Objective To analyze the correlation between the poor position of pedicle screw after lumbar internal fixation and the occurrence of postoperative neurological symptoms.Methods The clinical data of patients who underwent lumbar pedicle screw surgery in our hospital from January 2017 to December 2023 were analyzed retrospectively.Record the patient's sex,age,diagnosis,surgical segment,the presence of postoperative neurological complications,the types of neurological complications.According to the postoperative CT,the screw penetration zone and grade were evaluated,and the distribution of different pedicle screw penetration types was recorded.The correlation between different types of pedicle screw penetration and postoperative neurological symptoms was analyzed.Results A total of 184 patients were included,including 80 males and 104 females.Age ranged from 18 to 82 years,with an average of 60.1±14.2 years.35 patients developed new neurological symptoms after operation.The incidence of postoperative neurological symptoms caused by pedicle medial quadrant screw penetration and lower quadrant screw penetration was higher than that of pedicle superior quadrant and lateral quadrant screw penetration.From L1 to L5,the risk of postoperative neurological symptoms caused by screw penetration in the medial quadrant of the pedicle increases gradually.When the penetration distance of pedicle medial quadrant screws in L4 and L5 segments is≥2mm,the risk of postoperative neurological symptoms is high.When the penetration distance of pedicle medial quadrant screws in L1,L2 and L3 segments is greater than 4mm,the risk of postoperative neurological symptoms is high.The distance of pedicle screw penetrating the medial quadrant of pedicle was positively correlated with the incidence of postoperative neurological symptoms(P<0.05).Conclusion The lateral and superior quadrants of the pedicle may be regarded as safety zones for lumbar pedicle screw placement.For the L1～L3 segments,screw penetration depth should not exceed 4 mm;whereas for the L4～L5 segments,the safety threshold must be strictly controlled within 2 mm.

Objective To investigate the causal relationship between psychiatric and psychological disorders(depression,bipolar dis-order,and schizophrenia)and non-alcoholic fatty liver disease(NAFLD).Methods The two-sample Mendelian randomization(MR)method was adopted,with depression,bipolar disorder,and schizophrenia as exposure variables and NAFLD as the outcome variable.The single nucleotide polymorphisms(SNPs)independently associated with exposure variables were obtained from the summary data of the genome-wide association study(GWAS)as instrumental variables for MR analysis.The analysis results of the inverse-variance weighted(IVW)were used as the primary outcome indicators,while those of the MR Egger regression method,weighted median,and weighted mode as supplementary results.The Cochran's Q test,MR-Egger intercept,and"leave-one-out"method were used for sensi-tivity analysis.Results The results of IVW analysis showed that depression was positively correlated with the incidence risk of NAFLD(OR=1.21,95％CI:1.01-1.44,P＜0.05),while bipolar disorder was negatively correlated with the incidence risk of NAFLD(OR=0.91,95％CI:0.84-1.00,P＜0.05).No causal relationship was found between schizophrenia and NAFLD.The heterogeneity and sen-sitivity analysis supported the robustness of the results of the study.Conclusion Depression and bipolar disorder are causally associat-ed with the incidence of NAFLD.Depression is associated with an increased risk of NAFLD,while bipolar disorder is associated with a reduced risk of NAFLD.

Objective: To investigate the objective characteristics of tongue manifestation in different stages of damp-heat syndrome in diabetic kidney disease (DKD). Methods: A cross-sectional study enrolled 134 patients with DKD G3-5 stages who met the diagnostic criteria for damp-heat syndrome in DKD. The patients were treated at Dongzhimen Hospital, Beijing University of Chinese Medicine, from May 2023 to January 2024. The patients were divided into three groups: DKD G3, DKD G4, and DKD G5 stage, with 53, 33, and 48 patients in each group, respectively. Clinical general data (gender, age, and body mass index) and damp-heat syndrome scores were collected from the patients. The YZAI-02 traditional Chinese medicine (TCM) AI Tongue Image Acquisition Device was used to capture tongue images from these patients. The accompanying AI Open Platform for TCM Tongue Diagnosis of the device was used to analyze and extract tongue manifestation features, including objective data on tongue color, tongue quality, coating color, and coating texture. Clinical data and objective tongue manifestation characteristics were compared among patients with DKD G3-5 based on their DKD damp-heat syndrome status. Results: No statistically significant difference in gender or body mass index was observed among the three patient groups. The DKD G3 stage group had the highest age (P<0.05). The DKD G3 stage group had a lower score for symptoms of poor appetite and anorexia(P<0.05) than the DKD G5 group. No statistically significant difference was observed in damp-heat syndrome scores among the three groups. Compared with the DKD G5 stage group, the DKD G3 stage group showed a decreased proportion of pale color at the tip and edges of the tongue (P<0.05). The DKD G4 stage group exhibited an increased proportion of crimson at the root of the tongue, a decreased proportion of thick white tongue coating at the root, a decreased proportion of pale color at the tip and edges of the tongue, an increased hue value (indicating color tone) of the tongue color in the middle, an increased brightness value (indicating color lightness) of the tongue coating color in the middle, and an increased thickness of the tongue coating (P<0.05). No statistically significant difference was observed in other tongue color proportions, color chroma values, body characteristics, coating color proportions, coating color chroma values, and coating texture characteristics among the three groups. Conclusion Tongue features differ in different stages of DKD damp-heat syndrome in multiple dimensions, enabling the inference that during the DKD G5 stage, the degree of qi and blood deficiency in the kidneys, heart, lungs, liver, gallbladder, spleen, and stomach is prominent. Dampness is more likely to accumulate in the lower jiao, particularly in the kidneys, whereas heat evil in the spleen and stomach is the most severe. These insights provide novel ideas for the clinical treatment of DKD.

Objective To analyze the correlation between the poor position of pedicle screw after lumbar internal fixation and the occurrence of postoperative neurological symptoms.Methods The clinical data of patients who underwent lumbar pedicle screw surgery in our hospital from January 2017 to December 2023 were analyzed retrospectively.Record the patient's sex,age,diagnosis,surgical segment,the presence of postoperative neurological complications,the types of neurological complications.According to the postoperative CT,the screw penetration zone and grade were evaluated,and the distribution of different pedicle screw penetration types was recorded.The correlation between different types of pedicle screw penetration and postoperative neurological symptoms was analyzed.Results A total of 184 patients were included,including 80 males and 104 females.Age ranged from 18 to 82 years,with an average of 60.1±14.2 years.35 patients developed new neurological symptoms after operation.The incidence of postoperative neurological symptoms caused by pedicle medial quadrant screw penetration and lower quadrant screw penetration was higher than that of pedicle superior quadrant and lateral quadrant screw penetration.From L1 to L5,the risk of postoperative neurological symptoms caused by screw penetration in the medial quadrant of the pedicle increases gradually.When the penetration distance of pedicle medial quadrant screws in L4 and L5 segments is≥2mm,the risk of postoperative neurological symptoms is high.When the penetration distance of pedicle medial quadrant screws in L1,L2 and L3 segments is greater than 4mm,the risk of postoperative neurological symptoms is high.The distance of pedicle screw penetrating the medial quadrant of pedicle was positively correlated with the incidence of postoperative neurological symptoms(P<0.05).Conclusion The lateral and superior quadrants of the pedicle may be regarded as safety zones for lumbar pedicle screw placement.For the L1～L3 segments,screw penetration depth should not exceed 4 mm;whereas for the L4～L5 segments,the safety threshold must be strictly controlled within 2 mm.

Objective To investigate the causal relationship between psychiatric and psychological disorders(depression,bipolar dis-order,and schizophrenia)and non-alcoholic fatty liver disease(NAFLD).Methods The two-sample Mendelian randomization(MR)method was adopted,with depression,bipolar disorder,and schizophrenia as exposure variables and NAFLD as the outcome variable.The single nucleotide polymorphisms(SNPs)independently associated with exposure variables were obtained from the summary data of the genome-wide association study(GWAS)as instrumental variables for MR analysis.The analysis results of the inverse-variance weighted(IVW)were used as the primary outcome indicators,while those of the MR Egger regression method,weighted median,and weighted mode as supplementary results.The Cochran's Q test,MR-Egger intercept,and"leave-one-out"method were used for sensi-tivity analysis.Results The results of IVW analysis showed that depression was positively correlated with the incidence risk of NAFLD(OR=1.21,95％CI:1.01-1.44,P＜0.05),while bipolar disorder was negatively correlated with the incidence risk of NAFLD(OR=0.91,95％CI:0.84-1.00,P＜0.05).No causal relationship was found between schizophrenia and NAFLD.The heterogeneity and sen-sitivity analysis supported the robustness of the results of the study.Conclusion Depression and bipolar disorder are causally associat-ed with the incidence of NAFLD.Depression is associated with an increased risk of NAFLD,while bipolar disorder is associated with a reduced risk of NAFLD.

Objective To explore the treatment effects and mechanism of Fangji Huangqi Xiaozhong Prescription in metabolic syndrome phenotype osteoarthritis(MS-OA)based on PPARγ/NF-κB signaling pathway.Methods SD rats were randomly divided into sham-operation group,OA group,MS-OA group,Western medicine group,and TCM high-and low-dasage groups.The modified Hulth method was used to make the OA model,and OA model was added with high-carbohydrate high-fat diet to make the MS-OA model.TCM high-and low-dosage groups were given 15.12,7.56 g/kg Fangji Huangqi Xiaozhong Prescription for gavage.The Western medicine group was given 16.2 mg/kg of losoprofen sodium by gavage,while the other groups were given physiological saline by gavage once a day for 6 consecutive weeks.Rat body mass was measured,biochemical detection of blood lipids and blood glucose was conducted,ELISA was used to detect the contents of serum TNF-α,IL-1β,IL-10 and leptin,morphological changes in cartilage tissue were observed using safranin O-fixed green and HE staining,immunohistochemical staining was used to detect expressions of Acan,ColⅩ,MMP13,TNF-α,IL-1β and PPARγ in cartilage tissue,Western blot was used to detected the expression of PPARγ,NF-κBp65 and p-NF-κBp65 protein in cartilage tissue.Results Compared with the sham-operation group,body mass and serum TC,TG,LDL-C,TNF-α,IL-1β and leptin of MS-OA group increased significantly(P<0.01),the contents of HDL-C and IL-10 decreased(P<0.01),cartilage tissue degeneration was significant,and the Mankin score increased(P<0.01),the expression of ColⅩ,MMP13,TNF-α,IL-1β,p-NF-κBp65 protein increased(P<0.05,P<0.01),and the expression of Acan and PPARγ protein decreased(P<0.01).Compared with the MS-OA group,the contents of serum TC,TG,LDL-C,TNF-α and leptin decreased in TCM high-dosage group(P<0.05,P<0.01),the content of IL-10 increased(P<0.05),the pathological damage of cartilage tissue improved,the Mankin score decreased(P<0.01),the expressions of ColⅩ,MMP13,TNF-α,IL-1β and p-NF-κBp65 protein in cartilage tissue decreased(P<0.05,P<0.01),and the protein expressions of Acan and PPARγ protein increased(P<0.01,P<0.05).Conclusion Fangji Huangqi Xiaozhong Prescription can improve lipid metabolism disorder,improve intra-articular inflammatory environment,balance cartilage metabolism,and delay cartilage degeneration in MS-OA rats.Its mechanism may be related to the regulation of PPARγ/NF-κB signaling pathway.

A 3-year-old male patient was diagnosed with neurofibromatosis type 1(NF1) for two years. The patient has multiple neurofibromas in retroperitoneum, lumbococcygeal paravertebral, lumbosacral spinal canal, and foramina. Due to retroperitoneal mass compression, the child suffered from urological complications such as hydronephrosis, ureterdilation, neurogenic bladder, etc., which seriously affected the urination function and resulted in multiple surgical treatments. Currently, the patient has been treated with mitogen activates extracelluar signal-regulated kinases(MEK) inhibitor selumetinib targeted therapy, and has voluntarily urinated, and his general state is better than before medication. The diagnosis and treatment of this case reflects the importance of multidisciplinary collaboration in the diagnosis and treatment of rare diseases.

Objective Using olfactory task functional magnetic resonance imaging (fMRI) to investigate the difference in brain olfactory activation between patients with subjective cognitive decline and normal elderly subjects, and to explore the objective image markers for early identification and evaluation the progression from SCD to Alzheimer′s disease (AD). Methods Twenty patients with SCD (SCD group) and twenty matched normal elderly subjects (NC group) were recruited from the community from March 2017 to December 2018. A full neuropsychological scale tests battery, olfactory behavioral tests and olfactory task?fMRI were performed. The differences between olfactory behavior, neuropsychological scales, and task?fMRI brain activation between the two groups were tested. Further, brain regions, which had significantly different activations under task?fMRI, were used as seeds for resting state functional connectivity (FC) analysis. Finally, the correlations between brain activation and olfactory behavior along with clinical neuropsychological scale tests were examined. Results The results of this study showed SCD had a significant decrease in olfactory behavior (olfactory recognition ability) compared with NC (t=-3.042, P<0.01), and there was no statistically significant difference in olfactory threshold. Significant declines were also observed in the SCD self?rating scale (t=6.973, P<0.01), the immediate (t=-4.623, P<0.01) and delayed (t=-2.746, P<0.01) testing of Philadelphia word learning, while the remaining neuropsychological scales were normal. In the olfactory task?fMRI, activation of bilateral primary olfactory cortical regions was significantly reduced in SCD patients, including bilateral entorhinal cortex, amygdala, piriform cortex, anterior olfactory nucleus, and head of the hippocampus. The resting state functional connectivity with the primary olfactory cortex (POC) as the seed showed that the functional connectivity between the olfactory system and the default model network (DMN) of SCD patients was significantly weakened (AlphaSim correction with voxel level P<0.01 and cluster level P<0.05). The Beta value of the left POC was significantly positively correlated with the olfactory threshold and Montreal cognitive assessment (MoCA) (r=0.329, P=0.041; r=0.317, P=0.046). Partial correlation analysis indicated that there was a significantly positive correlation between the FC of the left POC with the right/left inferior frontal gyrus, the left frontal middle gyrus and the right inferior parietal, and the score of immediate Philadelphia word learning test(r=0.411, P=0.008; r=0.400, P=0.011; r=0.329, P=0.003; r=0.454, P=0.003). The FC between the left POC and the right inferior temporal gyrus was negatively correlated with the score of trail making test (TMT) B, and the FC between the left POC and the right inferior was negatively correlated with score of language fluency test (r=-0.317, P=0.047; r=-0.333, P=0.036). The FC between the right POC and the left inferior parietal was positively correlated with the score of immediate Philadelphia word learning (r=0.315, P=0.048), while the FC between right POC and left middle occipital gyrus was negatively corrected with Language Fluency Test (r=-0.403, P=0.01). Conclusion Olfactory function has been impaired in SCD patients with normal standard cognition and phychiatric rating scales, and the changes in the activation of the primary olfactory cortex, such as the entorhinal cortex, may be an early neural circuit damage biomarker for objective evaluation of SCD.

Middle East respiratory syndrome coronavirus (MERS-CoV) was identified as a novel human coronavirus and posed great threat to public health world wide,which calls for the development of effective and safe vaccine urgently. In the study, peptide epitopes tagrgeting spike antigen were predicted based on bioinformatics methods. Nine polypeptides with high scores were synthesized and linked to keyhole limpet hemocyanin (KLH). Female BALB/C mice were immunized with individual polypeptide-KLH, and the total IgG was detected by ELISA as well as the cellular mediated immunity (CMI) was analyzed using ELIs-pot assay. The results showed that an individual peptide of YVDVGPDSVKSACIEVDIQQTFFDKTWPRPIDVSKADGI could induce the highest level of total IgG as well as CMI (high frequency of IFN-γ secretion) against MERS-CoV antigen in mice. Our study identified a promising peptide vaccine candidate against MERS-CoV and provided an experimental support for bioinformatics-based design of peptide vaccine.
Animals ; Antibodies, Viral ; immunology ; Computational Biology ; Coronavirus Infections ; immunology ; prevention & control ; virology ; Female ; Humans ; Immunization ; Mice ; Mice, Inbred BALB C ; Middle East Respiratory Syndrome Coronavirus ; genetics ; immunology ; Peptides ; administration & dosage ; genetics ; immunology ; Spike Glycoprotein, Coronavirus ; administration & dosage ; genetics ; immunology ; Viral Vaccines ; administration & dosage ; genetics ; immunology

Objective To investigate the development strategy of novel T cell based vaccine against HCV infection.Methods BALB/c mice were primed with pSCK-based DNA vaccine and boosted with type 5 adenoviral vector-based vaccine, which expressed the structural proteins ( Core, E1 and E2) de-rived from a Chinese HCV patient (genotype 1b, Hebei strain).Enzyme linked immunospot assay (ELIS-POT) and intracellular cytokine staining ( ICS) were used to analyze the elicited antigen-specific immune re-sponses and the efficacy of cross-protection.Results Immunization of mice with the prime-boost vaccination strategy elicited stronger T cell immune responses against multiple HCV antigens than using the DNA vac-cines alone, especially the IFN-γ-secreting T cell responses against E1 protein as indicated by ELISPOT as-say.ICS data indicated that the prime-boost regimen elicited more TNF-α-producing CD4+and IFN-γ-produ-cing CD8+T cells against E1 protein and high levels of IFN-γ-producing CD4+and CD8+T cells against E2 protein in comparison with immunization with DNA vaccines.Moreover, the prime-boost vaccination was ca-pable of eliciting effective cross-protection in a surrogate challenge model based on a recombinant heterolo-gous HCV (JFH1, 2a) vaccinia virus.Conclusion The prime-boost vaccination using DNA and rAd5-based vaccine expressing HCV structural antigens induced significant cellular immune response and cross-protection in mice, suggesting the possibility of using it as a promising T cell based vaccine against HCV in-fection.