Evading host immunity killing is a critical step for virus survival. Inhibiting viral immune escape is crucial for the treatment of viral diseases. Serine/threonine kinase 39 (STK39) was reported to play an essential role in ion homeostasis. However, its potential role and mechanism in viral infection remain unknown. In this study, we found that viral infection promoted STK39 expression. Consequently, overexpressed STK39 inhibited the phosphorylation of interferon regulatory factor 3 (IRF3) and the production of type I interferon, which led to viral replication and immune escape. Genetic ablation or pharmacological inhibition of STK39 significantly protected mice from viral infection. Mechanistically, mass spectrometry and immunoprecipitation assays identified that STK39 interacted with PPP2R1A (a scaffold subunit of protein phosphatase 2A (PP2A)) in a kinase activity-dependent manner. This interaction inhibited DDB1 and CUL4 associated factor 1 (DCAF1)-mediated PPP2R1A degradation, maintained the stabilization and phosphatase activity of PP2A, which, in turn, suppressed the phosphorylation of IRF3, decreased the production of type I interferon, and then strengthened viral replication. Thus, our study provides a novel theoretical basis for viral immune escape, and STK39 may be a potential therapeutic target for viral infectious diseases.

Objective:To compare the efficacies of endovascular therapy (EVT) and standard medical therapy in acute ischemic stroke (AIS) patients aged ≥85 years, and analyze the independent influencing factors for poor prognosis of AIS patients after EVT.Methods:Sixty-nine AIS patients aged ≥85 years admitted to Department of Neurology, Xi'an Third Hospital from January 2018 to April 2024, including 40 accepted EVT and 28 accepted standard medicinal therapy, were enrolled. Modified Rankin scale (mRS) was used to evaluate the prognosis of the patients 90 days after onset. General data, prognosis and complications between the EVT group and standard medical therapy group were compared. General data, treatment processes and complications between patients with good prognosis and poor prognosis in the EVT group were compared. Multivariate Logistic regression was used to analyze the independent influencing factors for poor prognosis in AIS patients after EVT.Results:Compared with the standard medical therapy, the EVT group had significantly lower NIHSS score at discharge, greater improvement in NIHSS score (NIHSS score at admission-NIHSS score at discharge), lower mRS score 90 days after onset, higher good prognosis rate, lower mortality rate within 90 days of onset, and longer hospital stay ( P<0.05). In the EVT group, 11 patients (27.5%) had good prognosis and 29 patients (72.5%) had poor prognosis 90 days after onset. Compared with the good prognosis group, the poor prognosis group had significantly higher blood glucose level and lower Alberta Stroke Program Early CT Score (ASPECT) on admission ( P<0.05). Multivariate Logistic regression analysis showed that blood glucose on admission ( OR=2.363, 95% CI: 1.134-4.928, P=0.022) and ASPECT score on admission ( OR=0.273, 95% CI: 0.088-0.854, P=0.026) were independent influencing factors for poor prognosis in AIS patients after EVT. Conclusion:AIS patients aged ≥85 years received EVT have better prognosis compared with those accepted standard medical therapy; these patients with high glucose level and low ASPECT score on admission have poor prognosis.

lumbar fusion surgery is one of the commonly used surgical interventions and treatments for lumbar degenerative diseases.A small proportion of patients still experience complications such as low back pain after lumbar fusion surgery.Spinal-pelvic parameters are closely related to the occurrence of complications in patients after lumbar fusion surgery.This article reviews the commonly used lumbar fixation and fusion surgical techniques and mainstream sagittal spinal-pelvic parameters.Additionally,it summarizes the research progress and current status regarding the relationship between sagittal spinal-pelvic parameters and various postoperative complications,including low back pain.

lumbar fusion surgery is one of the commonly used surgical interventions and treatments for lumbar degenerative diseases.A small proportion of patients still experience complications such as low back pain after lumbar fusion surgery.Spinal-pelvic parameters are closely related to the occurrence of complications in patients after lumbar fusion surgery.This article reviews the commonly used lumbar fixation and fusion surgical techniques and mainstream sagittal spinal-pelvic parameters.Additionally,it summarizes the research progress and current status regarding the relationship between sagittal spinal-pelvic parameters and various postoperative complications,including low back pain.

Objective:To compare the efficacies of endovascular therapy (EVT) and standard medical therapy in acute ischemic stroke (AIS) patients aged ≥85 years, and analyze the independent influencing factors for poor prognosis of AIS patients after EVT.Methods:Sixty-nine AIS patients aged ≥85 years admitted to Department of Neurology, Xi'an Third Hospital from January 2018 to April 2024, including 40 accepted EVT and 28 accepted standard medicinal therapy, were enrolled. Modified Rankin scale (mRS) was used to evaluate the prognosis of the patients 90 days after onset. General data, prognosis and complications between the EVT group and standard medical therapy group were compared. General data, treatment processes and complications between patients with good prognosis and poor prognosis in the EVT group were compared. Multivariate Logistic regression was used to analyze the independent influencing factors for poor prognosis in AIS patients after EVT.Results:Compared with the standard medical therapy, the EVT group had significantly lower NIHSS score at discharge, greater improvement in NIHSS score (NIHSS score at admission-NIHSS score at discharge), lower mRS score 90 days after onset, higher good prognosis rate, lower mortality rate within 90 days of onset, and longer hospital stay ( P<0.05). In the EVT group, 11 patients (27.5%) had good prognosis and 29 patients (72.5%) had poor prognosis 90 days after onset. Compared with the good prognosis group, the poor prognosis group had significantly higher blood glucose level and lower Alberta Stroke Program Early CT Score (ASPECT) on admission ( P<0.05). Multivariate Logistic regression analysis showed that blood glucose on admission ( OR=2.363, 95% CI: 1.134-4.928, P=0.022) and ASPECT score on admission ( OR=0.273, 95% CI: 0.088-0.854, P=0.026) were independent influencing factors for poor prognosis in AIS patients after EVT. Conclusion:AIS patients aged ≥85 years received EVT have better prognosis compared with those accepted standard medical therapy; these patients with high glucose level and low ASPECT score on admission have poor prognosis.

Objective:To evaluate the clinical efficacy of Jianpi Bushen Zhixie Recipe combined with conventional western medicine therapy in the treatment of diabetic diarrhea patients with spleen and kidney yang-deficiency syndrome.Methods:According to the random number table method, 62 patients with diabetic diarrhea with spleen and kidney yang-deficiency syndrome from June 2019 to June 2021 in Shunyi Hospital of Beijing Traditional Chinese Medicine Hospital, who met the inclusion criteria, were divided into two groups, with 31 in each group. The control group was treated with standardized hypoglycemic and mecobalamin treatment, while the treatment group was treated with Jianpi Bushen Zhixie Recipe on the basis of the control group. Both groups were treated for 2 weeks and followed up for 2 weeks. Before and after treatment, TCM syndrome scores and Bristol Stool Form Scale (BSFS) scores were performed before and after treatment. The Health Related Quality of Life Scale (SF-36) was used to evaluate the quality of life of patients. The number of bowel movements and adverse reactions during treatment were recorded before and after treatment, and followed up for 2 weeks to observe the disease recurrence rate.Results:The total effective rate was 93.55% (29/31) in the treatment group and 74.19% (23/31) in the control group, with a statistically significant difference between both groups ( χ2=5.44, P=0.020). After treatment, the number of bowel movements in the treatment group [(1.02±0.23) times/d vs. (2.35±0.45) times/d, t=14.65] was significantly lower than that of the control group ( P<0.01); the BSFS scores (1.93±0.43 vs. 3.23±0.43, t=11.87) and TCM syndrome score (0.93±0.25 vs. 1.95±0.36, t=12.96) in the treatment group were significantly lower than those in the control group ( P<0.01); the SF-36 score (92.32±2.99 vs. 86.23±3.12, t=7.85) in the treatment group was significantly higher than that of the control group ( P<0.01). No gastrointestinal adverse events were found in both groups during treatment. During the follow-up period, there were 4 cases (4/23) of recurrence in the control group after treatment, and no recurrence in the treatment group. There was a statistically significant difference in the recurrence rate between the two groups ( χ2=4.28, P=0.039). Conclusion:The Jianpi Bushen Zhixie Recipe combined with conventional western medicine can improve symptoms and quality of life of patients with diabetic diarrhea with spleen and kidney yang-deficiency syndrome, reduce adverse reactions and recurrence rate.

Objective K93T point mutation exists in the quinoid dihydropteridine reductase ( QDPR) of OLEFT rats which catalyzes QDPR into tetrahydrobinopterin(BH4), while dihydrofolate reductase(DHFR) can reduce QDPR to BH4, which implies crosstalk between hydrobiopterin and folate metabolism.By investigating the influence of QDPR expression on DHFR expression of NRK-52E cells, the article aimed to find out the possible underlying mechanism of QDPR gene in diabetic nephropathy ( DN). Methods Western blot was performed to identify the expression level in NRK-52E cell under high glucose ambience and DHFR pro-tein expression of OLETF rats.NRK-52E cells were transfected by the lentivirus to establish no-load overexpression, overexpressed QDPR and knockdown QDPR models.Each group was given 5.4 mmol/L normal sugar medium and 30mmol/L in high glucose ambi-ence for 72 hours'cell cultivation to simulate DN model.Observation was made on the influence of QDPR gene expression levels on DHFR in high glucose ambience. Results The western blot analysis revealed that DHFR protein decreased in NHG group( [0.33 ± 0.16] vs [0.64 ±0.5], P<0.05) and OLETF rats cortex ([0.56 ±0.16] vs [1.03 ±0.12], P<0.01).In high glucose ambi-ence, compared with LV-OCON-HG group, the protein expression of DHFR was significantly decreased in LV-QDPR-HG group ([0.12 ±0.09] vs [0.63 ±0.08], P<0.01).No difference was found in the comparison of DHFR expression levels between LV-SHQDPR-HG and LV-SHCON-HG group. Conclusion DHFR protein expression decreases in NRK-52E cells of high glucose and LOLETF rat model, which suggests that DHFR protein plays an important role in the development of DN.QDPR overexpression leads to the decreased expression of DHFR, which implies that overexpressed QDPR influences the occurrence and process of DN by down-regulating DHFR expression level.

Objective To investigate the clinical and imaging characteristics of bilateral medial medullary infarction. Methods The clinical data of 3 patients with bilateral medial medullary infarction admitted to Shengjing Hospital of China Medical University were analyzed retrospectively. The related literature was reviewed. Results Three patients in this group were all males. Their main clinical manifestations were quadriplegia, dysarthria, and paresthesia, and 1 of them complicated with respiratory failure. One patient was suspected of having Guillain-Barre syndrome. The hyperintensities of heart-shape,Y- shape,and V- shape were its imaging features of typical MRI diffusion weighted imaging. Conclusion Bilateral medial medullary infarction is a rare posterior circulation ischemic lesion in clinical practice. Its early symptoms are not typical and easy to be misdiagnosed and missed. MRI diffusion weighted imaging is its main imaging examination method.

Objective To compare the effects of oxygen therapy and local pressurization in alleviating plateau hypoxia at high altitude.Methods Forty-five healthy male soldiers were investigated at an altitude of 3992 meters.The subjects were randomly divided into three groups, ie.an oxygen inhalation group, a single-soldier oxygen increasing respirator (SOIR) group and a BiPAP group.The oxygen inhalation group was treated with oxygen inhalation via nasal catheter at 2 L/min.SOIR was used to assist breath in the SOIR group.The BiPAP group were treated with bi-level positive airway pressure ventilation, with IPAP of 10 cm H20 and EPAP of 4 cm H2O.PaO2、PaCO2、SpO2 and heart rate were measured before and 30 minutes after the treatment.Results There were continuous increase of PaO2 from (53.30±4.88) mm Hg to (58.58±5.05) mm Hg and (54.43±3.01) mm Hg to (91.36±10.99) mm Hg after BiPAP ventilation and oxygen inhalation, respectively (both P < 0.01).However, the PaO2、of the SOIR group was decreased from (56.00±5.75) mm Hg to (50.82±5.40) mm Hg (P < 0.05).In the other hand, the PaCO2、 was increased from (30.41±1.51) mm Hg to (32.5±2.98) mm Hg in the oxygen inhalation group (P< 0.05), declined from (28.74±2.91) mm Hg to (25.82±4.35) mm Hg in the BiPAP group (P < 0.05), and didn't change significantly from (28.65±2.78)mm Hg to (29.75±3.89) nun Hg in the SOIR group (P > 0.05).Conclusions Both BiPAP ventilation and oxygen inhalation can alleviate plateau hypoxia by improving PaO2 at 3992 meter altitude while SOIR has no significant effect.