Objectives:To explore the application value of percutaneous co-axial large-channel endoscopic lumbar interbody fusion(PLE-LIF)combined with full surgical area closure technique(FSAC)in the treatment of degenerative lumbar spondylolisthesis.Methods:A retrospective analysis was conducted on 83 patients with single-segment degenerative lumbar spondylolisthesis who underwent PLE-LIF in our hospital from January 2020 to January 2023.Among the patients,46 received FSAC treatment during operation(FSAC group),and 37 patients did not receive FSAC treatment(N-FSAC group).Both groups of patients were comparable in gen-eral information such as gender,age,course of illness,and length of hospital stay(P＞0.05).The two groups of patients were followed up for l year.The operative time and complications of the two groups of patients were recorded.Both groups of patients were followed up regularly for 1 year.The visual analogue scale(VAS)for low back pain and lower limb pain was recorded on ld before surgery,3d after surgery,at 3 months and 1 year after surgery,in addition,the Oswestry disability index(ODI)on 1d before surgery,at 3 months and 1 year after surgery was recorded.X-ray examination was performed at 3 months after operation,and Meyerding grading was used to evaluate the reduction of spondylolisthesis.CT examination was performed at 1 year after operation,and Brantigan criteria were used to evaluate the intervertebral fusion.Results:The operative time in the FSAC group was shorter than that in the N-FSAC group(118.9±10.6min vs 130.6±16.3min,P＜0.05).The VAS for low back pain and lower limb pain and ODI at each postoperative time point in the two groups were significantly lower than those before surgery(P＜0.05),and there was no statistically significant difference between the two groups at each time point(P＞0.05).Two cases of lower limb numbness occurred in the N-FSAC group,while none occurred in the FSAC group;There were 4 cases and 1 case of neuroedema pain in the N-FSAC group and FSAC group,respectively;1 case in each group respectively had cage displacement,and there was no internal fixation loosening,infection,or dural sac tear in both groups.The incidence rate of intraoperative complications in the N-FSAC group was higher than that in the FSAC group(18.9％vs 4.3％)(P＜0.05).One year after surgery,the degree of slippage in both groups of patients improved significantly compared to the conditions before operation(P＜0.05),and there was no significant difference between the two groups(P＞0.05);Intervertebral fusion occurred in 42 cases in the FSAC group,and 34 cases in the N-FSAC group,and no statistically significant difference was there in the fusion rate(91.3％vs 91.9％)and intervertebral fusion grading between the two groups(P＜0.05).Conclusions:PEL-LIF combined with FSAC can shorten the operative time and improve safety in treating single-segment degenerative lumbar spondylolisthesis.

Astrocytes(AS)are the most abundant glial cells in the central nervous system and are involved in many physiological and pathological processes in the nervous system.Alterations in their phenotype are particularly important for the health of the CNS.Epigenetic mechanisms,including DNA methylation,histone modification,non-coding RNA regulation,and chromatin remodeling,are closely linked to alterations in AS proliferation,differentiation,inflammation,and other phenotypic features,but how these mechanisms function needs to be explored and summarized.By reviewing the recent advances in the role of epigenetic mechanisms in AS under various physiological and pathological states,we aim to provide new ideas for the understanding and treatment of related diseases.

The aim of this study is to evaluate the in vitro and in vivo antibacterial potential of Ly-sZHSHW,a phage lysin against Acinetobacter baumannii infections,and to study its characteris-tics.The pET28a-Lys recombinant plasmid containing LysZHSHW coding gene was constructed by PCR,enzyme digestion and ligation using the expression plasmid pET28a as the backbone and ex-pressed in E.coli BL21(DE3).After confirming the expression of the LysZHSHW through West-ern blot analysis,its characterization and potential applications were assessed both in vitro and in vivo.The results showed that the pET28a-Lys recombinant plasmid was successfully constructed and the LysZHSHW protein was expressed correctly.The mass concentration of the purified en-zyme was 4 086 mg/L,which could be used for subsequent experiments.The enzymatic activity of LysZHSHW was determined to be 630 U/μg,with maximum activity observed at 25 ℃ and pH9.0.In vitro experiments demonstrated that 1 000 or 750 mg/L of LysZHSHW,in the presence of EDTA,resulted in a four-log reduction in bacterial counts without any cytotoxicity.In vivo,2.5 μg of LysZHSHW combined with EDTA could increase the survival rate of Galleria mellonel-la larvae infection model to 92.86％after 24 hours,and 0.15 mg of LysZHSHW reduced the bacte-rial load in the thighs of mice by 2.8 logs and alleviated the inflammatory response in muscle fi-bers.In conclusion,LysZHSHW derived from Acinetobacter baumannii bacteriophage exhibited characteristics such as stability at room temperature,alkaline pH,and safety,making it a promis-ing candidate as a novel antimicrobial agent.

Objective:To investigate the relationship between the inflammatory cytokines level in the plasma of nasopharyngeal carcinoma patients before radiotherapy and acute radiotherapy adverse reactions, and to establish a preliminary model for predicting the risk of severe acute adverse reactions during radiotherapy.Methods:A cross-sectional study was conducted. A total of 85 nasopharyngeal carcinoma patients who received radical radiotherapy in Cancer Hospital of Chinese Academy of Medical Sciences from May 2016 to March 2019 were retrospectively collected. The highest grade adverse reactions of radiation oral mucositis, radiation dermatitis and xerostomia during radiotherapy were evaluated according to the American Cancer Radiotherapy Collaboration (RTOG) acute radiation injury evaluation criteria, and the above adverse reactions ≥ grade 3 were treated as the severity. Olink proteomics technology was used to detect the level of 92 inflammatory cytokines (the standardized protein expression values) in the plasma of patients before radiotherapy for the first time. Single factor analysis of variance and independent sample t-test were used to analyze the relationship between inflammatory cytokines and clinical factors, as well as acute adverse reactions during radiotherapy. Based on inflammatory cytokines and/or the clinical factors, binary logistic regression was used to construct a predictive model for the risk of severe acute radiotherapy adverse reactions. Whether the most severe adverse reactions assessed by the American RTOG acute radiation injury evaluation criteria during radiotherapy were severe or not were taken as the gold standard. Receiver operating characteristic (ROC) curve was used to analyze the effectiveness of the established models for judging the severe acute adverse reactions. Results:Among the 85 patients, 68 were males and 17 were females, with the median age [ M ( Q1, Q3)] of 49 years (43 years, 60 years). All patients received radical radiotherapy, of which 64 cases were treated with combination chemotherapy or targeted therapy. A total of 19 cases (22.1%) experienced severe acute radiotherapy adverse reactions. There were statistically significant differences in the levels of interleukin (IL)-22 receptor A1 (IL-22RA1), IL-18 receptor 1(IL-18R1), eotaxin-1 (CCL11), tumor necrosis factor ligand superfamily member 14 (TNFSF14), FMS-like tyrosine kinase 3 ligand (Flt3L), and monocyte chemotactic protein 2 (MCP-2) in the plasma of patients with grade 1, 2, 3 acute radiation oral mucositis before radiotherapy; there were statistically significant differences in the levels of CD244 (all P < 0.05); there were statistically significant differences in the levels of CD244, CC chemokines ligand 20 (CCL20), leukemia inhibitory factor ligand (LIF-R) and IL-4 in the plasma of patients with grade 1, 2, 3 acute radiation dermatitis before radiotherapy (all P < 0.05); there were statistically significant differences in the levels of IL-12B, CXC chemokines ligand 11 (CCL11), LIF-R and IL-33 in the plasma between patients with grade 1 and grade 2 xerostomia before radiotherapy (all P<0.05). The result of single factor analysis of variance showed that the clinical factors were not associated with severe acute radiation adverse reactions (all P > 0.05). Binary logistic regression model M1 was established by selecting 6 clinical factors including age, T staging, N staging, clinical staging, whether to receive chemotherapy or not and whether to suffer from diabetes or not in the literatures. Based on cytokine function and previous literatures, the binary logistic regression model M2 was established by selecting IL-22RA1, IL-18R1, MCP-2, CCL11, CD244, CCL20 and IL-33 from the differential cytokines. A binary logistic regression model M3 was established by combining the above clinical factors with cytokines. The ROC curve analysis showed that the area under the curve of the M1, M2, M3 predictive models for judging the severe acute radiation adverse reactions was 0.781, 0.841, 0.868, respectively. Conclusions:There were differences in the expression levels of various inflammatory cytokines in plasma before radiotherapy among patients with different grades of acute radiotherapy adverse reactions. Building the models based on plasma inflammatory cytokine levels combined with clinical factors before the first radiotherapy could effectively predict the risk of severe acute radiotherapy adverse reactions in patients with nasopharyngeal carcinoma.

Objective To observe the value of grey-level histogram analysis based on T2WI for differentiating consistency of meningioma.Methods Data of 109 patients with meningioma were retrospectively analyzed.The patients were divided into hard group(n=71)and soft group(n=38)according to the consistency of tumors.Tumor ROI was outlined on axial T2WI showing the largest tumor section,gray levels were extracted and histogram analysis was performed.The value of each histogram parameter were compared between groups.Then receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficiency for differentiating soft and hard meningioma.Results P1,P10,P50,P90,P99 and the mean grey levels on T2WI in soft group were all higher than those in hard group(all P＜0.05),while the variance,the kurtosis and the skewness were not significantly different between groups(all P＞0.05).The differentiating efficiency of P1,P10,P50,P90,P99 and the mean grey levels on T2WI were all fine,with AUC of 0.774 to 0.833,and no significant difference was found(all P＞0.05).Conclusion Parameters of grey-level histogram analysis such as P1,P10,Ps0,P90,P99 and the mean values based on T2WI were all valuable for differentiating soft and hard meningioma.

Intensity-modulated radiotherapy (IMRT) is a radical treatment for oropharyngeal carcinoma. The 5-year overall survival (OS) is approximately 60%, and 80% for human papillomavirus (HPV)-related oropharyngeal carcinoma patients. Late toxicities after IMRT, including xerostomia, dysphagia, hypothyroidism, trismus, osteoradionecrosis and caries, and lower cranial neuropathy, seriously affect the quality of life of long-term survivors. The research on treatment de-intensification for HPV-related oropharyngeal cancer has been widely carried out at home and abroad, but there is little research focusing on late toxicity. In this article, related research progress in the incidence, treatment, prediction of late toxicity after IMRT was reviewed, aiming to provide reference for research on radiation-induced injury in de-intensification therapy research, thereby further optimizing comprehensive treatment strategies.

Objective To design a mobile personnel radiation protection equipment for operation in environments with high radiation such as spent fuel reprocessing plants, to achieve simultaneous protection against γ radiation, neutron radiation, and radioactive aerosol, to reduce the internal and external exposure dose of radioactive workers, and to meet the requirement of operation for two hours. Methods The core parts of the mobile personnel radiation protection equipment included a shielding chamber and a respiratory maintenance system. An automated chassis was used for the movement and lifting of the shielding chamber. MCNP software was used to simulate and calculate the protective effects of shielding chamber made of different materials and material thicknesses. Experimental verification of the shielding chamber design was conducted. Mathematical models were established to describe the variations in the content of various gases in the chamber with personnel operation time. A respiratory maintenance system, a harmful gas absorption device, and an automated mobile chassis were designed. Results The shielding chamber made of polyethylene with a thickness of 80 mm achieved an 80% neutron shielding rate. The respiratory maintenance system could support workers for 2 hours of operation inside the equipment. The mobile chassis allowed operation of the equipment with one person. Conclusion This mobile personnel radiation protection equipment can solve the problem in simultaneous protection against γ radiation, neutron radiation, and radioactive aerosol. The equipment can provide radiation protection for radioactive workers, reduce exposure dose, and reduce personnel burden. This system provides technical means for the operation and maintenance of equipment in high-radiation sites such as spent fuel reprocessing plants.

Objective To investigate the feasibility of low-voltage,automatic tube current adjustment(ATCM)and low contrast agent concentration,dose and injection rate combined with full-model iterative re-construction(IMR)in vertebral artery V3-segment three-dimensional CT angiography(3DCTA).Methods A total of 60 patients with suspected upper cervical spine,craniocervical junction lesions undergoing cervical vertebral artery V3 segment 3DCTA in this hospital from November 2019 to May 2020 were selected and divided into the group A and B by adopting the random number table method,30 cases in each group.The group A adopted the ATCM technology of 80 kV,average tube current of 50 mAs,25 mL of contrast agent io-hexol(iodine content 300 mg/mL)combined IMR technology with an injection rate of 3 mL/s,while the group B adopted 120 kV,150 mAs fixed tube current,50 mL injection rate of 5 mL/s contrast agent iopamidol(iodine content 370 mg/mL)combined filter back projection(FBP)reconstruction technology.CT value,noise,signal-to-noise ratio(SNR),contrast noise ratio(CNR)and image sensitivity(FOM)were measured and compared between the two groups and the quality of the resulting images was evaluated.The CT volumet-ric dose index(CTDIvol)and dose-length product(DLP)were recorded,and the effective dose(ED)was cal-culated.Results There was no statistically significant difference in the vertebral arterial CT value between the two groups(P＞0.05),but the noise of the group A was lower than that of the group B(P＜0.05),SNR,CNR and FOM of the group A were greater than those of the group B(P＜0.05).The image quality of the two groups met the requirements of clinical diagnosis[(4.78±0.41)points vs.(4.85±0.35)points],and there was no statistically significant difference in the subjective evaluation of image quality(P＞0.05).The CTDIvol,DLP and ED levels in the group A were lower than those in the group B(P＜0.05).The iodine in-takes of contrast medium in the group A and group B were 7.5 g and 18.5 g,respectively,and the iodine flow rates of contrast agent were 0.9 and 1.85 mg/s,respectively,and compared with group B,the iodine intake and iodine flow rate of the group A were decreased by 59.5％and 51.4％,respectively.Conclusion Low tube voltage ATCM and low contrast concentration,dose and injection rate combined with IMR technology can not only ensure the 3DCTA image quality of vertebral artery V3 segment,but also reduce the radiation dose re-ceived by the patients,and reduce the iodine intake and iodine flow rate of contrast agent.

Objective:To compare the effects of glenosphere offset positions on the impingement-free range of motion (ROM) in reverse total shoulder arthroplasty (RTSA).Methods:Shoulder joint models were reconstructed using shoulder CT scans of 6 patients with primary osteoarthritis. RTSA was performed virtually according to standard surgical procedures, and shoulder movements were simulated. Reverse shoulder models were constructed with 2 lateral offsets (0 and 4 mm) and 6 positional offsets (center, inferior, posterior, anterior, anterior-inferior, and posterior-inferior). The impingement-free ROM and impingement sites for abduction-adduction, flexion-extension, total rotation (sum of internal and external rotation), and total ROM (sum of ROM in all movement modes) were evaluated.Results:All the 12 combinations of different glenosphere offsets achieved 50% of the original shoulder ROM in all movements. In the abduction-adduction motion with 0 and 4 mm lateral offsets, the anterior-inferior offset provided the largest ROM (94.4°±8.7° and 105.3°±6.9°, respectively), but there was no significant difference between the positions ( P>0.05). In the flexion-extension motion with 0 and 4 mm lateral offsets, the posterior-inferior offset showed the largest ROM (194.1°±6.9° and 196.9°±9.7°, respectively), but there was no significant difference between the positions ( P>0.05). In the total rotation motion with 0 and 4 mm lateral offsets, the anterior-inferior offset had the largest ROM (141.5°±5.9° and 160.6°±8.5°, respectively), showing significant advantages over the center, anterior, and posterior offsets ( P<0.05), but insignificant advantages over the inferior and posterior-inferior offsets ( P>0.05). In total ROM, the anterior-inferior offset provided the largest ROM. When the lateral offset was 0 mm, the anterior-inferior offset provided a ROM of 421.8°±16.4°, showing significant advantages over the center and posterior offsets ( P<0.05). Compared with the lateral glenosphere offset of 0 mm, the lateral glenosphere offset of 4 mm significantly improved total shoulder ROM (122.8°±10.6° versus 145.8°±4.8°) and total ROM (390.9°±11.6° versus 428.4°±19.8°) ( P<0.05). Conclusions:The anterior-inferior, inferior, and posterior-inferior glenosphere offsets can improve ROM in all movement patterns. The position and lateral offset of the glenosphere significantly affect the total rotation and total ROM of the shoulder joint. Specifically, the anterior-inferior and inferior offsets show significant advantages over the center position in total rotation and total ROM of the shoulder joint.

Objective To assess the feasibility of employing chip resistors for retrospective dose reconstruction following nuclear accidents, to examine the effects of storage temperature and storage time on the optically stimulated luminescence (OSL) characteristics of the chip resistors, and to explore measures to mitigate these effects. Methods Chip resistors were analyzed using automated instruments for measuring thermoluminescence and OSL manufactured by Risø in Denmark with various parameters to understand the impact of storage temperature and storage time on OSL signals. Results The OSL signals of chip resistors exhibited exponential attenuation within 10 min after irradiation, and then stabilized (count change < 10%) within 2-7 days of storage. The chip resistors exhibited linear dose responses within 1-3 days of storage after 0.1-2 Gy irradiation. OSL signals diminished as the storage temperature increased. However, preheating at 130 ℃ for 1 min effectively eliminated the differences caused by temperatures between 25 ℃ and 45 ℃. Conclusion The OSL signals of chip resistors are influenced by storage temperature and storage time. When preheated at 130 ℃ for 1 min, chip resistors stored for 1-7 days and at 25-45 ℃ exhibited OSL signal errors of 10% or less. This result emphasizes the importance of preheating for measurements in practical applications, thus providing a scientific approach and a solid foundation for the use of chip resistors in retrospective dose reconstruction.