Objective To explore the efficacy of unilateral biportal endoscopy(UBE)for lumbar intervertebral foramen stenosis combined with lumbar disc herniation through Sublamina approach.Methods From October 2021 to June 2022,7 elderly patients with typical symptoms of lumbar disc herniation in the intervertebral foramen area accompanied by spinal stenosis were retrospectively analyzed.There were 6 patients with lumbar disc herniation and nerve root canal stenosis at L4/5 and 1 patient at L5/S1.The mean course of disease was(8.6±2.5)months.All the patients were treated by UBE through Sublamina approach.Results Postoperative limb radicular symptoms of 7 patients were relieved.The visual analogue scale(VAS)of limb pain was significantly decreased from preoperative(8.6±1.3)to(2.1±1.1)at 2 d after the surgery(P<0.05),the Japanese Orthopaedic Association(JOA)score was significantly increased from preoperative(10.1±2.4)to(17.3±1.8)at 2 d after the surgery(P<0.05).Conclusion UBE for lumbar intervertebral foramen stenosis combined with lumbar disc herniation through Sublamina approach has a satisfactory therapeutic effect,providing a new idea for the surgical treatment of this disease.

Objective To investigate effect of remote ischemic preconditioning(RIPC)com-bined with transcutaneous vagus nerve stimulation(tVNS)on reperfusion injury in ST-segment eleva-tion myocardial infarction(STEMI).Methods A total of 132 STEMI patients were selected,and were randomly divided into control group,tVNS group and combined group(RIPC combined with tVNS)before percutaneous coronary intervention(PCI).A total of 9 of the 132 patients were exclu-ded,including 42 in the control group,40 in the tVNS group,and 41 in the combination group.The area under the curve(AUC)of creatine kinase isoenzyme(CK-MB)within 72 h and the ventricular arrhythmia(VAs)within 24 h after reperfusion were compared among the three groups.The levels of interleukin-6(IL-6),high mobility group protein B1(HMGB1),tumor necrosis factor-α(TNF-α)and left ventricular ejection fraction(LVEF)of the three groups were compared at admission and 24 h after reperfusion.Results The AUC of CK-MB in the combination group was significantly lower than that in the control group within 72 h(P＜0.05).The total number of premature ventricular beats and the number of ventricular tachycardia in the tVNS group and combined group were significantly lower than those in the control group within 24 h after reperfusion(P＜0.05).The levels of IL-6,HMGB1 and TNF-α in the combination group were significantly lower than those in the control group 24 h after reperfusion(P＜0.05).LVEF in the combination group was significantly higher than that in the light group at 7 days after reperfusion(P＜0.05).Conclusion The tVNS significantly reducs the incidence of VAs after PCI in STEMI patients,but has little effect on the level of reperfusion inflam-matory markers,myocardial infarction size,and acute left ventricular systolic function.The tVNS com-bined with RICP can produce significant benefits in the above indexes.

The severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2） and its variants are still globally spreading. Vaccines can reduce the mortality， but cannot eliminate the risk of infection. The identification and protection of the high-risk susceptible population remains of great importance for the prevention and control of SARS-CoV2 and other coronavirus infections. Smoking is an important risk factor for many respiratory diseases， and therefore may also influence the risk of SARS-CoV2 infection and the disease progression after infection. This study reviewed the epidemiological and mechanistic evidence supporting the relationship between tobacco exposure and SARS-CoV2 infection， summarized the contributing effects of tobacco exposure to the infection risk， disease severity， and mortality of COVID-19， and analyzed the molecular mechanisms by which cigarette smoking affects COVID-19 through regulating inflammatory microenvironment and gene expression.

Objective To investigate effect of remote ischemic preconditioning(RIPC)com-bined with transcutaneous vagus nerve stimulation(tVNS)on reperfusion injury in ST-segment eleva-tion myocardial infarction(STEMI).Methods A total of 132 STEMI patients were selected,and were randomly divided into control group,tVNS group and combined group(RIPC combined with tVNS)before percutaneous coronary intervention(PCI).A total of 9 of the 132 patients were exclu-ded,including 42 in the control group,40 in the tVNS group,and 41 in the combination group.The area under the curve(AUC)of creatine kinase isoenzyme(CK-MB)within 72 h and the ventricular arrhythmia(VAs)within 24 h after reperfusion were compared among the three groups.The levels of interleukin-6(IL-6),high mobility group protein B1(HMGB1),tumor necrosis factor-α(TNF-α)and left ventricular ejection fraction(LVEF)of the three groups were compared at admission and 24 h after reperfusion.Results The AUC of CK-MB in the combination group was significantly lower than that in the control group within 72 h(P＜0.05).The total number of premature ventricular beats and the number of ventricular tachycardia in the tVNS group and combined group were significantly lower than those in the control group within 24 h after reperfusion(P＜0.05).The levels of IL-6,HMGB1 and TNF-α in the combination group were significantly lower than those in the control group 24 h after reperfusion(P＜0.05).LVEF in the combination group was significantly higher than that in the light group at 7 days after reperfusion(P＜0.05).Conclusion The tVNS significantly reducs the incidence of VAs after PCI in STEMI patients,but has little effect on the level of reperfusion inflam-matory markers,myocardial infarction size,and acute left ventricular systolic function.The tVNS com-bined with RICP can produce significant benefits in the above indexes.

Objective: To understand the current situation and associated factors of cellphone usage and addiction among Chinese children and adolescents, to provide reference for effective prevention and intervention of cellphone addiction. Methods: Using a stratified random sampling approach, 11 213 children and adolescents and their parents from 31 provinces, municipalities and autonomous regions in China were recruited and surveyed. Results: The median of daily mobile phone use time among Chinese children and adolescents were 120.00 minutes, as reported by either children or parents. Child s age( β =0.12), hedonic( β =0.11) and social( β =0.09) cellphone use motivations positively related to time spent on cellphone( P <0.01). Cellphone related parental communication( β =-0.06) and knowledge( β =-0.03), as well as cellphone usage on instrumental( β =-0.04) or self representation( β =-0.16) motivation negatively related to time spent on cellphone( P <0.05). Child s age( β =-0.04), cellphone related parental communication( β =-0.09) and awareness( β =-0.14), cellphone use on instrumental motivation( β =-0.22) were negatively associated with cellphone addiction among children and adolescents( P <0.05). Cellphone related parental monitoring( β =0.07), as well as cellphone usage on self representation motivation( β =0.03) or hedonic motivation( β =0.29) positively related to cellphone addiction in children and adolescents( P <0.05). Conclusion Time spent on mobile phone and mobile phone addiction of Chinese children and adolescents are influenced by various internal and external factors, such as the mobile phone use motivation and parenting style.Future school education should help children develop scientific motivation for mobile phone use. Family education should help parents develop positive parenting behaviors such as communication and awareness, so as to reduce the possibility of improper mobile phone use.

Objective　To study the clinical characteristics and differentiation between TS-AMCI and AF-AMCI.It aims to help clinicians better distinguish and treat patients with two diseases.Methods　The clinical symptoms,imaging tests,prognostic data of 30 TS-AMCI (TS-AMCI group) and 39 AF-AMCI (AF-AMCI group) who received hospital treatment from June 2017 to June 2020 in Rizhao people’s Hospital were retrospectively analyzed.Results　The proportion of hypertension,diabetes and stroke history in TS-AMCI group was lower than that in AF-AMCI group (P＜0.05);But the plasma fibrinogen and D-dimer in TS-AMCI group were significantly higher than those in AF-AMCI group (P<0.001).The proportion of the number of cerebral infarction lesions less than 10 in DWI of TS-AMCI group was significantly lower than that in AF-AMCI group (P<0.001).The number of cerebral infarction lesions in bilateral anterior and posterior circulation in TS-AMCI group was significantly higher than that in AF-AMCI group(P＜0.001),while,AF-AMCI group was characterized by unilateral anterior circulation,which was significantly higher than that in TS-AMCI group (P＜0.001).The mRS score and the Death cases at 30 days of follow-up in TS-AMCI group were significantly higher than those in AF-AMCI group (P＜0.05).Conclusion　Compared with the AF-AMCI group.The traditional risk factors of stroke such as hypertension and diabetes in TS-AMCI group were more rare than those in AF-AMCI group.The plasma fibrinogen and D-dimer value increased more obviously and multiple small lesions in the blood supply area of multiple arteries were more common in TS-AMCI group.There was no significant difference in clinical manifestations at the onset of the disease between the two groups,but the prognosis of TS-AMCI group was poor at 30 days.

Objective:To explore the effects of hnRNP E1 on the expression of early genes E2, E6 of HPV16 and the biological function in cervical cancer SiHa cell lines.Methods:The cell experiments in vitro were carried out in cervical cancer cell lines SiHa. The expression levels of E2, E6 mRNA and protein of HPV16 were detected by Real-time PCR and Western blot, respectively, before and after up-regulating hnRNP E1. Meanwhile, the cell proliferation, cycle and apoptosis were evaluated by CCK-8 and flow cytometry. Data analyses were performed using SPSS 22.0 and Graphpad Prism 7.0 software. Results:Compared with the blank and the blank plasmid group, the cells activity and proliferation decreased at 24, 48 and 72 h after up-regulating hnRNP E1 ( P<0.05), while the percentage of cells in G0/G1 phase increased and the percentage in S and G2/M phase and proliferation index decreased ( P<0.05). Moreover, the late apoptotic rate and the total apoptotic rate increased ( P<0.05). The expression levels of E6 mRNA and protein of HPV16 in hnRNP E1 up-regulated group were significantly lower than that in both blank group and blank plasmid group, the differences were significant ( P<0.05), showing the tendency of cells proliferation index decrease and total apoptotic rate increase with decreased HPV16 E6 expression. There were no significant differences in the expression of E2 mRNA of HPV16 among the three groups ( P=0.427), and no E2 protein of HPV16 was detected. Conclusions:hnRNP E1 could inhibit the transcription and translation of E6 oncogene of HPV16 and further inhibit the proliferation and promote apoptosis of cervical cancer cells, suggesting that hnRNP E1 might be a potential target marker to prevent cervical lesions. But no association between hnRNP E1 and HPV16 E2 was found in SiHa cells.

Objective:To explore the effect of dietary water-soluble vitamins on the poor prognosis of low-grade cervical intraepithelial neoplasia (CINⅠ).Methods:A total of 564 participants with CINⅠ were selected from a community-based married women cohort established in 2014. The general baseline information was collected, and HPV genotyping was detected. A food frequency questionnaire was used to investigate dietary water-soluble vitamins' consumption and determine their exposure levels. The follow-up program was carried out for 12 months, and the regression, persistence, and progression of CINⅠ was determined according to histopathological results at 12-month.Results:The low-levels of dietary water-soluble vitamins could promote CINⅠ's persistence and progression, showing the increasing tendency of CINⅠ poor prognosis with the decrease of water-soluble vitamin levels. Especially folate, VB1, VB2, VB6, niacin, biotin, and VC ( RR values were 15.22, 1.86, 1.92, 2.11, 2.98, 2.14, 2.19, respectively) played an important role. Considering the status of high-risk human papillomavirus (HR-HPV) infection, our results showed that the low levels of folate, niacin, biotin could promote the poor prognosis of CINⅠ. Conclusions:The low-level of dietary water-soluble vitamins could facilitate the poor prognosis of CINⅠ. In addition, folate, niacin, biotin were more effective on HR-HPV positive women.

Objective:To describe the characteristics of high-risk human papillomavirus (HR-HPV) infection and its influences by vaginal micro-environmental factors.Methods:A total of 421 women with HR-HPV infection and normal cervix diagnosed by pathology were selected from a community cohort established earlier by our research group for a 24-month follow-up. The baseline data were collected at enrollment. The vaginal micro-environmental factors were detected by using the combined detection kit of aerobic vaginitis and bacterial vaginosis. And the HPV was detected by using the flow-through hybridization technology. According to the HR-HPV infection status in baseline and 24 months of follow-up, with the prognosis characteristics of HR-HPV infection described, the impact of vaginal micro-environmental factors on the prognosis of HR-HPV infection was explored as well.Results:Among 390 HR-HPV infected women who completed 24 months of follow-up, the top five types of persistent HR-HPV infection rate appeared as HPV16 (24.1%), HPV58 (22.2%), HPV53 (21.7%), HPV52 (20.0%), and HPV39 (11.8%), respectively. The results showed that women with abnormal vaginal pH (a OR=1.74, 95% CI: 1.08-2.80), abnormal neuraminidase (a OR=2.70, 95% CI: 1.52-4.83), or abnormal leucocyte esterase (a OR=3.41, 95% CI: 2.13-5.44), the risk of HR-HPV persistent infection increased. The abnormalities of neuraminidase and leukocyte esterase could increase the risk of persistent infection of homotype and heterotypic HR-HPV. Conclusions:HPV16 was prone to persistent infection. Abnormalities of vaginal pH, neuraminidase, and leukocyte esterase might increase the risk of HR-HPV persistent infection. Both the abnormalities of neuraminidase and leukocyte esterase play an essential role in the HR-HPV persistent infection.

Objective:To investigate the diagnostic value of different vaginal micro-environmental factors in low-grade cervical intraepithelial neoplasia (CIN Ⅰ) and determine the optimal model in high-risk human papillomavirus (HR-HPV) infection.Methods:A total of 926 women, including 623 with normal cervical (NC) condition and 303 CINⅠ patients, had undergone pathological examinations, and were enrolled in the study. All the women were from a community previously established cohort. Vaginal cleanliness, pH, H 2O 2, β-glucuronidase, coagulase, sialidase, and leukocyte esterase (LE) were detected by the combined detection method aerobic vaginitis/bacterial vaginosis in vaginal secretions. HPV genotyping was performed by using the flow-through hybridization technology. The data were analyzed by SAS 9.2 and SPSS 23.0. Results:The vaginal cleanliness, pH, sialidase, and LE were determined as the representative vaginal micro-environment factors by principal component analysis. Based on logistic regression theory to analyze the ROC curve, the results showed that the highest sensitivity was with pH value (76.2%), and the highest specificity was with sialidase (90.9%). The area under ROC curve were higher in combination detection modes of sialidase+LE (0.714), pH+sialidase+LE (0.719), vaginal cleanness+sialidase+LE (0.713) and pH+vaginal cleanness+sialidase+LE (0.709). According to HR-HPV infection status, the TOPSIS method was used to analyze the combined detection optimal model. Specifically, we found that the best diagnostic model was pH+sialidase +LE ( C i=0.585) in the HR-HPV positive group and vaginal cleanness+sialidase+LE ( C i=0.641) in the negative group. Conclusions:The combined detection of vaginal microenvironment factors could be used for auxiliary diagnosis for CINⅠ. It would be more effective when detecting pH, sialidase, and LE in HR-HPV positive women while vaginal cleanness, sialidase, and LE in HR-HPV negative women at the same time.