a-3p could inhibit the proliferation activity(P<0.05)and proliferation levels(P<0.001).Compared with the negative control group,overexpression of miR-27a-3p promoted the phosphorylated levels of extracellular regulated protein kinase,c-Jun N-terminal kinase,and p38 mitogen-activated protein kinase(P<0.05).Compared with the negative control group,knockdown of miR-27a-3p inhibited the phosphorylated levels of extracellular regulated protein kinase,c-Jun N-terminal kinase,and p38 MAPK(P<0.05).Compared with the miR-27a-3p mimic group,specific inhibitors of extracellular regulated protein kinase,c-Jun N-terminal kinase,and p38 MAPK reversed the effects of miR-27a-3p on the proliferative activity(P<0.01)and proliferation level(P<0.001)of fibroblasts.To conclude,these results suggest that miR-27a-3p promotes the proliferation of human hypertrophic scar fibroblasts by activating the MAPK signaling pathway.
7.Buccal Acupuncture Alleviates Postoperative Pain in Patients Undergoing Radical Resection of Gastrointestinal Cancers: A Randomized Controlled Pilot Study.
Zhi-Xin ZHU ; Chen CHEN ; Yong-Feng ZHENG ; Wei-Li GONG ; Zheng CHEN ; Shi-Lei FANG ; Dong-Hua SHAO ; Cai-Xia SUN
Chinese journal of integrative medicine 2025;31(6):558-565
OBJECTIVE:
To preliminarily investigate the effect of buccal acupuncture therapy on ameliorating postoperative pain and enhancing recovery quality among patients undergoing radical resection of gastrointestinal cancers.
METHODS:
Fifty-two participants were randomized at a 1:1 ratio to either the buccal acupuncture or the control group. The acupuncture protocol entailed targeting 5 predetermined acupoints [CA-2 (Upper jiao), CA-3 (Middle jiao), CA-4 (Lower jiao), CA-6 (back), and CA-7 (waist) and two adjustable acupoints [CA-1 (head) and CA-8 (sacrum)] on each side of the face. The outcomes included the Numeric Rating Scale (NRS) scores for each day within 7 days postoperatively, 15-Item Quality of Recovery Scale (QoR-15) scores, analgesics consumption during and after surgery, incidences of postoperative nausea and vomiting, and perioperative levels of interleukin-6 and glucose. Adverse events related to acupuncture were recorded.
RESULTS:
Of the initial 52 participants, 46 completed the study and were included in the analysis. Findings indicated that the buccal acupuncture group experienced significantly reduced resting NRS scores in post-anesthesia care unit and throughout the postoperative phase (P=0.001 and P=0.003, respectively), along with enhanced QoR-15 scores on the 3rd postoperative day (P=0.008), compared to the control group. No notable differences were identified in the remaining indicators (P>0.05).
CONCLUSION
Buccal acupuncture therapy demonstrated significant effectiveness in reducing postoperative pain and improving recovery quality for patients undergoing radical resection of gastrointestinal cancers, presenting a viable intervention without associated adverse outcomes. (Trial registration No. ChiCTR2200060441).
Humans
;
Male
;
Pilot Projects
;
Female
;
Acupuncture Therapy/methods*
;
Pain, Postoperative/therapy*
;
Middle Aged
;
Gastrointestinal Neoplasms/surgery*
;
Aged
;
Acupuncture Points
;
Adult
8.Glucocorticoid Discontinuation in Patients with Rheumatoid Arthritis under Background of Chinese Medicine: Challenges and Potentials Coexist.
Chuan-Hui YAO ; Chi ZHANG ; Meng-Ge SONG ; Cong-Min XIA ; Tian CHANG ; Xie-Li MA ; Wei-Xiang LIU ; Zi-Xia LIU ; Jia-Meng LIU ; Xiao-Po TANG ; Ying LIU ; Jian LIU ; Jiang-Yun PENG ; Dong-Yi HE ; Qing-Chun HUANG ; Ming-Li GAO ; Jian-Ping YU ; Wei LIU ; Jian-Yong ZHANG ; Yue-Lan ZHU ; Xiu-Juan HOU ; Hai-Dong WANG ; Yong-Fei FANG ; Yue WANG ; Yin SU ; Xin-Ping TIAN ; Ai-Ping LYU ; Xun GONG ; Quan JIANG
Chinese journal of integrative medicine 2025;31(7):581-589
OBJECTIVE:
To evaluate the dynamic changes of glucocorticoid (GC) dose and the feasibility of GC discontinuation in rheumatoid arthritis (RA) patients under the background of Chinese medicine (CM).
METHODS:
This multicenter retrospective cohort study included 1,196 RA patients enrolled in the China Rheumatoid Arthritis Registry of Patients with Chinese Medicine (CERTAIN) from September 1, 2019 to December 4, 2023, who initiated GC therapy. Participants were divided into the Western medicine (WM) and integrative medicine (IM, combination of CM and WM) groups based on medication regimen. Follow-up was performed at least every 3 months to assess dynamic changes in GC dose. Changes in GC dose were analyzed by generalized estimator equation, the probability of GC discontinuation was assessed using Kaplan-Meier curve, and predictors of GC discontinuation were analyzed by Cox regression. Patients with <12 months of follow-up were excluded for the sensitivity analysis.
RESULTS:
Among 1,196 patients (85.4% female; median age 56.4 years), 880 (73.6%) received IM. Over a median 12-month follow-up, 34.3% (410 cases) discontinued GC, with significantly higher rates in the IM group (40.8% vs. 16.1% in WM; P<0.05). GC dose declined progressively, with IM patients demonstrating faster reductions (median 3.75 mg vs. 5.00 mg in WM at 12 months; P<0.05). Multivariate Cox analysis identified age <60 years [P<0.001, hazard ratios (HR)=2.142, 95% confidence interval (CI): 1.523-3.012], IM therapy (P=0.001, HR=2.175, 95% CI: 1.369-3.456), baseline GC dose ⩽7.5 mg (P=0.003, HR=1.637, 95% CI: 1.177-2.275), and absence of non-steroidal anti-inflammatory drugs use (P=0.001, HR=2.546, 95% CI: 1.432-4.527) as significant predictors of GC discontinuation. Sensitivity analysis (545 cases) confirmed these findings.
CONCLUSIONS
RA patients receiving CM face difficulties in following guideline-recommended GC discontinuation protocols. IM can promote GC discontinuation and is a promising strategy to reduce GC dependency in RA management. (Trial registration: ClinicalTrials.gov, No. NCT05219214).
Adult
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Aged
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Female
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Humans
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Male
;
Middle Aged
;
Arthritis, Rheumatoid/drug therapy*
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Glucocorticoids/therapeutic use*
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Medicine, Chinese Traditional
;
Retrospective Studies
9.Clinical efficacy of robot-assisted single-position OLIF with lateral plate combined with posterior unilateral fixation for single-segment lumbar spinal stenosis.
Yuekun FANG ; Zhilin YANG ; Haotian LI ; Weizhou WANG ; Hangchuang BI ; Bing WANG ; Junjie DONG ; Jin YANG ; Zhiqiang GONG ; Lingqiang CHEN
Journal of Central South University(Medical Sciences) 2025;50(1):119-129
OBJECTIVES:
Oblique lateral interbody fusion (OLIF) has become a well-established treatment for lumbar spinal stenosis (LSS) due to its advantages of being minimally invasive, effective, and associated with fewer complications. However, relying solely on lateral fixation provides limited strength and uneven load distribution. Conventional posterior bilateral fixation after OLIF typically requires intraoperative repositioning, increases fluoroscopy frequency, and involves extensive dissection of posterior muscles and soft tissues, resulting in greater trauma, blood loss, and risks of dural tear, nerve root injury, and persistent postoperative low back pain. This study aims to compare the clinical efficacy of robot-assisted single-position OLIF with lateral plating and posterior unilateral fixation, OLIF with lateral fixation alone, and OLIF combined with posterior bilateral fixation for treating single-segment LSS, and to explore how to enhance fixation stability, reduce trauma, and achieve precise minimally invasive outcomes without changing patient positioning.
METHODS:
A retrospective analysis was conducted on the clinical data from patients treated for single-segment LSS between January 2020 and June 2023 at the First Affiliated Hospital of Kunming Medical University. Patients were divided into 3 groups: Robot group (robot-assisted single-position OLIF with lateral plate and posterior unilateral fixation, 33 cases), lateral group (OLIF with lateral fixation alone, 52 cases), and combined group (OLIF with posterior bilateral fixation, 45 cases). Surgical time, intraoperative blood loss, fluoroscopy frequency, hospital stay, pedicle screw placement accuracy, and complication rates were recorded. Pain visual analogue scale (VAS) scores and Oswestry disability index (ODI) scores were assessed preoperatively, postoperatively, and at the final follow-up. Radiological evaluations (X-ray, computed tomography, and magnetic resonance imaging) measured interbody disc height (IDH), intervertebral foraminal height (IFH), and cross-sectional area (CSA) of the dural sac. Differences between pre- and postoperative imaging indices were statistically analyzed, and complication rates, fusion rates, and cage subsidence rates were recorded.
RESULTS:
All patients exhibited good positioning of internal fixation devices and cages, with significant symptom relief and no cases of spinal cord injury or symptom worsening. The follow-up time was (15.2±3.6) months. The operation time of the robot group was (70.62±8.99) min, which was longer than that of the lateral group (45.90±6.09) min and shorter than that of the combined group (110.12±8.44) min. The intraoperative blood loss of the robot group was (44.27±6.87) mL, which was more than that of the lateral group (33.58±9.73) mL and less than that of the combined group (79.19±10.35) mL. The number of intraoperative fluoroscopy times of the robot group was (9.49±2.25), which was comparable to that of the lateral group (7.45±2.02) but less than that of the combined group (12.24±4.25). The hospital stay of the robot group was (9.28±2.10) days, which was longer than that of the lateral group (7.95±1.91) days and shorter than that of the combined group (12.49±5.07) days. The screw placement accuracy of the robot group was 98.48%, which was higher than that of the combined group (90.55%). Postoperative and final follow-up VAS and ODI scores were significantly lower than preoperative scores in all 3 groups (all P<0.05), and there were no significant differences in preoperative VAS and ODI scores among the groups (all P>0.05). Radiologically, IDH, IFH, and CSA at the surgical segment were significantly increased postoperatively and at final follow-up compared to preoperatively and at final follow-up compared to preoperative values (all P<0.05), with no significant differences among the groups postoperatively (all P>0.05). Internal fixation remained stable during the follow-up period, and all cages achieved fusion at final follow-up. The intervertebral fusion rate of the robot-assisted group was 93.40%, which was similar to that of the combined group (95.56%) and higher than that of the lateral approach group (90.34%). The complication rate of the robot-assisted group was 6.1%, which was comparable to that of the combined group (8.9%) and lower than that of the lateral approach group (15.4%) (P<0.05). No cases of fixation loosening or breakage were observed throughout the follow-up period.
CONCLUSIONS
Robot-assisted single-position OLIF with lateral plate combined with posterior unilateral fixation effectively achieves indirect decompression and excellent spinal stability without the need for intraoperative repositioning. It provides high pedicle screw accuracy, reduces intraoperative blood loss, fluoroscopy times, and complication rates, offering a fully minimally invasive new treatment option for single-segment LSS.
Humans
;
Spinal Stenosis/surgery*
;
Robotic Surgical Procedures/methods*
;
Lumbar Vertebrae/surgery*
;
Spinal Fusion/instrumentation*
;
Male
;
Female
;
Retrospective Studies
;
Middle Aged
;
Aged
;
Treatment Outcome
;
Bone Plates
;
Minimally Invasive Surgical Procedures/methods*
;
Adult
10.Exploration on the Potential Mechanism of Guben Zhike Pingchuan Granules in the Treatment of Cough-variant Asthma Based on Network Pharmacology and Experimental Validation
Yaqiao GONG ; Xingshi HUA ; Li MENG ; Xiaonan FANG ; Yu GAN
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(9):31-39
Objective To explore the molecular mechanism of Guben Zhike Pingchuan Granules in treating cough variant asthma(CVA)through network pharmacology and molecular docking technology;To use CVA model rats for validation;To provide a basis for the basic research and clinical application of Guben Zhike Pingchuan Granules.Methods TCMSP and BATMAN-TCM databases were used to retrieve the active components and corresponding targets of Guben Zhike Pingchuan Granules,and CVA disease targets were screened using OMIM,GeneCards,DrugBank,PharmGKB databases to obtain drug disease intersection targets.Cytoscape 3.10.1 software was used to construct the drug-component-target network and screen the key components;STRING database was used to construct protein-protein interaction(PPI)network and screen core targets;GO and KEGG enrichment analysis was conducted using DAVID platform;AutoDock Vina software was used to conduct molecular docking on the core targets and key components with high degree value respectively.CVA rat model was established by smoking combined with intraperitoneal and subcutaneous multi-point injection of ovalbumin.The rats were randomly divided into blank group,model group,montelukast sodium tablets group,Guben Zhike Pingchuan Granules low-and high-dosage groups.The groups received corresponding medicine for 15 d.HE staining was used to observe the morphology of lung tissue;ELISA was used to detect the contents of serum interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α);immunohistochemistry was used to detect the positive expressions of AKT,EGFR and NFKB1 in lung tissue.Results A total of 9 996 active components and 1 119 potential targets of Guben Zhike Pingchuan Granules,2 740 CVA targets,467 drug and disease intersection targets were screened out;PPI network topology analysis showed that AKT1,STAT3,EGFR,NFKB1 and MTOR were the core targets;the results of enrichment analysis showed that Guben Zhike Pingchuan Granules played an anti-inflammatory role in the treatment of CVA mainly through the interaction of EGFR/PI3K-Akt/NF-κB signaling pathway;molecular docking showed good binding ability between the core targets and key components,with a binding energy of<-7.0 kcal/mol for EGFR and Quercetin.Animal experiment results showed that after intervention with Guben Zhike Pingchuan Granules,the alveolar walls of the lung tissue in the model rats narrowed,the size of the alveoli became uniform,lymphocyte infiltration improved significantly,bronchioles contracted,and mucus in the lumen decreased;compared with the model group,the serum contents of IL-1β and TNF-α decreased in Guben Zhike Pingchuan Granules low-and high-dosage groups and montelukast sodium tablets group,and the positive expressions of AKT,EGFR and NFKB1 in lung tissue decreased(P<0.05,P<0.01).Conclusion Guben Zhike Pingchuan Granules may mediate the inflammatory response through the EGFR/PI3K-Akt/NF-κB signaling pathway,significantly improve the structural damage of CVA lung tissue,inhibit inflammatory cell infiltration,down-regulate the expressions of inflammatory factors,and thus exert therapeutic effects on CVA.


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