Spinal cord injury (SCI), as a serious traumatic disease of the central nervous system, often leads to irreversible damage to neurological function and has a high disability rate. Induced pluripotent stem cells (iPSCs) have the ability of self-renewal capacity and multilineage differentiation potential, and thus show broad application prospects and research value in the repair of SCI. iPSCs can replace damaged cells by directionally differentiating into neurons, oligodendrocytes, etc., secrete neurotrophic factors to optimize the microenvironment, promote myelin regeneration, and regulate immune responses. In recent years, research has concentrated on refining the directional differentiation protocol of iPSCs, improving survival rate and functional integration of transplanted cells, and actively exploring combined treatment strategies with biomaterial scaffolds, electrical stimulation, etc., to enhance the repair effect. Preclinical studies substantiate that iPSC transplantation can improve motor function, and early-phase clinical trials have also demonstrated its biological safety. Furthermore, iPSCs avoid ethical controversies and can be applied to disease modeling and mechanism research.

Spinal cord injury (SCI), as a serious traumatic disease of the central nervous system, often leads to irreversible damage to neurological function and has a high disability rate. Induced pluripotent stem cells (iPSCs) have the ability of self-renewal capacity and multilineage differentiation potential, and thus show broad application prospects and research value in the repair of SCI. iPSCs can replace damaged cells by directionally differentiating into neurons, oligodendrocytes, etc., secrete neurotrophic factors to optimize the microenvironment, promote myelin regeneration, and regulate immune responses. In recent years, research has concentrated on refining the directional differentiation protocol of iPSCs, improving survival rate and functional integration of transplanted cells, and actively exploring combined treatment strategies with biomaterial scaffolds, electrical stimulation, etc., to enhance the repair effect. Preclinical studies substantiate that iPSC transplantation can improve motor function, and early-phase clinical trials have also demonstrated its biological safety. Furthermore, iPSCs avoid ethical controversies and can be applied to disease modeling and mechanism research.

Objective To explore the effect of intestinal nitrates on the growth of Klebsiella pneumoniae and its regulatory mechanisms. Methods K. pneumoniae strains with nitrate reductase narG and narZ single or double gene knockout or with NarXL gene knockout were constructed and observed for both aerobic and anaerobic growth in the presence of KNO3 using an automated bacterial growth analyzer and a spectrophotometer, respectively. The mRNA expressions of narG and narZ in K. pneumoniae in anaerobic cultures in the presence of KNO3 and the effect of the binary regulatory system NarXL on their expresisons were detected using qRT-PCR. Electrophoretic mobility shift assays (EMSA) and MST analysis were performed to explore the specific regulatory mechanisms of NarXL in sensing and utilizing nitrates. Competitive experiments were conducted to examine anaerobic growth advantages of narG and narZ gene knockout strains of K. pneumoniae in the presence of KNO3. Results The presence of KNO3 in anaerobic conditions, but not in aerobic conditions, promoted bacterial growth more effectively in the wild-type K. pneumoniae strain than in the narXL gene knockout strain. In anaerobic conditions, the narXL gene knockout strain showed significantly lowered mRNA expressions of narG and narZ (P<0.0001). EMSA and MST experiments demonstrated that the NarXL regulator could directly bind to narG and narZ promoter regions. The wild-type K. pneumoniae strain in anaerobic cultures showed significantly increased expressions of narG and narZ mRNAs in the presence of KNO3 (P<0.01), and narG gene knockout resulted in significantly attenuated anaerobic growth and competitive growth abilities of K. pneumoniae in the presence of KNO3 (P<0.01). Conclusion The binary regulatory system NarXL of K. pneumoniae can sense changes in intestinal nitrate concentration and directly regulate the expression of nitrate reductase genes narG and narZ to promote bacterial growth.

BACKGROUND:Functional training has been popular in recent years,but it is mainly applied in sports training field.There are still insufficient studies and applications in medical and health fields. OBJECTIVE:To provide a theoretical basis for relevant research in sports,medical and health fields,through a more comprehensive and in-depth exploration and analysis of the research hot spots,ideological trends,frontiers and development trends of international functional training in the field of medical and health care. METHODS:The 2 206 high-quality articles addressing health-related functional training during 2012-2022 were exported from the Web of Science Core Set Database as the object of analysis.Combined with research methods such as literature analysis,Citespace V analysis software was used for visual analysis of keywords,subject categories and highly cited literatures. RESULTS AND CONCLUSION:The number of articles published on functional training in the field of health is on the rise.There are more articles from the United States,with a larger impact.China also has a high volume of publications,but the impact and depth of research is lacking.Improving physical and mental health and cognitive ability of middle-aged and older people is the main focus,followed by preventing sports injuries and promoting recovery in athletes.In the future,more research will be conducted on teenagers,the disabled and other groups,and there will be a continued increase in injury prevention and recovery promotion for athletes.Chinese scholars have less research on the effects of functional training on the physical health of the general public,and more attention should be paid to improving the physical and mental health of the general public.

Objective To explore the effect of intestinal nitrates on the growth of Klebsiella pneumoniae and its regulatory mechanisms. Methods K. pneumoniae strains with nitrate reductase narG and narZ single or double gene knockout or with NarXL gene knockout were constructed and observed for both aerobic and anaerobic growth in the presence of KNO3 using an automated bacterial growth analyzer and a spectrophotometer, respectively. The mRNA expressions of narG and narZ in K. pneumoniae in anaerobic cultures in the presence of KNO3 and the effect of the binary regulatory system NarXL on their expresisons were detected using qRT-PCR. Electrophoretic mobility shift assays (EMSA) and MST analysis were performed to explore the specific regulatory mechanisms of NarXL in sensing and utilizing nitrates. Competitive experiments were conducted to examine anaerobic growth advantages of narG and narZ gene knockout strains of K. pneumoniae in the presence of KNO3. Results The presence of KNO3 in anaerobic conditions, but not in aerobic conditions, promoted bacterial growth more effectively in the wild-type K. pneumoniae strain than in the narXL gene knockout strain. In anaerobic conditions, the narXL gene knockout strain showed significantly lowered mRNA expressions of narG and narZ (P<0.0001). EMSA and MST experiments demonstrated that the NarXL regulator could directly bind to narG and narZ promoter regions. The wild-type K. pneumoniae strain in anaerobic cultures showed significantly increased expressions of narG and narZ mRNAs in the presence of KNO3 (P<0.01), and narG gene knockout resulted in significantly attenuated anaerobic growth and competitive growth abilities of K. pneumoniae in the presence of KNO3 (P<0.01). Conclusion The binary regulatory system NarXL of K. pneumoniae can sense changes in intestinal nitrate concentration and directly regulate the expression of nitrate reductase genes narG and narZ to promote bacterial growth.

Objective:To investigate the effectiveness of medical simulation for improving the quality of standardized residency training during clinical anesthesia rotation.Methods:Thirty-six newly admitted anesthesia residents in 2019 were randomly divided into control group and simulation training group, with 18 people in each group. During a week of admission training, the control group learned theoretical knowledge such as sterile techniques, and observed practical videos about central venous puncture, tracheal intubation, spinal puncture, nerve block, and other skills; and the simulation training group practiced the above skills with intelligent medical simulators in the simulation operating room. After a month of rotation, the trainees were assessed on sterile techniques, invasive procedures, and humanistic care, and questionnaires were used to survey the self-rated and teacher-rated scores of their performance. SPSS 22.0 was used to perform the t test and χ2 test. Results:The simulation training group was superior to the control group in terms of the operating processes of tracheal intubation, deep vein puncture, and spinal puncture [(74.16±2.35) vs. (76.05±1.89); (20.22±1.43) vs. (18.61±1.78); (23.17±0.78) vs. (21.11±1.13)], the overall scores of deep vein puncture and spinal puncture [(22.78±1.68) vs. (20.83±1.42); (23.28±0.75) vs. (21.83±1.09)], and the hand-eye coordination and operating time of nerve block [(15.78±1.38) vs. (14.33±1.51); (15.28±1.30) vs. (13.39±1.40)].Conclusions:Medical simulation training can significantly improve the post competencies of anesthesia residents to enter clinical rotation, which is worth further promotion.

Objective:To investigate the clinical efficacy of arthroscopy combined with sodium hyaluronate and platelet-rich plasma in the treatment of Stoller grade III meniscus injury.Methods:Sixty patients with Stoller grade III meniscus injury who received treatment in The Second People's Hospital of Liaocheng from October 2019 to October 2020 were included in this study. They were randomly divided into an observation group and a control group ( n = 30 per group). Patients in the observation group were treated with arthroscopy combined with sodium hyaluronate and platelet-rich plasma, while patients in the control group were treated with arthroscopy combined with sodium hyaluronate. Before and 1, 3, and 6 months after surgery, the Visual Analogue Scale (VAS) score, Lysholm score, and The Western Ontario and McMaster Universities Arthritis Index (WOMAC) score of the knee joint were compared between the two groups. Results:There were no serious complications in each group. Compared with pre-treatment, the VAS and Lysholm scores of the knee joint in both groups significantly decreased at 1, 3, and 6 months after surgery, while the WOMAC score showed a significant increase ( F = 514.96, 673.19, 96.31, 124.16, 230.99, 531.84, all P < 0.001). After 3 and 6 months of treatment, the VAS score in the observation group was (1.1 ± 0.5) points and (0.8 ± 0.4) points, respectively, which were significantly lower than (2.5 ± 0.7) points and (1.3 ± 0.5) points in the control group ( t = 8.91, 4.28, both P < 0.001). After 3 and 6 months of treatment, the Lysholm score of the knee joint in the observation group was (86.2 ± 9.1) points and (93.8 ± 13.2) points, respectively, which were significantly higher than (79.8 ± 11.3) points and (87.5 ± 9.2) points in the control group ( t = 2.42, 2.14, both P < 0.05). After 3 and 6 months of treatment, the WOMAC score in the observation group was (17.5 ± 3.6) points and (16.5 ± 3.2) points, respectively, which were significantly lower than (25.4 ± 5.2) points and (24.8 ± 6.4) points in the control group ( t = 6.84, 6.35, both P < 0.001). Conclusion:Arthroscopy combined with sodium hyaluronate and platelet-rich plasma is more effective in treating Stoller III grade meniscus injury than arthroscopy combined with sodium hyaluronate. The former therapy can be promoted in the clinic.

Objective:To investigate the effect of L-carnitine on calcium oxalate-induced ferroptosis in renal tubular epithelial cells (HK-2).Methods:The effects of calcium oxalate(0, 2, 4 and 8 mmol/L) on the expression of ferroptosis-related protein long chain fatty acyl-CoA synthetase 4 (ACSL4), cystine/glutamate transporter(XCT) and glutathione peroxidase 4 (GPX4) in HK-2 cells were detected by Western blotting. The experiment was then divided into four groups: ①control group, cells were cultured in normal medium for 12 hours, then continued to use normal medium; ②L-carnitine group, cells were pretreated with medium containing 5mmol/L L-carnitine for 12 hours, then changed to medium containing 5mmol/L L-carnitine; ③calcium oxalate group, cells were cultured in normal medium for 12 hours, and then replaced with medium containing 4 mmol/L calcium oxalate; ④calcium oxalate+ L-carnitine group, the cells were pretreated with medium containing 5mmol/L L-carnitine for 12 h, and then replaced with 5mmol/L L-carnitine and 4mmol/L calcium oxalate medium. After changing the culture medium for 24 hours, the cells or supernatants were collected, and the expression levels of ferroptosis-related protein quinone oxidoreductase (NQO1), ACSL4, XCT and GPX4 were detected by Western blotting. The levels of superoxide dismutase (SOD), glutathione (GSH) and malondialdehyde were detected by corresponding kit, and the level of reactive oxygen species in cells was detected by reactive oxygen species kit.Results:The results of Western blotting showed that the expression of ACSL4 protein in 0, 2, 4, 8 mmol/L calcium oxalate was 0.37±0.16, 0.68±0.16, 0.73±0.09, 0.89±0.03 respectively. The expression of XCT protein was 1.11±0.10, 0.91±0.14, 0.83±0.09, 0.80±0.07, respectively. The expression of GPX4 protein was 1.23±0.13, 0.99±0.17, 0.81±0.05, 0.72±0.06, respectively. Compared with 0mmol/L group, the expression of ACSL4 protein increased and the expression of XCT and GPX4 decreased in 2, 4 and 8 mmol/L groups, and the difference was more significant between 4 mmol/L group and 0 mmol/L group. So 4 mmol/L was taken as the optimal concentration for follow-up experiment. The levels of NQO1 in control group, L-carnitine group, calcium oxalate group and calcium oxalate+ L-carnitine group were (0.36±0.06, 0.54±0.05, 0.76±0.07, 0.90±0.03) respectively. There was significant difference between L-carnitine group and control group ( P<0.05). There was significant difference between calcium oxalate group and control group ( P<0.05). There was significant difference between calcium oxalate group and control group ( P<0.01). There was significant difference between calcium oxalate + L-carnitine group and calcium oxalate group ( P<0.05). The levels of ACSL4 in control group, L-carnitine group, calcium oxalate group and calcium oxalate + L-carnitine group were (0.66±0.10, 0.58±0.08, 0.99±0.03, 0.77±0.09) respectively. There was no significant difference between L-carnitine group and control group(P>0.05). There was significant difference between calcium oxalate group and control group ( P<0.01). There was significant difference between calcium oxalate + L-carnitine group and calcium oxalate group ( P<0.05). The levels of XCT in control group, L-carnitine group, calcium oxalate group and calcium oxalate + L-carnitine group were (0.93±0.08, 0.85±0.07, 0.76±0.06, 0.99±0.05). There was no significant difference between L-carnitine group and control group (P>0.05). There was significant difference between calcium oxalate group and control group ( P<0.01). There was significant difference between calcium oxalate + L-carnitine group and calcium oxalate group ( P<0.05). The levels of GPX4 in control group, L-carnitine group, calcium oxalate group and calcium oxalate + L-carnitine group were (1.10±0.09, 1.09±0.09, 0.85±0.03, 0.99±0.02) respectively. There was no significant difference between L-carnitine group and control group( P>0.05). There was significant difference between calcium oxalate group and control group ( P<0.01). There was significant difference between calcium oxalate + L-carnitine group and calcium oxalate group ( P<0.05). The levels of LDH in control group, L-carnitine group, calcium oxalate group and calcium oxalate + L-carnitine were (100.00±5.37)%, (99.50±6.38)%, (153.77±6.06)% and (132.50±5.58)%, respectively. There was no significant difference between L-carnitine group and control group( P>0.05). There was significant difference between calcium oxalate group and control group ( P<0.01). There was significant difference between calcium oxalate + L-carnitine group and calcium oxalate group ( P<0.05). The SOD levels in control group, L-carnitine group, calcium oxalate group and calcium oxalate + L-carnitine group were (100.00±5.79)%, (105.80±3.26)%, (44.74±7.60)% and (85.01±5.15)%, respectively. There was no significant difference between L-carnitine group and control group( P>0.05). There was significant difference between calcium oxalate group and control group ( P<0.01). There was significant difference between calcium oxalate + L-carnitine group and calcium oxalate group ( P<0.05). The levels of GSH in control group, L-carnitine group, calcium oxalate group and calcium oxalate + L-carnitine group were (100.00±4.73)%, (107.10±5.48)%, (53.49±3.98)% and (85.18±5.48)%, respectively. There was no significant difference between L-carnitine group and control group( P>0.01). There was significant difference between calcium oxalate group and control group ( P<0.01). There was significant difference between calcium oxalate + L-carnitine group and calcium oxalate group ( P<0.01). The levels of MDA in control group, L-carnitine group, calcium oxalate group and calcium oxalate + L-carnitine group were (100.00±2.36)%, (98.00±11.10)%, (129.11±2.59)% and (113.35±5.79)%, respectively. There was no significant difference between L-carnitine group and control group( P>0.05). There was significant difference between calcium oxalate group and control group ( P<0.01). There was significant difference between calcium oxalate + L-carnitine group and calcium oxalate group ( P<0.01). The fluorescence intensity of ferrous ion in control group, calcium oxalate group and calcium oxalate + L-carnitine group was (39.77±0.68) AU, (68.40±3.14) AU and (48.60±4.30) AU, respectively. There was significant difference between calcium oxalate group and control group ( P<0.01). There was significant difference between calcium oxalate + L-carnitine group and calcium oxalate group ( P<0.05). The fluorescence intensity of reactive oxygen species in control group, calcium oxalate group and calcium oxalate + L-carnitine group was (63.98±9.41) AU, (145.41±8.39) AU and (85.37±4.51) AU, respectively. There was significant difference between calcium oxalate group and control group ( P<0.01). There was significant difference between calcium oxalate + L-carnitine group and calcium oxalate group ( P<0.01). Transmission electron microscopy results showed that mitochondria were wrinkled, cristae were broken or disappeared in the calcium oxalate group compared to the control group, and a double-layer membrane structure was evident. DAPI staining showed that compared with the control group, some of the nuclei in the calcium oxalate group were significantly more damaged, while compared with the calcium oxalate group, the nuclei in the calcium oxalate + L-carnitine were significantly less damaged. The results of crystal adhesion test showed that compared with the control group, calcium oxalate crystals in the calcium oxalate group adhered to the cells in black-like particles and formed clusters. Compared with the calcium oxalate group, the calcium oxalate + L-carnitine showed less black particles adhering to the cells. Conclusions:L-carnitine may reduce the effects of oxidative stress and ferroptosis induced by calcium oxalate, thus reducing cell damage and crystal adhesion.

Objective:To explore the clinical value of preconception expanded carrier screening (PECS) in Chinese Han population of childbearing age.Methods:The gene detection results of infertile couples with PECS in the Reproductive Medicine Center of the Second Affiliated Hospital of Zhengzhou University from September 2019 to May 2022 were analyzed retrospectively. The carrier rate of pathogenic gene, the detection rate of high-risk couples and the clinical outcome of high-risk couples were counted and analyzed.Results:A total of 1 565 patients received PECS and they were all Chinese Han. A total of 504 patients received the 108 extended monogenic diseases testing, including 420 females and 84 males, the overall carrier rate of the target genes was 30.75% (129/420), and the detection rate of high-risk couples was 1.19% (1/84), the higher carrier rates of the tested genes were MMACHC [2.58% (13/504)], ATP7B [2.38% (12/504)], SLC22A5 [2.18% (11/504)], GALC [1.79% (9/504)], PAH [1.79% (9/504)] and MLC1 [1.19% (6/504)], the rest are less than 1%. There were 555 patients accepted FMR1 gene detection, and 5 patients with FMR1 gene mutation, accounting for 0.90%. Testing for direct relatives of patients with complete mutations, her mother is a pre mutation carrier with a CGG repeat count of 105. A total of 502 patients accepted SMN1 gene testing. Totally 14 femals and 2 males were found to be SMN1 gene carriers in this study, with a carrier rate of 3.19%. Conclusion:The carryier rate of single gene recessive disorder is high in the population. Screening before pregnancy can provide birth health guidance for patients, help them to choose preimplantation genetic testing for monogenic/single gene disorders (PGT-M) and prenatal diagnosis, to avoid the birth of silk children.

Objective:To explore the clinical value of preconception expanded carrier screening (PECS) in Chinese Han population of childbearing age.Methods:The gene detection results of infertile couples with PECS in the Reproductive Medicine Center of the Second Affiliated Hospital of Zhengzhou University from September 2019 to May 2022 were analyzed retrospectively. The carrier rate of pathogenic gene, the detection rate of high-risk couples and the clinical outcome of high-risk couples were counted and analyzed.Results:A total of 1 565 patients received PECS and they were all Chinese Han. A total of 504 patients received the 108 extended monogenic diseases testing, including 420 females and 84 males, the overall carrier rate of the target genes was 30.75% (129/420), and the detection rate of high-risk couples was 1.19% (1/84), the higher carrier rates of the tested genes were MMACHC [2.58% (13/504)], ATP7B [2.38% (12/504)], SLC22A5 [2.18% (11/504)], GALC [1.79% (9/504)], PAH [1.79% (9/504)] and MLC1 [1.19% (6/504)], the rest are less than 1%. There were 555 patients accepted FMR1 gene detection, and 5 patients with FMR1 gene mutation, accounting for 0.90%. Testing for direct relatives of patients with complete mutations, her mother is a pre mutation carrier with a CGG repeat count of 105. A total of 502 patients accepted SMN1 gene testing. Totally 14 femals and 2 males were found to be SMN1 gene carriers in this study, with a carrier rate of 3.19%. Conclusion:The carryier rate of single gene recessive disorder is high in the population. Screening before pregnancy can provide birth health guidance for patients, help them to choose preimplantation genetic testing for monogenic/single gene disorders (PGT-M) and prenatal diagnosis, to avoid the birth of silk children.