High mobility group box protein 1(HMGB1)is one of the most widely expressed protein member in the HMGs family,which is well known for its involvement in the body inflammatory response.Previous researches have found that it plays a significant role in cell migration,immune identification and neuroprotection.Spinal cord injury is a disease that causes severe damage to the nervous system,and neural circuits are disrupted after a spinal cord injury,which leads to many conditions including ischemia and hypoxia,inflammatory responses,demyelinating lesions,and glial scar formation that are detrimental to nerve regeneration and repair,making it one of the most difficult diseases to treat in the modern spinal surgery field.HMGB1 is upregulated after spinal cord injury,thereby regulating neuroinflam-matory responses,and participating in the neuronal apoptosis,promoting neuronal regeneration,and inducing neural stem cell differentiation and migration,which plays an important role in the process of neural function recovery.This paper summarizes the structure and function of HMGB1,as well as its role in spinal cord injury,in order to provide direction for founding therapeutic target for neurological function recovery after spinal cord injury.

Objective:To observe the effect of Guilu Taohong Formula on semen quality in varicocele(VC)models of rats,and to explore its possible mechanism.Methods:Forty-eight male SD rats were randomly divided into four groups(sham group,model group,Guilu Taohong Formula group and L-carnitine group).After the establishment of models,the rats were treated with intra-gastric administration for eight consecutive weeks.The general condition of the rats was observed.After the gavage,the testicular and epididymal indices were calculated.Semen quality was assessed using an automatic semen analyzer.Apoptosis of testicular cells was assessed by TUNEL staining.And the expression levels of B-cell lymphocytoma-2(Bcl-2),Bcl-2-associated X protein(Bax)and cys-teine aspartate protease-3(caspase-3)in testicular tissue were detected by Western blot.Results:Compared with the sham group,testicular index,epididymal index,sperm concentration,the percentage of progressive motility of sperm(PR％)and the expression level of Bcl-2 decreased in model group(P＜0.01).An increased apoptosis rate of spermatogenic cells and the expression levels of Bax and caspase-3 proteins were observed in model group as well(P＜0.01).Compared with the model group,the testicular index,epidid-ymal index,sperm concentration,PR％and the expression level of Bcl-2 in Guilu Taohong Formula group increased significantly(P＜0.05,P＜0.01).A decreased apoptosis rate of spermatogenic cells and the expression levels of Bax and caspase-3 proteins were de-tected in Guilu Taohong Formula group as well(P＜0.01).Similarly,the L-carnitine group showed increased testicular index,epidid-ymal index,sperm concentration,PR％and the expression level of Bcl-2 protein(P＜0.05,P＜0.01),where showed decreased ap-optosis rate of spermatogenic cells and the expression levels of Bax and caspase-3 proteins compared with model group(P＜0.01,P＜0.05).Conclusion:Guilu Taohong Formula improves semen quality in VC model rats and reduces the apoptosis rate of spermato-genic cells in testicular tissue,which may be related to the promotion of Bcl-2 protein expression and the inhibition of Bax and caspase-3 protein expression levels.

This study was aimed at determining the genetic characteristics of Yersinia pestis in Subei County through differ-ential region(DFR),clustered regularly interspaced short palindromic repeats(CRISPR),and variable number tandem repeat(VNTR)analyses,to guide the tracing of plague outbreaks.The DNA of 89 Yersinia pestis strains isolated from various ani-mal in foci of Subei County from 1973 to 2017 was extracted.Primers for genotyping by DFR,CRISPR,and MLVA were used in PCR,and agarose electrophoresis was used to determine whether the amplified products were present.Genotypes were deter-mined through comparison against the DFR database of Yersinia pestis in China.The PCR products were sequenced and com-pared against the online CRISPR database for Yersinia pestis to determine the genotype.The number of VNTR repeats in each strain was calculated through capillary electrophoresis,and the minimum spanning tree was constructed with BioNumerics 7.6 according to the numbers of VNTR repeats from 89 Yersinia pestis strains in Subei County and 11 strains from a Marmota hi-malayana focus in Qinghai Province.The Yersinia pestis strains in Subei County were divided into six main genotypes by DFR:8,7,lb,5,32,and 44.The Yersinia pestis strains were divided into three gene clusters and three genotypes by CRISPR.Ca35'was the main gene cluster in Subei County;the genotype was 26';and the distribution was primarily in Dangchengwan Town,Yuerhong Township,and Shibaocheng Township.Ca7 and CaΔ5'comprised secondary gene clusters,with genotypes 22 and 24,and were distributed in Dangchengwan Town,Yuerhong Township,and Shibaocheng Township.The Yersinia pes-tis strains in Subei County were divided primarily into three clusters:the Dangchengwan Machang cluster,Yuerhong Township cluster and Dangchengwan Town cluster.Therefore,the Yersinia pestis strains in Subei County,divided into major and minor genotypes according to DFR,CRISPR and MLVA,showed different regional distribution characteristics,highly diverse geno-types,and complex population characteristics.These aspects are particularly important in tracing the sources of plague out-breaks.

OBJECTIVE To explore the efficacy of low temperature plasma(LTP)in treatment of the rats with Pseudomonas aeruginosa(PA)wound infection.METHODS Totally 20 SD rats were assigned to establish the PA wound infection models and were randomly divided into the LTP group with 10 rats and the air control group with 10 rats.The wound healing dynamics,bacterial loading capacity,histopathology,levels of cytokines and microen-vironment features were observed during the healing process.RESULTS LTP accelerates the healing of PA infec-tion wound,the wound area reduced after the treatment for 3 days,and the inflammatory reactions alleviated;the infection symptoms subsided after the treatment for 7 days,and the wounds became dry and scabbed;the wounds reduced in size by day 15,showing favorable healing trends.Repeated measurement analysis of variance(ANOVA)indicated that there was significant difference in the impact of LTP on the covering rate of wounds(Ftime=10.230,P＜0.001;Fbetween-group=11.340,P=0.001;Finteraction=2.890,P=0.042).The result of quantitative bacterial loads analysis showed that the bacterial loads of the LTP group were lower than those of the control group after the treatment for 3,7 and 15 days(P＜0.05).The result of histopathology indicated that the infiltra-ted wound inflammatory cells of the LTP group reduced,the collagen fibers were well-aligned,and the neovascu-larization and formation of granulation tissues were evident.In addition,the pH value of wound tissues and reac-tive oxygen species(ROS)level were improved after the treatment with LTP,which was matched with the process of wound healing.The result of cytokines test showed that LTP could upregulate the levels of VEGF and TGF-β1,downregulate the levels of IL-1β and TNF-α,and promote the wound healing,with statistically signifi-cant differences observed(P＜0.05).CONCLUSION LTP may facilitate the control of infections by reducing the bacterial colony counts,establish the effective microenvironment for tissue healing,and accelerate the healing of wounds with PA infection by regulating the release of healing-related cytokines.

Objective To explore the feasibility and corresponding implementation methods of constructing a sample resource bank based on individual-level data of completed clinical trials and using it to construct external controls for drug/device clinical trials.Methods Taking the pre-marketing clinical trial of transcatheter active valve replacement(TAVR)for the treatment of aortic valve stenosis as an example,the individual-level databases of multiple trials were standardized to form a sample bank.The original data of any trial in the sample bank were selected as the experimental group,and the remaining samples were selected as the control group.The potential confounding was handled by using the propensity score matching and stratification methods to clarify the process of constructing external controls based on the sample bank of individual-level data of clinical trials.Results This study included individual-level data of single-group trials of 4 TAVR devices,with a total of 569 subjects(59.2%male).The number of subjects in Trials 1 to 4 was 120,120,163,and 166,respectively.Propensity score matching enabled the matching of 113,117,125,and 147 subjects with comparable or similar characteristics from individual-level data from other trials,respectively,demonstrating a high matching success rate.The PS score distribution plot after stratification showed that the proportions of subjects in the experimental and control groups in strata 1 to 5 in scheme 1 were 4/103,11/103,22/92,32/87,and 51/64,respectively.For all constructed external controlled trials,a certain number of control samples with similar baseline characteristics to the experimental groups were distributed within each propensity score stratum.The results of the simulation test also reflected the potential differences between different devices in the 12-month all-cause mortality rate.Conclusions The sample bank constructed with individual-level data from clinical trials,as a high-quality data source,can serve as a source of external control for single-arm trials in the same field,and as a useful supplement to the external control scenario of real-world evidence to support drug and device development.At the same time,targeted research on research methods and bias control measures in related fields is also needed.

High mobility group box protein 1(HMGB1)is one of the most widely expressed protein member in the HMGs family,which is well known for its involvement in the body inflammatory response.Previous researches have found that it plays a significant role in cell migration,immune identification and neuroprotection.Spinal cord injury is a disease that causes severe damage to the nervous system,and neural circuits are disrupted after a spinal cord injury,which leads to many conditions including ischemia and hypoxia,inflammatory responses,demyelinating lesions,and glial scar formation that are detrimental to nerve regeneration and repair,making it one of the most difficult diseases to treat in the modern spinal surgery field.HMGB1 is upregulated after spinal cord injury,thereby regulating neuroinflam-matory responses,and participating in the neuronal apoptosis,promoting neuronal regeneration,and inducing neural stem cell differentiation and migration,which plays an important role in the process of neural function recovery.This paper summarizes the structure and function of HMGB1,as well as its role in spinal cord injury,in order to provide direction for founding therapeutic target for neurological function recovery after spinal cord injury.

Objective To investigate and compare the epidemiological characteristics of common respiratory viruses among influenza-like illness(ILI)and severe acute respiratory infection(SARI)cases in Huzhou,Zhejiang Province before and after the COVID-19 pandemic,so as to provide a basis for formulating and adjusting the prevention and control strategies for viral respiratory infectious diseases.Methods ILI and SARI cases at two influenza surveillance sentinel hospitals in Huzhou and had throat swab samples collected during Nov 2017 to Feb 2020(pre-COVID-19 pandemic period)and Dec 2022 to Apr 2024(post-COVID-19 mitigation phase)were selected as the participants.Seven common viral respiratory pathogens were tested,including influenza A virus(H1N1 and H3N2 subtypes),influenza B virus(Victoria lineage,FluB),respiratory syncytial virus(RSV),rhinovirus(HRV),adenovirus(ADV),and severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).The positive rates of respiratory pathogens before and after the COVID-19 pandemic were compared across different age groups and different time.Results A total of 7 948 ILI samples and 2 294 SARI samples were included.The overall positive rate of ILI samples increased from 33.6%to 47.1%,primarily due to the increase in influenza and COVID-19 infections;the overall positive rate of SARI samples decreased from 31.4%to 24.8%,mainly due to the reduction in HRV and ADV infections.During the post-COVID-19 mitigation phase,SARS-CoV-2(22.1%),H3N2(12.7%),and FluB(6.0%)were the primary pathogens in ILI samples,while RSV(7.1%),H3N2(5.3%),and HRV(4.5%)dominated in SARI samples.During the post-COVID-19 mitigation phase,the influenza virus circulation period was shortened.Before the COVID-19 pandemic,RSV was mainly detected in autumn and winter,while during the post-COVID-19 mitigation phase,out-of-season RSV epidemics were observed in spring and summer.Co-infection rate in ILI cases increased significantly in the post-COVID-19 mitigation phase,predominantly consisting of co-infections of COVID-19 and influenza A virus,while co-infection rate in SARI cases showed a decline.Conclusion We found important epidemiological changes in respiratory viruses in Huzhou during the post-COVID-19 mitigation phase compared to pre-COVID-19 period,including increased positive rates of influenza and COVID-19,and disruptions to the seasonal patterns of influenza and RSV.The prevention and control strategies should be adjusted in a timely manner based on the monitoring data.

Objective:To explore the effects of stepped exercise rehabilitation training on cardiopulmonary function and quality of life in patients with ischemic heart disease.Methods:This randomized controlled study enrolled 110 patients with ischemic heart disease admitted to Jiangsu Province Hospital between January 2021 and December 2023.Patients were randomly divided into control group(n=53,routine intervention program)and intervention group(n=52,additional stepped exercise rehabilitation training).After 3-month intervention,cardiopulmonary function[stroke volume(SV),cardiac index(CI),forced expiratory volume in the first second(FEV1),maximum voluntary ventilation(MVV)],quality of life[China questionnaire of quality of life in patients with cardiovascular diseases(CQQC)score],exercise endurance[exercise duration(ED),peak oxygen intake(VO2peak),anaerobic threshold(AT)]and incidence of major adverse cardiovascular events(MACE)were compared between the two groups.Results:We included 53 patients[28 males(52.83％),age 40～69(56.25±7.76)years old]in control group compared to 52 patients[27 males(51.92％),age 40～71(55.25±2.40)years old]in the intervention group after 3-month intervention.Com-pared to patients in the control group,those in the intervention group had significantly higher SV[(65.46±3.58)ml vs.(61.69±3.78)ml],CI[(2.82±0.12)L·min-1·m-2 vs.(2.54±0.09)L·min-1·m-2],FEV1[(2.50±0.06)L vs.(2.31±0.06)L],MVV[(79.66±0.82)L/min vs.(77.16±1.09)L/min],CQQC score[(65.23±2.84)points vs.(47.98±3.25)points],ED[(382.62±31.19)s vs.(353.37±36.32)s],VQ2peak[(20.05±2.43)ml·kg-1·min-2 vs.(16.86±1.61)ml·kg-1·min-2]and AT[(13.34±0.83)ml·kg-1·min-2 vs.(11.46±0.89)ml·kg-1·min-2](P＜0.001 all),and significantly lower total incidence of MACE(11.54％vs.32.08％,P=0.011).Conclu-sion:Stepped exercise rehabilitation training may improve cardiopulmonary function,quality of life,and exercise endurance in patients with ischemic heart disease during the rehabilitation.

Objective To explore the application effect of 3D printed individualized model in the treatment of complex ankle fractures(AF).Methods Patients with complex AF admitted to our hospital from July 2021 to October 2022 were selected and divided into the control group and the observation group using a random number table method,with 50 cases in each group.Patients in the control group were received minimally invasive reduction and internal fixation,while these in the observation group were given minimally invasive reduction and internal fixation under the guidance of 3D printed individualized model.The surgical conditions,ankle joint reduction,stress indicators[norepinephrine(NE)and angiotensin Ⅱ(AngⅡ)],ankle function and postoperative complications were compared between the two groups.Results There were 2 patients in the observation group and 3 patients in the control group were lost to follow-up 12 months after surgery.Compared with the control group,the observation group showed a decrease in the intraoperative blood loss,shortened surgical time,hospitalization time,and weight-bearing activity time,and an increase in the anatomical reduction rate(P<0.05).The observation group had lower serum levels of NE and AngⅡ 1 and 3 days after surgery(P<0.05)and higher Kofoed score and American Orthopedic Foot and Ankle Society(AOFAS)scores 1,6,and 12 months after surgery(P<0.05),as well as lower incidence of postoperative complications(P<0.05)than those in the control group.Conclusion For the treatment of complex AF,3D printed individualized model assisted the formulation of minimally invasive reduction and fixation surgical plans before surgery can shorten surgical time,reduce stress injury,decrease the risk of complications,and simultaneously increase the anatomical reduction rate and improve ankle joint function,thereby accelerating postoperative recovery of patients.

Objective:To explore the effects of stepped exercise rehabilitation training on cardiopulmonary function and quality of life in patients with ischemic heart disease.Methods:This randomized controlled study enrolled 110 patients with ischemic heart disease admitted to Jiangsu Province Hospital between January 2021 and December 2023.Patients were randomly divided into control group(n=53,routine intervention program)and intervention group(n=52,additional stepped exercise rehabilitation training).After 3-month intervention,cardiopulmonary function[stroke volume(SV),cardiac index(CI),forced expiratory volume in the first second(FEV1),maximum voluntary ventilation(MVV)],quality of life[China questionnaire of quality of life in patients with cardiovascular diseases(CQQC)score],exercise endurance[exercise duration(ED),peak oxygen intake(VO2peak),anaerobic threshold(AT)]and incidence of major adverse cardiovascular events(MACE)were compared between the two groups.Results:We included 53 patients[28 males(52.83％),age 40～69(56.25±7.76)years old]in control group compared to 52 patients[27 males(51.92％),age 40～71(55.25±2.40)years old]in the intervention group after 3-month intervention.Com-pared to patients in the control group,those in the intervention group had significantly higher SV[(65.46±3.58)ml vs.(61.69±3.78)ml],CI[(2.82±0.12)L·min-1·m-2 vs.(2.54±0.09)L·min-1·m-2],FEV1[(2.50±0.06)L vs.(2.31±0.06)L],MVV[(79.66±0.82)L/min vs.(77.16±1.09)L/min],CQQC score[(65.23±2.84)points vs.(47.98±3.25)points],ED[(382.62±31.19)s vs.(353.37±36.32)s],VQ2peak[(20.05±2.43)ml·kg-1·min-2 vs.(16.86±1.61)ml·kg-1·min-2]and AT[(13.34±0.83)ml·kg-1·min-2 vs.(11.46±0.89)ml·kg-1·min-2](P＜0.001 all),and significantly lower total incidence of MACE(11.54％vs.32.08％,P=0.011).Conclu-sion:Stepped exercise rehabilitation training may improve cardiopulmonary function,quality of life,and exercise endurance in patients with ischemic heart disease during the rehabilitation.