ObjectiveTo evaluate the efficacy and possible mechanism of Wei's Huoxue Tongluo Formula （韦氏活血通络方，WHTF） in treating atrophic-stage non-arteritic anterior ischemic optic neuropathy （NAION） with qi deficiency and blood stasis. MethodsA total of 82 atrophic-stage NAION patients with qi deficiency and blood stasis were randomly divided into a treatment group and a control group， with 41 cases in each group. The treatment group was given oral administration of WHTF twice a day plus acupoint injection of distilled water 2 ml at Taiyang （EX-HN5） once daily， while the control group received injection of compound anisodine injection 2 ml at Taiyang （EX-HN5） once daily and oral administration of WHTF placebo twice a day. Both groups received treatment for a course of 14 days. The best-corrected visual acuity （BCVA）， optic disc perfusion density （PD）， flux index （FI）， macular superficial PD， vascular density （VD）， and traditional Chinese medicine （TCM） syndrome scores were compared between groups before treatment and on day 7 and day 14 of treatment. Additionally， mean defect （MD） and mean sensitivity （MS） of visual fields were measured before treatment and on day 14， along with safety evaluation. ResultsAfter treatment， both groups showed significant improvement in BCVA， visual field MD and MS， and TCM syndrome scores （P＜0.05 or P＜0.01）. On day 14 of treatment， the TCM syndrome score in the treatment group was significantly lower than that in the control group （P＜0.05）. There was no significant improvement in optic disc PD and FI， and macular superficial PD and VD after treatment in either group （P＞0.05） except that on day 7 the macular superficial foveal PD in the control group was significantly better than that in the treatment group （P＜0.05）. During the treatment period， no serious adverse events occurred in either group. ConclusionWHTF can improve the visual function indicators including visual acuity and visual field， as well as TCM syndrome scores in atrophic-stage NAION patients with qi deficiency and blood stasis. It shows clinical safety， although it does not appear to have a significant effect on optic disc or macular blood flow.

Objective To analyze the differences in structural integrity of cerebral white matter fiber bundles in vegetative state(VS)patients with different prognoses,and to construct an early-stage prognostic prediction model for 1-year post-stabilization prognosis.Methods A retrospective analysis was conducted on 52 VS patients admitted to the Department of Rehabilitation Medicine at Zhujiang Hospital of Southern Medical University.Patients were stratified into good prognosis(n=22)and poor prognosis(n=30)at 1-year follow-up based on Coma Recovery Scale-Revised(CRS-R)scores.The fractional anisotropy values of cerebral white matter fiber bundles were derived from diffusion tensor imaging,and for the first time,the scores of the visual subscales of CRS-R were combined with FA values as input features for the prognostic model.To optimize model construction,the least absolute shrinkage and selection operator regression was employed for feature screening,and synthetic minority over-sampling technique for data balancing.The prognostic prediction model was subsequently developed using a support vector machine algorithm and validated via leave-one-out cross-validation.Model performance was evaluated using area under receiver operating characteristic curve,along with accuracy,sensitivity,specificity,and F1 score metrics.Results Following LASSO regression feature screening,the pontine crossing tract,medial lemniscus,tapetum,splenium of corpus callosum,and visual subscale scores were identified as key predictors.A multimodal SVM-based prediction model constructed with the above features could effectively predict the 1-year prognosis of VS patients,achieving a high predictive performance(AUC=0.894).Conclusion The SVM-based model integrating FA values of specific white matter fiber bundles and visual subscale scores demonstrates excellent predictive performance in predicting the 1-year prognosis of VS patients.

BACKGROUND:Stand-alone oblique lateral interbody fusion has a high rate of complications of fusion segment sink.Oblique lateral interbody fusion with posterior fixation can provide stable support,but intraoperative position changes and double incisions weaken the advantages of this technique.Oblique lateral interbody fusion combined with lateral plate fixation can achieve one-stage decompression in the same incision,while the lateral internal fixation provides stable support. OBJECTIVE:To analyze the short-term efficacy of oblique lateral interbody fusion combined with lateral plate fixation in the treatment of single-level lumbar degenerative disease. METHODS:The clinical data of 34 patients with single-level lumbar degenerative disease treated with oblique lateral interbody fusion combined with lateral plate fixation were collected from May 2020 to October 2022.Among them,14 were males and 20 were females aged from 41 to 72 years at the mean age of(58.6±9.9)years.There were 11 cases of lumbar spondylolisthesis(Ⅰ°),7 cases of lumbar disc herniation with segmental instability,and 16 cases of lumbar spinal stenosis.Operation time,blood loss,and complications were recorded.Visual analog scale scores of lumbago,radiative pain of both lower limbs,and Oswestry disability index scores were evaluated before surgery,3 months after surgery,and the last follow-up.Dural sac cross-sectional area,intervertebral height,and intervertebral fusion were measured and observed. RESULTS AND CONCLUSION:(1)The 34 patients were followed up for 14-36 months,with an average of(21.3±5.2)months.(2)The operation time ranged from 50 to 92 minutes,with an average of(68.5±11.1)minutes.Intraoperative blood loss was 50-170 mL,with an average of(71.6±25.3)mL.(3)Compared with the preoperative results,the visual analog scale scores and Oswestry disability index scores were significantly decreased at 3 months after surgery and at the last follow-up(P<0.001),and the maximum Oswestry disability index scores were improved by nearly 50％.(4)Bone fusion was achieved in all patients during half-year follow-up.The overall complication rate was 21％(7/34),including 1 case of plate displacement,3 cases of cage subsidence,1 case of psoas weakness,and 2 cases of anterior thigh pain.(5)It is concluded that oblique lateral interbody fusion combined with lateral plate fixation for the treatment of lumbar degenerative diseases has the characteristics of less blood loss,short operation time,rapid postoperative recovery,and significant short-term clinical efficacy with the stable support to a certain extent.The long-term curative effect needs further follow-up observation.

Objective:To investigate the differences in brain age and brain age gap (BAG) between patients with prolonged disorders of consciousness (pDoC) and healthy controls (HC).Methods:A retrospective cross-sectional study was performed; 43 patients with pDoC admitted to Rehabilitation Medicine Center, Zhujiang Hospital, Southern Medical University from January 2020 to October 2022 were enrolled; 26 healthy volunteers recruited at the same time and 187 healthy subjects from the publicly available healthy control dataset Nathan Kline Institute-Rockland Sample (NKI-RS) were chosen as HC group. The clinical and imaging data of these subjects were collected. A brain age estimation model was constructed based on amplitude of low-frequency fluctuation (ALFF) in resting-state functional magnetic resonance imaging (rs-fMRI) for healthy individuals, and the pDoC group was used as the test set. A two-sample t-test was used to compare the brain age and BAG differences between the pDoC group and HC group. Pearson correlation analysis was used to explore the correlation between BAG and coma recovery scale-revised (CRS-R) in the pDoC group. Results:The chronological age and estimated brain age in the HC group were (41.54±9.61) and (42.32±10.65) years, respectively, without significant difference ( t=-0.254, P=0.801). The chronological age and estimated brain age in the pDoC group were (49.91±12.03) and (62.79±15.00) years, respectively, with significant difference ( t=-4.341, P<0.001). The BAG in the HC and pDoC groups were (0.78±4.59) and (12.88±7.17) years, respectively, with significant difference ( t=-7.822, P<0.001). Correlation analysis results showed that in the pDoC patients, no correlation was noted between BAG and CRS-R score on the day of imaging scan or 6 months after the day of imaging scan ( r=0.090, P=0.738; r=0.205, P=0.674); no correlation was noted between BAG and difference in CRS-R score (difference value of CRS-R score 6 months after the day of imaging scan-CRS-R score on the day of imaging scan, r=0.246, P=0.687). Conclusion:Compared with the HC subjects, patients with pDoC exhibit an abnormal increase in brain age, suggesting that pDoC caused by severe brain injury may lead to accelerated brain aging.

Objective To analyze the differences in structural integrity of cerebral white matter fiber bundles in vegetative state(VS)patients with different prognoses,and to construct an early-stage prognostic prediction model for 1-year post-stabilization prognosis.Methods A retrospective analysis was conducted on 52 VS patients admitted to the Department of Rehabilitation Medicine at Zhujiang Hospital of Southern Medical University.Patients were stratified into good prognosis(n=22)and poor prognosis(n=30)at 1-year follow-up based on Coma Recovery Scale-Revised(CRS-R)scores.The fractional anisotropy values of cerebral white matter fiber bundles were derived from diffusion tensor imaging,and for the first time,the scores of the visual subscales of CRS-R were combined with FA values as input features for the prognostic model.To optimize model construction,the least absolute shrinkage and selection operator regression was employed for feature screening,and synthetic minority over-sampling technique for data balancing.The prognostic prediction model was subsequently developed using a support vector machine algorithm and validated via leave-one-out cross-validation.Model performance was evaluated using area under receiver operating characteristic curve,along with accuracy,sensitivity,specificity,and F1 score metrics.Results Following LASSO regression feature screening,the pontine crossing tract,medial lemniscus,tapetum,splenium of corpus callosum,and visual subscale scores were identified as key predictors.A multimodal SVM-based prediction model constructed with the above features could effectively predict the 1-year prognosis of VS patients,achieving a high predictive performance(AUC=0.894).Conclusion The SVM-based model integrating FA values of specific white matter fiber bundles and visual subscale scores demonstrates excellent predictive performance in predicting the 1-year prognosis of VS patients.

Objective:To investigate the differences in brain age and brain age gap (BAG) between patients with prolonged disorders of consciousness (pDoC) and healthy controls (HC).Methods:A retrospective cross-sectional study was performed; 43 patients with pDoC admitted to Rehabilitation Medicine Center, Zhujiang Hospital, Southern Medical University from January 2020 to October 2022 were enrolled; 26 healthy volunteers recruited at the same time and 187 healthy subjects from the publicly available healthy control dataset Nathan Kline Institute-Rockland Sample (NKI-RS) were chosen as HC group. The clinical and imaging data of these subjects were collected. A brain age estimation model was constructed based on amplitude of low-frequency fluctuation (ALFF) in resting-state functional magnetic resonance imaging (rs-fMRI) for healthy individuals, and the pDoC group was used as the test set. A two-sample t-test was used to compare the brain age and BAG differences between the pDoC group and HC group. Pearson correlation analysis was used to explore the correlation between BAG and coma recovery scale-revised (CRS-R) in the pDoC group. Results:The chronological age and estimated brain age in the HC group were (41.54±9.61) and (42.32±10.65) years, respectively, without significant difference ( t=-0.254, P=0.801). The chronological age and estimated brain age in the pDoC group were (49.91±12.03) and (62.79±15.00) years, respectively, with significant difference ( t=-4.341, P<0.001). The BAG in the HC and pDoC groups were (0.78±4.59) and (12.88±7.17) years, respectively, with significant difference ( t=-7.822, P<0.001). Correlation analysis results showed that in the pDoC patients, no correlation was noted between BAG and CRS-R score on the day of imaging scan or 6 months after the day of imaging scan ( r=0.090, P=0.738; r=0.205, P=0.674); no correlation was noted between BAG and difference in CRS-R score (difference value of CRS-R score 6 months after the day of imaging scan-CRS-R score on the day of imaging scan, r=0.246, P=0.687). Conclusion:Compared with the HC subjects, patients with pDoC exhibit an abnormal increase in brain age, suggesting that pDoC caused by severe brain injury may lead to accelerated brain aging.

Objective : To investigate the role and related molecular mechanisms of vitamin D3 ( VitD3 ) in airway inflammation and oxidative stress response in bronchial asthma mice． Methods : Twenty-eight female C57BL/6 mice were randomly divided into a control group ( Ctrl) and a model group．The model group mice were sensitized using ovalbumin ( OVA) to establish an asthma model，and were further divided into an asthma (Asthma) group， VitD3 treatment (Asthma + VitD3 ) group，and Forkhead Box O1 (FOXO1) inhibitor AS1842856 treatment (Asth- ma + AS) group．Lung resistance (LR) changes were measured in each group of mice．Enzyme-linked immunosor- bent assay (ELISA) was used to detect the levels of tumor necrosis factor-alpha (TNF-α) ，interleukin ( IL) -1 β , and IL-18 in bronchoalveolar lavage fluid ( BALF) ．Western blot was used to determine the expression levels of FOXO1，NOD-like receptor pyrin domain containing 3 (NLRP3) ，Caspase-1，and apoptosis-associated speck-like protein (ASC) in lung tissue. Results : ompared to the Ctrl group mice，LR increased in the Asthma group mice (P＜0. 01) ．Compared to the Asthma group，LR decreased in the Asthma + VitD3 and Asthma + AS group mice (P＜0. 05) ，with no significant difference in LR change between Asthma + VitD3 and Asthma + AS group mice. Compared to the Ctrl group，TNF-α , IL-1 β , and IL-18 levels in BALF，as well as NLRP3，Caspase-1，and ASC protein expression levels in lung tissue，increased in the Asthma，Asthma + VitD3 ，and Asthma + AS group mice (P＜0. 05) ．Compared to the Asthma group，the Asthma + VitD3 and Asthma + AS group mice showed decreased levels of the mentioned inflammatory factors in BALF and reduced protein expression of NLRP3，FOXO1，Caspase- 1，and ASC in lung tissue (P＜0. 05) ．Compared to the Asthma + VitD3 group，the Asthma + AS group showed in- creased FOXO1 protein expression (P ＜0. 05) ，with no statistically significant differences in the other measured indicators． Conclusion VitD3 can alleviate asthma symptoms induced by OVA in mice，improve the degree of air- way inflammation，and reduce oxidative stress levels．The mechanism may be related to the downregulation of the FOXO1/ NLRP3 axis.

Objective:To observe the effect of metformin on intestinal metabolites and its protective effect on lung injury in an elderly sepsis rat.Methods:SD rats were fed at the Animal Laboratory Center of Zhengzhou University, fourteen elderly SD rats were randomly divided into three groups: sham surgery (age-Sham, AgS group, n=4), cecal ligation and perforation induced sepsis (age-Cecal ligation and puncture, AgCLP group, n=5), and oral administration of metformin (100 mg/kg) after 1 h of CLP treatment (age-Metformin, AgMET group, n=5). Collected rat feces 24 h after modeling, and analyzed the composition and inter group differences of metabolites in the feces using liquid chromatography tandem mass spectrometry non targeted metabolomics. Collected rat lung tissues and detected the expression levels of inflammation related genes and pathological changes in the tissue. The visualization of metabolic changes between groups were presented using orthogonal partial least squares discriminant analysis, heatmaps, and unsupervised principal component analysis, respectively. MetaboAnalyst 3.0 was used to evaluate the Pathway analysis of metabolites, and this software was based on the KEGG database and the human metabolome database. Results:The expressions of CCL4 ( F=203.00, P<0.001), CXCL1( F=65.69, P<0.001), IL-6 ( F=38.94, P<0.002), TNF-α ( F=14.85, P=0.005) between two groups of rats were significantly different (all P<0.05). However, there was no significant difference in CCL2 expression between AgCLP group and AgMET group. Furthermore, compared with the AgS group, the relative intensities of 17 metabolites such as 7-methylxanthine, N-Arachidonylglycine and Manolide in AgCLP group were significantly increased, whereas the 9 metabolites such as Phenazone, Gly-Phe and Valyproline were significantly decreased, and metformin treatment could reverse these changes of the above metabolites. Correlation analysis showed that the IL-6 and TNF-α levels were positively correlated with the relative strength of 7-Methylxanthine, N-Arachidonylglycine and other metabolites, but negatively correlated with the Phenazone and Gly-Phe. CCL4 and CXCL1 were positively correlated with Manolide, but negatively correlated with Valyproline. Conclusion:The results of this study showed that metformin improved sepsis induced acute lung injury and regulates the host intestinal metabolites, which might provide a potential and effective treatment for elderly sepsis induced acute lung injury.

Objective To report and analyze the clinical characteristics of kidney transplant recipients(KTRs)combined with novel coronavirus Omicron variant strain infection of novel coronavirus(SARS-CoV-2),and to investigate the possible factors affecting the serum creatinine change.Methods The patients under-going allogeneic kidney transplantation and complicating Omicron variant strain infection in this hospital from October 2022 to December 2023 were retrospectively observed.Their clinical data,basic complications and prognosis,etc.were collected and analyzed.The possible factors affecting the serum creatinine change were an-alyzed.Results Among the 114 cases of KTRs combined with Omicron variant strain infection included in this study,there were 90 cases(78.9％)in the home management group(group A),18 cases(15.8％)in the non-intensive isolation ward group(group B)and 6 cases(5.3％)in the ICU group(group C).The most common symptoms were in turn fever(90.4％),fatigue(65.8％)and cough(61.4％),the clinical manifesta-tions were mainly upper respiratory tract infection symptoms.The overall mortality rate was 2.6％(3/114),moreover the dead patients all were in the group C.The number of basic comorbidities in the group C was higher than that in the group B and group A(P＜0.05).The patients were re-divided into 33 cases(28.9％)in the creatinine increase group(group D),71 cases(62.3％)in the creatinine unchange group(group E)and 10 cases(8.8％)in the creatinine decrease group(group F).The patients in the F group were the patients with mild and moderate Omicron variant strain infection in the group A,and a larger proportions of the pa-tients in the group D and group F discontinued or reduced the calcineurin inhibitor(CNI)type drugs than in the group E.Conclusion The hazard of Omicron variant strains to KTRs has been greatly reduced compared with previous other variant strains.Realizing the immune balance between anti-infection and anti-rejection is the effective measure for preventing renal function damage in KTRs.

Inhibiting the death receptor 3(DR3)signaling pathway in group 3 innate lymphoid cells(ILC3s)pre-sents a promising approach for promoting mucosal repair in individuals with ulcerative colitis(UC).Paeoniflorin,a prominent component of Paeonia lactiflora Pall.,has demonstrated the ability to restore barrier function in UC mice,but the precise mechanism remains unclear.In this study,we aimed to delve into whether paeoniflorin may promote intestinal mucosal repair in chronic colitis by inhibiting DR3 signaling in ILC3s.C57BL/6 mice were subjected to random allocation into 7 distinct groups,namely the control group,the 2％dextran sodium sulfate(DSS)group,the paeoniflorin groups(25,50,and 100 mg/kg),the anti-tumor necrosis factor-like ligand 1A(anti-TL1A)antibody group,and the IgG group.We detected the expression of DR3 signaling pathway proteins and the proportion of ILC3s in the mouse colon using Western blot and flow cytometry,respectively.Meanwhile,DR3-overexpressing MNK-3 cells and 2％ DSS-induced Rag1-/-mice were used for verification.The results showed that paeoniflorin alleviated DSS-induced chronic colitis and repaired the intestinal mucosal barrier.Simultaneously,paeoniflorin inhibited the DR3 signaling pathway in ILC3s and regulated the content of cytokines(interleukin-17A,granulocyte-macrophage colony stimulating factor,and interleukin-22).Alternatively,paeoniflorin directly inhibited the DR3 signaling pathway in ILC3s to repair mucosal damage indepen-dently of the adaptive immune system.We additionally confirmed that paeoniflorin-conditioned me-dium(CM)restored the expression of tight junctions in Caco-2 cells via coculture.In conclusion,paeoniflorin ameliorates chronic colitis by enhancing the intestinal barrier in an ILC3-dependent manner,and its mechanism is associated with the inhibition of the DR3 signaling pathway.