Objective To verify the safety and effectiveness of a new percutaneous controllable curved plasma radiofrequency instrument for nucleus pulposus ablation. Methods A new percutaneous controllable curved plasma radiofrequency instrument were designed (controllable curved group), and its ablation effect was compared with the currently used straight head non-bendable plasma ablation instrument (non-bendable group) on gross specimens. The ablation instrument was placed through the right intervertebral foramen, and continuous ablation on the same intervertebral disc was conducted for three times. The ablation range and trajectory were recorded, and the temperature changes in the front, back, left, and right of the ablation center during and 15 seconds after ablation were monitored by the inserted temperature probe. Results There were no difference in temperature changes in the front, back, right regions of the ablation center during and 15 seconds after ablation between the two groups. The temperature changes in the left region of the ablation center both during and 15 seconds after 3rd ablation were larger than those in the non-bendable group (P＜0.01). Compared with the non-bendable group, the controllable curved group achieved angle control and larger single ablation area (2.282 5 mm² vs 1.135 8 mm², P＜0.000 1). Conclusions This new percutaneous controllable curved plasma ablation instrument can achieve angle control and ablation on the side opposite to the puncture site, increase ablation volume, and is safe.

Objectives:To assess the efficacy of surgical intervention in the management of spinal myeloma(SM)with regards to pain relief,restoration of neurological function,and enhancement of quality of life,as well as to examine the variables influencing the postoperative survival duration of patients.Methods:A retro-spective analysis was conducted on the 49 patients with SM who underwent surgical treatment at the Depart-ment of Orthopaedic Surgery,Zhongshan Hospital,Fudan University and Central Hospital of Xuhui District from January 2010 to December 2022,with complete clinical and follow-up data.Among the patients,there were 28 males and 21 females,with an average age of 64.3±11.3 years,ranging from 36 to 90 years.The average operative time was 148.7±106.4mins,and the average bleeding volume was 792.1±1091.2mL.The fol-low-up time was 1-158 months,with an average of 52.9±37.7 months.There were 4 cases of lesions located alone in the cervical vertebrae,20 cases in the thoracic vertebrae,18 cases in the lumbosacral vertebrae,4 cases in the entire spine,and 8 cases of simultaneous invasion of the thoracic and lumbar vertebrae.There were 24 cases with pain as the main complaint,11 cases with neurological impairment,and 14 cases with concurrent symptoms.Three cases undeiwent anterior surgery and 46 cases undeiwent posterior surgery.The visual analogue scale(VAS)score,Frankel grade of spinal cord injury,and Eastern Cooperative Oncology Group(ECOG)score of patients before and after surgery were compared,and survival analysis of the patients was conducted.Results:The median VAS score and median ECOG score of the patients were 1 and 1 points respectively after surgery,which were significantly lower than before surgery(7 and 2 points respectively,both P＜0.001).The median Frankel grade was E,which was significantly improved compared to preoperative D grade(P＜0.001).One case of spinal implant related complications and two cases of new extraspinal lesions oc-curred after surgery,and no recurrence was observed during follow-up at the surgical site.12 deaths were caused by the progression of myeloma.The 1-year,5-year,and 10-year survival rates of the patients were 89.8％,79.5％,and 75.5％,respectively.Univariate analysis showed that preoperative hemoglobin,blood creati-nine,and postoperative comprehensive treatment were the risk factors affecting patient prognosis(P＜0.1).Cox multiple regression analysis showed that postoperative comprehensive treatment can significantly improve the survival time of patients(P＜0.01).Conclusions:Surgical treatment for SM can effectively alleviate spinal insta-bility,pain and nerve compression symptoms in patients,and significantly improve their qualities of life.Post-operative comprehensive treatments such as chemotherapy,immunotherapy,or targeted therapy are independent influencing factors for improving patient survival.

Objectives:To assess the efficacy of surgical intervention in the management of spinal myeloma(SM)with regards to pain relief,restoration of neurological function,and enhancement of quality of life,as well as to examine the variables influencing the postoperative survival duration of patients.Methods:A retro-spective analysis was conducted on the 49 patients with SM who underwent surgical treatment at the Depart-ment of Orthopaedic Surgery,Zhongshan Hospital,Fudan University and Central Hospital of Xuhui District from January 2010 to December 2022,with complete clinical and follow-up data.Among the patients,there were 28 males and 21 females,with an average age of 64.3±11.3 years,ranging from 36 to 90 years.The average operative time was 148.7±106.4mins,and the average bleeding volume was 792.1±1091.2mL.The fol-low-up time was 1-158 months,with an average of 52.9±37.7 months.There were 4 cases of lesions located alone in the cervical vertebrae,20 cases in the thoracic vertebrae,18 cases in the lumbosacral vertebrae,4 cases in the entire spine,and 8 cases of simultaneous invasion of the thoracic and lumbar vertebrae.There were 24 cases with pain as the main complaint,11 cases with neurological impairment,and 14 cases with concurrent symptoms.Three cases undeiwent anterior surgery and 46 cases undeiwent posterior surgery.The visual analogue scale(VAS)score,Frankel grade of spinal cord injury,and Eastern Cooperative Oncology Group(ECOG)score of patients before and after surgery were compared,and survival analysis of the patients was conducted.Results:The median VAS score and median ECOG score of the patients were 1 and 1 points respectively after surgery,which were significantly lower than before surgery(7 and 2 points respectively,both P＜0.001).The median Frankel grade was E,which was significantly improved compared to preoperative D grade(P＜0.001).One case of spinal implant related complications and two cases of new extraspinal lesions oc-curred after surgery,and no recurrence was observed during follow-up at the surgical site.12 deaths were caused by the progression of myeloma.The 1-year,5-year,and 10-year survival rates of the patients were 89.8％,79.5％,and 75.5％,respectively.Univariate analysis showed that preoperative hemoglobin,blood creati-nine,and postoperative comprehensive treatment were the risk factors affecting patient prognosis(P＜0.1).Cox multiple regression analysis showed that postoperative comprehensive treatment can significantly improve the survival time of patients(P＜0.01).Conclusions:Surgical treatment for SM can effectively alleviate spinal insta-bility,pain and nerve compression symptoms in patients,and significantly improve their qualities of life.Post-operative comprehensive treatments such as chemotherapy,immunotherapy,or targeted therapy are independent influencing factors for improving patient survival.

OBJECTIVES: To study the gene expression of adipose tissue CD14 METHODS: The data of GSE54350 were obtained from the public database of gene expression profiling. The data were pre-processed by Network Analyst, String 11.0, Cytoscape 3.7.1, and other analytical software. The differentially expressed genes were analyzed by gene ontology biological function and kyoto encycopedia of genes and genomes (KEGG) signaling pathway to establish differential gene protein interaction network, transcription factor-gene regulatory network, microRNA-gene regulatory network, environmental factors-gene regulatory network, and other interaction systems. RESULTS: The gene expression pattern of CD14 CONCLUSIONS The gene expression of adipose tissue CD14
Adipose Tissue ; Computational Biology ; DNA-Binding Proteins ; Diabetes Mellitus, Type 2/genetics* ; Gene Expression ; Gene Expression Profiling ; Gene Regulatory Networks ; Humans ; MicroRNAs/genetics* ; Muscle Proteins

Objective:To evaluate the mid- and long-term outcomes of Dynesys hybrid surgery (in some segments act as a non-fusion device, in other segments act as an alternative of rigid fixation in combination with interbody fusion) in the treatment of multi-segmental lumbar degenerative disease (LDD).Methods:The data of 27 patients who received Dynesys hybrid surgery (hybrid group) for the treatment of LDD from May 2011 to September 2016 and completed the follow-up were retrospectively analyzed. Among them, there were 8 males and 19 females; their average age was 59.1±11.9 years (23-78 years). Main diagnosis: 13 cases of lumbar spinal stenosis, 14 cases of lumbar disc herniation; 4 cases of combined lumbar dynamic position instability, 7 cases of combined lumbar spondylolisthesis. There were 15 cases of two-segment disease, 11 cases of three-segment disease, and 1 case of four-segment disease. Segments distribution: 9 cases of L 3-L 5, 6 cases of L 4-S 1, 7 cases of L 3-S 1, 4 cases of L 2-L 5, and 1 case of L 2-S 1. Midline incision was used to exposure, followed by bilateral pedicle screws implantation, and interbody fusion cage with bone grafting were performed at the fusion level. Twenty-seven patients who underwent TLIF+rigid internal fixation during the same period were included as the control group. Clinical outcomes were measured by visual analog scale (VAS) for low back pain and leg pain, and Oswestry disability index (ODI). Radiological outcomes included fusion rate, intervertebral disc height (DH) of surgical segments and the proximal adjacent segment, range of motion (ROM) of non-fusion segments and the proximal adjacent segment. At the same time, the occurrence of complications was observed. Results:Patients of Hybrid group and control group were followed up for an average of 83.8±20.9 months (48-112 months) and 87.3±16.2 months (53-114 months), respectively. Baseline data of the two groups (average follow-up time, age, gender, surgical level, diagnosis) showed no significant difference. The operation time (183.0±27.8 min) and intraoperative blood loss (301.9±178.9 ml) in the hybrid group were significantly lower than those in the control group (operation time t=2.337, P=0.023; blood loss t=2.706, P=0.01). At the final follow-up, the VAS scores of low back pain and leg pain (low back pain t=12.164, P<0.001; leg pain t=20.603, P<0.001), as well as ODI were significantly improved ( t=22.827, P<0.001). A total of 32 segments received TLIF+Dynesys stabilization and 35 segments received Dynesys non-fusion stabilization in the hybrid group, with 28 segments (87.5%) achieved solid fusion at 1-year follow-up. There were 67 fusion segments in the control group, and the fusion rate at 1-year follow-up was 85.1%. DH of non-fusion segments were lower than that before surgery with statistical significance at final follow-up ( t=2.647, P=0.012), while DH of the fusion segments in the hybrid group and the surgical segments in the control group increased compared with that before surgery at the final follow-up. A certain degree of ROM (2.4°±1.5°) was retained of the non-fusion segments at the final follow-up; the ROM of proximal adjacent segments of non-fused segments was significantly smaller than that of proximal adjacent segments of fused segments ( t=2.126, P=0.044). In the hybrid group, screw loosening occurred in 4 patients (8 screws) and adjacent segment degeneration (ASD) occurred in 5 patients. In the control group, screw loosening occurred in 3 patients (6 screws), while ASD occurred in 8 patients. No screw fracture was observed during the follow-up period and no patients received reoperation. Conclusion:Hybrid surgery of Dynesys stabilization combined with interbody fusion is a safe and effective method for the treatment of multi-segmental LDD. Compared with multi-segmental fusion, this lumbar hybrid surgery has the advantages of less trauma and retaining partial segmental ROM.

Objective: To investigate the influence of bigeminy drug regimen on short-term clinical effects, quality of life and recurrence rate in children with adenoid hypertrophy. Methods: One hundred and thirty patients with adenoid hypertrophy were chosen in the period from January 2014 to December 2016. They were randomly divided into 2 groups:control group (65 patients, nasal glucocorticoid used alone) and observation group (65 patients, montelukast sodiumon the basis of control group). The short-term clinical effect, the levels of A/N, serum inflammatory cytokine and OSA-18 score before and after treatment and recurrence rate of 2 groups were compared. Results: The short-term clinical effects of control group and observation group were separately 73.85%(60/65) and 92.31% (48/65). The levels of A/N after treatment in observation group were significantly lower than those in control group and before treatment: 0.60 ± 0.07 vs. 0.74 ± 0.10, 0.94 ± 0.15 (P<0.05). The levels of IL-1β, IL-2 and IL-4 after treatment in observation group were significantly lower than those in control group and before treatment:IL-1β: (1.50 ± 0.48) ng/L vs. (2.21 ± 0.44), (3.42 ± 0.68) ng/L; IL-2: (21.80 ± 2.08) ng/L vs. (24.28 ± 2.50), (26.61 ± 3.35) ng/L; IL-4: (179.12 ± 35.91) ng/L vs. (244.70 ± 44.42), (284.07 ± 51.87) ng/L (P<0.05). The OSA-18 score after treatment in observation group was significantly lower than that in control group and before treatment (P<0.05). The recurrence rate in control group and observation group was separately 32.31%(21/65) and 15.39%(10/65). The recurrence rate in observation group was significantly lower than that in control group (P<0.05). Conclusions Bigeminy drug regimen in the treatment of children with adenoid hypertrophy can efficiently relieve the respiratory obstruction degree, reduce the levels of inflammatory response, improve the quality of daily life and be helpful to prevent long-term recurrence.

AIM:To investigate the role of caveolin-1 on epithelial-mesenchymal transition (EMT) in human bronchial epithelial (HBE) cells induced by transforming growth factor beta 1 (TGF-β1).METHODS:Immunofluorescence, real-time PCR and Western blot were applied to detect the mRNA and the protein expression of caveolin-1 in the 16HBE cells during EMT.The influence of siRNA-mediated silencing of caveolin-1 on EMT in the 16HBE cells was detected by Western blot.RESULTS:Caveolin-1 was widely present on the cell membrane of the 16HBE cells.The expression of caveolin-1 at mRNA and protein levels was significantly decreased in a time-dependent manner in the 16HBE cells compared with control group (P<0.05) after stimulation with TGF-β1.The morphologic changes of the 16HBE cells induced by TGF-β1 were promoted by caveolin-1 silencing compared with TGF-β1 group.The protein expression of E-cadherin and α-SMA induced by TGF-β1 was promoted by caveolin-1 silencing compared with TGF-β1 group (P<0.05).The phosphorylation levels of AKT and Smad3 were the highest at 30 min and increased significantly compared with control group (P<0.05) after stimulated with TGF-β1.Treatment of the 16HBE cells with TGF-β1 for 30 min after silencing caveolin-1 gene for 24 h significantly increased the phosphorylation levels of AKT and Smad3 compared with TGF-β1 group (P<0.05).CONCLUSION:TGF-β1 down-regulates the expression of caveolin-1 in the 16HBE cells.Caveolin-1 may participate in TGF-β1/Smad pathway and PI3K-AKT pathway, which are the signal transduction pathways for TGF-β1 inducing EMT.

AIM:To investigate the role of canonical transient receptor potential channel 1 ( TRPC1 ) in the migration of human bronchial epithelial cells (16HBE) induced by transforming growth factor-β1 ( TGF-β1).METH-ODS:Silencing of TRPC1 gene expression was performed by siRNA.The cell activity and apoptosis were measured by CCK-8 assay and flow cytometry, respectively.The migration and invasion abilities of the 16HBE cells were detected by wound-healing assay and Transwell assay.The protein expression of E-cadherin and vimentin was determined by Western blot.RESULTS:TGF-β1 treatment significantly enhanced the cell migration distance compared with control groups ( P<0.01 ) .The results of CCK-8 assay and flow cytometry indicated that there were no significant difference in proliferation and apoptosis among TRPC1 siRNA group, TGF-β1 group and control group (P>0.05).The results of wound-healing and Tr-answell assays showed that migration and invasion abilities in TRPC1 siRNA +TGF-β1 group were markedly suppressed compared with TGF-β1 group (P<0.01).The protein expression of E-cadherin and vimentin induced by TGF-β1 was in-hibited by TRPC1 silencing compared with TGF-β1 group (P<0.05).CONCLUSION:TRPC1 is involved in the migra-tion of human bronchial epithelial cells induced by TGF-β1 through regulating the protein expression of E-cadherin and vim-entin.

OBJECTIVETo discuss the treatment characteristics of secretory otitis media (SOM) in cleft palate children.

METHODSA total of 319 patients (524 ears) with SOM and cleft palate (3-14 years old) who accepted treatment were divided into experiment group A, group B, and group C according to effusion characteristics in the middle ear and tympanic pressure. Group A included 112 patients with serous effusion (198 ears). Group B included 162 patients with mucinous effusion (248 ears). Group C included 45 patients (78 ears) with negative pressure in the middle ear without effusion and an acoustic immittance. A total of 208 patients (246 ears) with SOM and tonsil and adenoid hypertrophy were divided into control group Al, group B1, and group Cl matched with the same effusion characteristics in the middle ear and tympanic pressure. Group A and Al accepted puncture in the tympanic cavity, group B and B1 accepted tympanostomy tubes, and group C and Cl accepted puncture in the tympanic cavity after palatoplasty, adenoidectomy, and tonsillectomy. All groups were treated with antibiotics and ear drops. Cure rate and recurrence rate between the experiment group and the control group were compared.

RESULTSThe control group had a better cure rate [93.09% (229/246)] than the experiment group [77.29% (405/524)] 12 months after treatment. The experiment group had a higher recurrence rate [14.57% (59/405)] than the control group [3.93% (9/229)]. Statistical differences were observed between the two groups (P<0.05). SOM with cleft palate initially had a low cure rate, and thus it was treated repeatedly for many times.

CONCLUSIONSOM with cleft palate is different from normal otitis media in terms of clinical manifestation, treatment, outcome, and prognosis. This case should be considered a special otitis media to be treated with special examination and therapy to obtain better results. Repeated puncture in the tympanic cavity and tympanostomy tubes for six months according to effusion characteristics are better treatment options for patients with SOM and cleft palate.

Objective??To?discuss?the?treatment?characteristics?of?secretory?otitis?media?(SOM)?in?cleft?palate?children. Methods??A?total?of?319?patients?(524?ears)?with?SOM?and?cleft?palate?(3-14?years?old)?who?accepted?treatment?were?divided?into?experiment?group?A,?group?B,?and?group?C?according?to?effusion?characteristics?in?the?middle?ear?and?tympanic?pressure.?Group?A?included?112?patients?with?serous?effusion?(198?ears).?Group?B?included?162?patients?with?mucinous?effusion?(248?ears).?Group?C?included?45?patients?(78?ears)?with?negative?pressure?in?the?middle?ear?without?effusion?and?an?acoustic?immit-tance.?A?total?of?208?patients?(246?ears)?with?SOM?and?tonsil?and?adenoid?hypertrophy?were?divided?into?control?group?A1,?group?B1,?and?group?C1?matched?with?the?same?effusion?characteristics?in?the?middle?ear?and?tympanic?pressure.?Group?A?and?A1?accepted?puncture?in?the?tympanic?cavity,?group?B?and?B1?accepted?tympanostomy?tubes,?and?group?C?and?C1?accepted?puncture?in?the?tympanic?cavity?after?palatoplasty,?adenoidectomy,?and?tonsillectomy.?All?groups?were?treated?with?antibiotics?and?ear?drops.?Cure?rate?and?recurrence?rate?between?the?experiment?group?and?the?control?group?were?compared.?Results??The?control?group?had?a?better?cure?rate?[93.09%?(229/246)]?than?the?experiment?group?[77.29%?(405/524)]?12?months?after?treatment.?The?experiment?group?had?a?higher?recurrence?rate?[14.57%?(59/405)]?than?the?control?group?[3.93%?(9/229)].?Statistical?diffe-rences?were?observed?between?the?two?groups?(P<0.05).?SOM?with?cleft?palate?initially?had?a?low?cure?rate,?and?thus?it?was?treated?repeatedly?for?many?times.?Conclusion??SOM?with?cleft?palate?is?different?from?normal?otitis?media?in?terms?of?clinical?manifestation,?treatment,?outcome,?and?prognosis.?This?case?should?be?considered?a?special?otitis?media?to?be?treated?with?special?examination?and?therapy?to?obtain?better?results.?Repeated?puncture?in?the?tympanic?cavity?and?tympanostomy?tubes?for?six?months?according?to?effusion?characteristics?are?better?treatment?options?for?patients?with?SOM?and?cleft?palate.