Objective To investigate the predictive value of systemic immune-inflammation index(SII)and N-terminal pro-brain natriuretic peptide(NT-proBNP)level in elderly patients with acute ST-segment elevation myocardial infarction(STEMI)developing contrast-induced acute kidney injury(CIAKI)after PCI.Methods A total of 1085 elderly STEMI patients undergoing emergency PCI in the Affiliated Hospital of Xuzhou Medical University from January 2018 to March 2023 were consecutively recruited as a training set,and another 287 elderly STEMI pa-tients receiving emergency PCI in the East Branch of the Affiliated Hospital from January 2021 to June 2023 were included as a verification set.According to the diagnostic criteria of CIAKI,they were divided into CIAKI group(n=95)and non-CIAKI group(n=990).Based on the results of restricted cubic spline(RCS)analysis,the patients from the training set were assigned into low-risk subgroup(n=292),moderate-risk group(n=515)and high-risk group(n=278).Multivari-ate logistic regression analysis was used to analyze the independent risk factors of CIAKI in elder-ly STEMI patients after PCI,and ROC curve was plotted to analyze the predictive value of combi-nation of SII and NT-proBNP.The risk of CIAKI was compared among the patients at different risk grades.Results Age,SII,baseline serum creatinine,NT-proBNP,fasting blood glucose and use of diuretics were independent risk factors for CIAKI after primary PCI in elderly STEMI patients(P＜0.05,P＜0.01).The AUC value of SII combined with NT-proBNP in predicting CIAKI was 0.801(95％CI:0.761-0.842,P＜0.01),with a sensitivity of 83.2％and a specificity of 67.5％,both superior to that of SII or NT-proBNP alone.RCS analysis revealed an increased risk of CIAKI at SII ≥1084.97 × 109/L and NT-proBNP ≥296.12 ng/L.The incidence of CIAKI was increased with the increase of risk grades(1.71％vs 6.41％vs 20.50％).Conclusion SII and NT-proBNP are independent risk factors for CIAKI after emergency PCI in elderly STEMI pa-tients.And their combination has better predictive value for CIAKI.

Hepatectomy and liver transplantation are the most effective radical treatment for patients with hepatocellular carcinoma, but the high recurrence rate after surgery which seriously affects the prognosis of patients cannot be ignored. Microvascular invasion (MVI) is a risk factor for postoperative recurrence and metastasis in patients with hepatocellular carcinoma. There is no consensus or guideline recommendation locally or intermutually on postoperative adjuvant therapy of patients with hepatocellular carcinoma with MVI. Appropriate selection of postoperative adjuvant therapy is worth more in-depth discussion. This article reviews recent and relevant studies on postoperative adjuvant therapy for patients with hepatocellular carcinoma and MVI, including local anti-tumor therapy, systemic chemotherapy, immunotherapy, targeted therapy and combination therapy, with the aim to provide better reference to clinicians in managing these patients with postoperative adjuvant therapy.

Rho-associated kinases (ROCKs) are serine-threonine protein kinases that act downstream of small Rho GTPases to regulate the dynamics of the actin cytoskeleton. Two ROCK isoforms (ROCK1 and ROCK2) are expressed in the mammalian central nervous system. Although ROCK activity has been implicated in synapse formation, whether the distinct ROCK isoforms have different roles in synapse formation and function in vivo is not clear. Here, we used a genetic approach to address this long-standing question. Both Rock1 and Rock2 mice had impaired glutamatergic transmission, reduced spine density, and fewer excitatory synapses in hippocampal CA1 pyramidal neurons. In addition, both Rock1 and Rock2 mice showed deficits in long-term potentiation at hippocampal CA1 synapses and were impaired in spatial learning and memory based on the water maze and contextual fear conditioning tests. However, the spine morphology of CA1 pyramidal neurons was altered only in Rock2 but not Rock1 mice. In this study we compared the roles of ROCK1 and ROCK2 in synapse formation and function in vivo for the first time. Our results provide a better understanding of the functions of distinct ROCK isoforms in synapse formation and function.

Objective This study aimed to investigate whether the copy numbers of the CCL3L1 (Chemokine C-C-Motif Ligand 3 Like Protein 1) gene were associated with susceptibility to ankylosing spondylitis (AS). Methods A total of 806 Chinese individuals including 405 AS patients and 401 healthy controls were enrolled. The CCL3L1 gene copy number was measured by a custom-by-design Multiplex AccuCopyTM Kit based on a multiplex fluorescence competitive polymerase chain reaction (PCR) principle, and 50 samples were randomly selected using the fluorescent quantitative PCR method to verify copy number. Main statistical method was t test, chi-square test and logistic regression model. Results There were no statistically significant differences between the case group and control group in age and gender ( t=1.77, P=0.076, χ2=1.14, P=0.289). The copy number of CCL3L1 gene ranged from 0 to 13 in both AS patients and the controls. After copy numbers were classified into 3 categories by 3, we did not find significant difference between the two groups ( χ2=0.591, P=0.669). And regression analyses also did not support the hypothesis that CCL3L1 gene copy number variation (CNV) could be an impact factor to the severity or function indexes of AS patients ( χ2=0.341, P=0.804 and χ2=0.472, P=0.774, respectively). Conclusion We suggest that the copy number of the CCL3L1 gene does not have a role in the susceptibility and the severity or function to AS.

Objective To study the changes and clinical significance of serum interleukin-2 (IL-2) ,interleukin-6 (IL-6) ,interleu-kin-10 (IL-10) ,cholinesterase (ChE) and hyaluronic acid (HA) in the patients with chronic hepatitis B (CHB) and liver cirrhosis (LC) .Methods The serum concentrations of IL-2 ,IL-6 ,IL-10 ,ChE and HA were detected in 92 cases of CHB(CHB group) ,63 cases of LC (group LC) and 46 cases of healthy populations (control group) .Results The serum concentrations of IL-2 ,IL-6 and HA in the CHB group and the LC group were higher than those in the control group ,while the serum concentrations of IL-10 and ChE were lower than those in the control group ,the differences had statistical significance (P<0 .05) .The serum concentrations of IL-2 ,IL-6 and HA in the patients with HBV DNA copy number of 6 .0-6 .9 log10 copy/mL were higher than those with the copy number of 3 .0-4 .9 log10 copy/mL and 5 .0 -5 .9 log10 copy/mL ,while the serum concentrations of IL-10 and ChE were lower than those with HBV DNA copy number of 3 .0-4 .9 log10 copy/mL and 5 .0-5 .9 log10 copy/mL ,the differences had statistical significance(P<0 .05) .The serum concentrations of IL-2 ,IL-6 and HA in the LC patients with the Child-Pugh grade C were higher than those with the Child-Pugh grade A and B ,while serum concentrations of IL-10 and ChE were lower than those with the Child-Pugh grade A and B ,the differences were statistically significant (P<0 .05) .Conclusion The simultaneous detection of serum IL-2 ,IL-6 ,IL-10 ,ChE and HA concentration changes can provide certain clinical reference value for the evaluation of severity and prognosis in the patients with CHB and LC .

BACKGROUND:A large number of studies have confirmed that anterior approach and posterior approach for multilevel cervical spondylotic myelopathy were effective, but there is stil no conclusion in which one is better.
OBJECTIVE:To systematical y assess the clinical effectiveness and safety of anterior approach versus posterior approach for multilevel cervical spondylotic myelopathy.
METHODS:The databases such as The Cochrane Library (Issue 3, 2013), PubMed (from 1966 to March 2013), OVID (from 1950 to March 2013), EMbase (from 1966 to March 2013), Chinese Biomedical Literature Database (from 1978 to March 2013), WanFang Database (from 1998 to March 2013), China National Knowledge Infrastructure (from 1999 to March 2013) were electronical y searched and five relevant journals were searched by hand to col ect the randomized control ed trials or non-randomized control ed trials about the clinical effectiveness and safety of anterior approach versus posterior approach for multilevel cervical spondylotic myelopathy. Two reviewers independently screened the literature according to the inclusive and exclusive criteria, extracted the data, and assessed the methodological quality of included studies. Then the meta-analysis was performed by using RevMan5.2 software.
RESULTS AND CONCLUSION:A total of 11 control ed trials involving 814 patients were included. Meta-analysis results showed that, compared with posterior approach, postoperative Japanese Orthopaedic Association scores were better (P<0.000 01), improvement rate of neurological function was higher (P=0.000 3), the incidence of C5 root palsy was lower (P=0.007), but operation time was longer (P<0.000 01), amount of intraoperative bleedin g was larger (P=0.000 7), incidence of adjacent segments degeneration was higher (P=0.01), incidence of postoperative complications was higher (P<0.000 01) and the rate of secondary surgical procedures was higher (P=0.003) after anterior approach. Additional y, there were no differences between the two groups in the cervical range of motion (P=0.56). For quantity limitation and low methodological quality of included studies, this conclusion stil needs to be further proved by performing more high-quality and large-scale randomized control ed trials.

BACKGROUND:Telomerase reverse transcriptase (TERT) plays an important role in telomerase activation, however there is rare report addressing the construction of the lentivirus targeted its genes to inhibit its expression in the spinal cord astrocytes.
OBJECTIVE:To construct recombinant lentivirus vector expressing smal interfering RNA against TERT gene and to evaluate its potential for inhibiting the TERT expression.
METHODS:After shRNA-TERT sequence was designed and synthesized, the sequence was amplified by PCR and then connected to plasmid pLentilox3.7U6-hTERT to construct recombinant plasmid. The recombinant plasmid was then transfected to DH5αcel s to screen positive colony, and the sequence was identified. The recombinant plasmid pLentilox3.7U6-TERT was transfected in 293T cel s, generating recombinant lentivirus Le-TERT. The titer of recombinant lentivirus was determined and Le-TERT was transfected into the rat spinal cord astrocytes. The expression of TERT in astrocytes was detected by RT-PCR, western blot and immunofluorescence assay.
RESULTS AND CONCLUSION:The gene sequencing analysis confirmed that, recombinant plasmid pLentilox3.7U6-TERT was successful y constructed. The real-time quantitative PCR, western blot analysis and immunofluorescence assay indicated that, after Le-TERT was transfected in the astrocytes for 4 days, the inhibition rate of TERT mRNA was (63.98±2.6)%, and Le-TERT was lowly expressed in the transfected astrocytes. Recombinant expression vector pLentilox3.7U6-TERT can produce the lentivirus at high titer and effectively inhibit TERT expression in the transfected astrocytes.

OBJECTIVE: To study the changes of serum vascular endothelial growth factor (VEGF) and beta 2-microglobulin levels before and after radiotherapy in 58 patients with nasopharyngeal carcinoma (NPC), and to elucidate the clinical significance of VEGF and beta 2-microglobulin test before radiotherapy. METHODS: Serum VEGF level was measured by sandwich ELISA in 58 patients with NPC and 24 healthy individuals, and the serum beta 2-microglobulin was assayed with time-resolved fluoroimmunoassay. RESULTS: The serum VEGF level in patients with NPC was (174.0+/-130.0) ng/L, higher than (134.1+/-66.6) ng/L of the healthy subjects, but the difference was not significant (P>0.05). The serum VEGF level was higher in T4 and IV a patients with NPC. No significant differences in the levels of serum VEGF were found among various N classifications in the patients with NPC. Patients with the serum VEGF level higher than 267.3 ng/L (mean+2 s of the serum VEGF level in the healthy individuals) had a shorter metastasis-free survival time (P<0.05). Although the patients with high beta 2-microglobulin level had a shorter survival time, the difference was not significant. CONCLUSION: The NPC patients with high serum VEGF level have a poor prognosis.

Objective: To quantify the effect of motor-developmental Tuina therapy on 61children with cerebral palsy. Methods: All the children received the motor-developmental Tuina therapy for 20 min each time, 3 to 6 times per week. The gross motor functions of the children were evaluated by GMFM 66. The baseline period evaluations in 15 children and follow-up period evaluations in 26 children were performed. Results: GMFM 66 score significantly increased at the end of treatment period (P<0.001). The GMFM 66 score changes per month in treatment period was significantly greater than those of both baseline period and follow-up period (P<0.001). Conclusion: The effect of motor-developmental Tuina therapy was notable on children with cerebral palsy. Continuous progress of the gross motor functions in these children may be obtained by continuous therapy.

In the treatment of 100 cases of prolapsed lumbar intravertebral disc mainly by electric acupuncture on Jiaji( Ex-B 2) plus traction, the total effecrive rate was 91%.