Lumbar spinal stenosis (LSS) is a common disabling condition in the elderly, and its clinical assessment relies not only on imaging and neurofunctional indicators but also on traditional Chinese medicine (TCM) syndrome differentiation. To evaluate the concordance between existing LSS animal models and clinical characteristics of TCM and Western medicine, clarify their advantages and limitations, and explore their translational potential, Chinese and English databases, including CNKI, Wanfang Data, PubMed, and Web of Science, are searched using combinations of the terms "lumbar spinal stenosis," "model," "guideline," "consensus," and "norm" from inception to the end of June 2025. After screening, a total of 21 publications are included, of which 15 report animal experimental studies, and 6 are guidelines, consensus statements, or normative documents. Based on these, the existing modeling methods are summarized, diagnostic indicators are extracted from clinical guidelines and expert consensus, and clinical concordance is evaluated using an assessment system proposed in the relevant literature. The results show that the existing animal models are categorized into three concordance levels: high (laminectomy/spinous process removal with filling; laminectomy/spinous process + ligament/muscle removal with filling; autologous bone backfilling), moderate (nylon tape dural binding method, adjustable screws, fixation combined with removal of ligament/muscle), and low (balloon compression method, adjustable balloon compression method, bipedal standing, ligament/muscle resection, steel wire cerclage method). Overall, current animal models of LSS generally perform well in terms of structural construction but show clear limitations in replicating clinical diagnostic logic and TCM syndromes. Future research should enhance syndrome phenotype collection and enrich TCM-based evaluation systems based on existing models. Additionally, multifactorial integrated modeling strategies should be introduced to extend the depth of syndrome-level simulation. This study aims to analyze LSS animal models that can faithfully recapitulate disease pathogenesis, conform to clinical realities of both Western medicine and TCM clinical practice, and have broad application potential, so as to narrow the translational gap between experimental findings and clinical practice.

Objective:To evaluate the effect of sevoflurane on mitochondrial-associated endoplasmic reticulum membranes (MAMs) in mouse microglia and the relationship with silent information regulator-related enzyme 3 (SIRT3)/adenosine triphosphatase family protein 3A (ATAD3A) signaling pathway.Methods:After normal culture of mouse microglia (BV-2 cell line), the cells were divided into 4 groups ( n=33 each) by a random number table method: empty adenovirus-control group (group C), empty adenovirus-sevoflurane exposure group (group Sev), SIRT3 overexpression adenovirus-control group (group SIRT3 + C) and SIRT3 overexpression adenovirus-sevoflurane exposure group (group SIRT3 + Sev). The cells were infected with SIRT3 overexpression adenovirus 100 pmol/well in SIRT3+ C group and SIRT3+ Sev group and with empty adenovirus 100 pmol/well in C group and Sev group. After 48 h of infection, the cells were routinely cultured for 48 h in C group and SIRT3+ C group, the cells were incubated with 3% sevoflurane for 2 h, once a day for 3 consecutive days, followed by routine culture for 48 h in Sev group and SIRT3+ Sev group. The contents of mitochondrial Ca 2+ and reactive oxygen species (mtROS) were measured by flow cytometry. The mitochondrial membrane potential (MMP) was measured by JC-1 probe. The mitochondrial ATP content was measured by luciferase luminescence method. The expression of SIRT3 was detected by Western blot. The expression of acetylated ATAD3A was detected by immunoprecipitation. The co-localization of endoplasmic reticulum and mitochondria was determined by confocal fluorescence microscopy, and the Manders co-localization coefficient was calculated to evaluate the development of MAMs. Results:Compared with group C, the contents of mitochondrial Ca 2+ and mtROS were significantly increased, the contents of MMP and mitochondrial ATP were decreased, the expression of SIRT3 was down-regulated, the expression of acetylated ATAD3A was up-regulated, and the development of MAMs was increased in group Sev ( P<0.05). Compared with Sev group, the contents of mitochondrial Ca 2+ and mtROS were significantly decreased, the contents of MMP and mitochondrial ATP were increased, the expression of SIRT3 was up-regulated, the expression of acetylated ATAD3A was down-regulated, and the development of MAMs was decreased in SIRT3 + Sev group ( P<0.05). Compared with SIRT3+ C group, the contents of mitochondrial Ca 2+ and mtROS were significantly increased, the contents of MMP and mitochondrial ATP were decreased, the expression of SIRT3 was down-regulated, the expression of acetylated ATAD3A was up-regulated, and the development of MAMs was increased in SIRT3+ Sev group ( P<0.05). Conclusions:The mechanism by which sevoflurane induces mitochondrial dysfunction in mouse microglia may be related to the inhibition of SIRT3/ATAD3A signaling pathway, leading to excessive development of MAMs.

Objective:To evaluate the effect of sevoflurane on mitochondrial-associated endoplasmic reticulum membranes (MAMs) in mouse microglia and the relationship with silent information regulator-related enzyme 3 (SIRT3)/adenosine triphosphatase family protein 3A (ATAD3A) signaling pathway.Methods:After normal culture of mouse microglia (BV-2 cell line), the cells were divided into 4 groups ( n=33 each) by a random number table method: empty adenovirus-control group (group C), empty adenovirus-sevoflurane exposure group (group Sev), SIRT3 overexpression adenovirus-control group (group SIRT3 + C) and SIRT3 overexpression adenovirus-sevoflurane exposure group (group SIRT3 + Sev). The cells were infected with SIRT3 overexpression adenovirus 100 pmol/well in SIRT3+ C group and SIRT3+ Sev group and with empty adenovirus 100 pmol/well in C group and Sev group. After 48 h of infection, the cells were routinely cultured for 48 h in C group and SIRT3+ C group, the cells were incubated with 3% sevoflurane for 2 h, once a day for 3 consecutive days, followed by routine culture for 48 h in Sev group and SIRT3+ Sev group. The contents of mitochondrial Ca 2+ and reactive oxygen species (mtROS) were measured by flow cytometry. The mitochondrial membrane potential (MMP) was measured by JC-1 probe. The mitochondrial ATP content was measured by luciferase luminescence method. The expression of SIRT3 was detected by Western blot. The expression of acetylated ATAD3A was detected by immunoprecipitation. The co-localization of endoplasmic reticulum and mitochondria was determined by confocal fluorescence microscopy, and the Manders co-localization coefficient was calculated to evaluate the development of MAMs. Results:Compared with group C, the contents of mitochondrial Ca 2+ and mtROS were significantly increased, the contents of MMP and mitochondrial ATP were decreased, the expression of SIRT3 was down-regulated, the expression of acetylated ATAD3A was up-regulated, and the development of MAMs was increased in group Sev ( P<0.05). Compared with Sev group, the contents of mitochondrial Ca 2+ and mtROS were significantly decreased, the contents of MMP and mitochondrial ATP were increased, the expression of SIRT3 was up-regulated, the expression of acetylated ATAD3A was down-regulated, and the development of MAMs was decreased in SIRT3 + Sev group ( P<0.05). Compared with SIRT3+ C group, the contents of mitochondrial Ca 2+ and mtROS were significantly increased, the contents of MMP and mitochondrial ATP were decreased, the expression of SIRT3 was down-regulated, the expression of acetylated ATAD3A was up-regulated, and the development of MAMs was increased in SIRT3+ Sev group ( P<0.05). Conclusions:The mechanism by which sevoflurane induces mitochondrial dysfunction in mouse microglia may be related to the inhibition of SIRT3/ATAD3A signaling pathway, leading to excessive development of MAMs.

POEMS syndrome is a rare plasma cell dysplasia. Its clinical manifestations include polyneuropathy, monoclonal protein, increased extravascular volume load, endocrinopathy, organomegaly and skin changes. The complex and atypical symptoms at presentation make early diagnosis challenging due to multiple system involvement. Peripheral neuropathy, limb numbness, is the most common initial symptom of this disease. However, case reports of increased extravascular volume load are rare. This article collected and analyzed the clinical data of two groups of patients with different initial symptoms (increased extravascular volume load and limb numbness). The clinical characteristics and treatment responses were summarized.

Objective:This study aimed to examine the relationship between low T3 syndrome (LT3S) and the prognosis of newly diagnosed multiple myeloma (NDMM) patients.Methods:A retrospective examination of 211 NDMM patients treated at the Department of Hematology, Jiangsu Provincial People's Hospital from July 2009 to December 2020 was performed, and all patients received thyroid function testing to determine if they had LT3S. We investigated the relationship between LT3S and clinical features, as well as its impact on MM prognosis.Results:Of the 211 patients, 119 were males, and 92 were females, with a median age of 60 (33-86) years. Patients with LT3S had significantly higher levels of β 2-microglobulin, C-reactive protein, and blood creatinine compared to those with normal T3 levels. They also had lower levels of hemoglobin, platelets, and serum albumin, as well as more advanced ISS stages ( P<0.001) . Patients with LT3S had shorter progression-free survival (PFS) (16 months vs 30 months, P=0.003) and overall survival (OS) (57 months vs 75 months, P=0.004) than patients without LT3S. LT3S was found to be a standalone unfavorable factor in multivariate analysis, LT3S was an independent unfavorable factor in predicting both PFS ( HR=2.114, 95% CI 1.271-3.516, P=0.004) and OS ( HR=2.231, 95% CI 1.088-4.577, P=0.029) . Conclusions:Low T3 syndrome was an independent unfavorable prognostic predictor for NDMM.

Objective:This study aimed to investigate the influence of FGFR3 gene mutations on the clinical characteristics and prognosis of patients with newly diagnosed multiple myeloma (NDMM) .Methods:A total of 198 patients with NDMM admitted to the Department of Hematology in Jiangsu Province Hospital between January 2016 and February 2023 were retrospectively analyzed. Next-generation sequencing and cytoplasmic light chain immunofluorescence with fluorescence in situ hybridization were performed for all patients. The prognostic significance of FGFR3 mutation and clinical features were analyzed using the Log-rank test and Cox proportional hazards model.Results:Among 198 patients, 28 carried the FGFR3 gene mutation. These patients had significantly lower serum albumin levels, higher β 2-microglobulin levels, advanced Revised International Staging System stages, more frequent occurrence of t (4;14) , and shorter median progression-free survival (PFS) time (28 months vs 33 months, P=0.024) and overall survival (OS) time (54 months vs undefined, P=0.028) than patients without FGFR3 mutation. Additionally, patients carrying either FGFR3 mutation or t (4;14) had lower PFS (30 months vs 38 months, P=0.012) and OS (54 months vs undefined, P=0.017) than those without. The Cox proportional hazards model identified FGFR3 mutation as an independent risk factor for PFS and OS. Conclusion:FGFR3 gene mutation was an unfavorable independent prognostic predictor for NDMM.

Objective:To evaluate the predictive value of the UK Myeloma Research Alliance Risk Profile(MRP)score based on clinical outcomes in elderly patients with newly diagnosed multiple myeloma(NDMM).Methods:Patients aged ≥65 years with NDMM in our hospital from March 2018 to September 2021 were divided into three groups with low, medium and high risk according to MRP scores.Their therapeutic efficacy, adverse effects, and survival were analyzed.Results:A total of 63 NDMM patients were enrolled with median age of 69 years(65-84 years)and median follow-up of 13.3(1.2-43.4)months.Based on MRP score, there were 22 patients in the low-risk group, 13 cases in medium-risk group, 28 patients in the high-risk group.The median progression-free survival(PFS)time of the three groups was 38.4, 25.1 and 21.2 months respectively, and the estimated 2-year PFS rate was 83.9%, 60.0%, and 45.6%, respectively(all P=0.177). The estimated 2-year overall survival(OS)rate was 100.0%, 90.0%, 74.6%, respectively(all P=0.049). Among patients with grade 2 or above hematological adverse events, there were 20 cases(71.4%), 7 cases(53.8%)and 8 cases(36.4%)in the high-, medium-and low-risk groups, with statistically significant differences( χ2=6.154, P=0.046). Among patients with grade 3 or higher non-hematological adverse events, there were 17 cases(60.7%), 5 case(38.5%)and 5 cases(22.7%)in the high-, medium-and low-risk groups, with statistically statistical significance( χ2=7.389, P=0.025). The patients experiencing interruption, delay or replacement of chemotherapy regimen were 6 cases(46.2%)and 19 cases(67.9%)in the medium-and high-risk groups, which were higher than in the low-risk group(31.8%, χ2=6.543, P=0.038). Conclusions:It is feasible to conduct MRP score in elderly NDMM patients.The MRP score can be used to predict the adverse events of chemotherapy, etc, and has certain value for the prognosis evaluation of patients.

Objective:To investigate the clinical effect of Banxia Baizhu Tianma decoction combined with bean embedding in ear points on patients with cervical vertigo.Methods:From May 2018 to October 2020, 160 cases of cervical vertigo patients with phlegm turbidity and moderate resistance in Jinhua Central Hospital were selected as the research objects. According to the random number table method, the research objects were divided into ear acupoint buried beans group (A group, n=53), Banxia Baizhu Tianma decoction group (B group, n=54), Banxia Baizhu Tianma decoction combined with ear-buried beans group (C group, n=53). The three groups were treated with ear point burying bean, Banxia Baizhu Tianma decoction and Banxia Baizhu Tianma decoction combined with ear point burying bean for 10 consecutive days. The clinical effect, traditional Chinese medicine (TCM) syndrome score, cerebral blood flow velocity and hemorheology of the three groups were compared. Results:There was no significant difference in the total clinical effective rate between group B and group C ( P>0.05). The total clinical effective rate of group C was significantly higher than that of group A, the difference was statistically significant ( P<0.05). After treatment, scores of vertigo, neck and shoulder pain, headache and symptoms of daily life and work in 3 groups were significantly higher than before treatment, the differences were statistically significant (all P<0.05); The scores of TCM syndrome in group C were significantly higher than those in group A and group B, with statistical significance (all P<0.05). After treatment, the cerebral blood flow velocity of left vertebral artery (LVA), right vertebral artery (PVA), and basilar artery (BA) in the three groups were significantly increased compared with that before treatment, and the cerebral blood flow velocity of LVA, PVA, and BA in group C was significantly faster than that in A, B group, with statistical significance ( P<0.05). After treatment, the plasma viscosity, whole blood high shear viscosity and hematocrit of the patients in the three groups were significantly lower than those before treatment, and the cerebral blood flow velocity of group C was significantly lower than that of group A and group B ( P<0.05). Conclusions:Banxia Baizhu Tianma decoction combined with ear acupoint buried beans in the treatment of cervical vertigo with middle resistance of phlegm and turbidity can improve the symptoms of cervical vertigo, cerebral blood flow velocity and reduce blood viscosity, which is worthy of clinical promotion.

Objective To investigate the effect of esmolol pretreatment on Toll like receptor-4 (TLR4)/nuclear factor-kappa-B (NF-кB) pathway in rats with repeated cerebral ischemia/reperfusion (IR) injury. Methods Forty-eight adult male Sprague-Dawley rats were randomly allocated into sham-operated group, IR group and esmolol group (n=16). Rats in the IR group and esmolol group were injected intravenously with esmolol at a dose of 200 g/(kg?min) or normal saline for one h before surgery, and then, bilateral common carotid arteries were clipped to establish the repeated IR injury models. Bilateral common carotid arteries in rats of sham-operated group were only isolated but not clipped, and injected intravenously with normovolemic normal saline for one h. Learning and memory abilities of rats were measured by Morris water maze test before, and one, 3 and 7 d after surgery. Rats were euthanized and hippocampus tissues were excised. The wet to dry (W/D) ratio of the hippocampus was tested. The permeability of blood-brain barrier was determined by Evans blue (EB) method. The levels of tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6 and IL-1β in the hippocampus were tested by enzyme linked immunosorbent assay (ELISA). The NF-кB p65 and TLR4 mRNA expressions in the hippocampus were determined by reverse transcription-polymerase chain reaction (RT-PCR). The NF-кB p65 and TLR4 protein expressions in hippocampus were detected by Western blotting. Results As compared with those in the sham-operated group, the escape latency was significantly prolonged and swimming distance was signficantly longer in rats of IR group one, 3 and 7 d after surgery (P<0.05), the W/D ratio of the hippocampus and the content of EB in brain tissues were significantly increased in the IR group (P<0.05), the levels of TNF-α, IL-6 and IL-1β in hippocampus were significantly increased in the IR group (P<0.05), and the NF-кB p65 or TLR4 mRNA and protein expressions in the hippocampus of IR group were statistically higher (P<0.05). As compared with IR group, the escape latency and swimming distance of rats in the esmolol group were significantly shortened one, 3 and 7 d after surgery (P<0.05), the W/D ratio of the hippocampus and content of EB in brain tissues of esmolol group were significantly decreased (P<0.05), the levels of TNF-α, IL-6 and IL-1β in the hippocampus of esmolol group were signficantly lower(P<0.05), and the NF-кB p65 or TLR4 mRNA and protein expressions in hippocampus of esmolol group were statistically lower in the esmolol group (P<0.05). Conclusion Esmolol preconditioning can alleviate cerebral injury and improve learning and memory abilities of rats with repeated cerebral IR injury, which may be involved in alleviating inflammation and suppressing TLR4/NF-кB pathway.

Objective To investigate the effect of cerebral ischemia on functional parameters of affected arteries and probe into the possible pathogenesis of ischemia-reperfusion injury.Methods Intraluminal suture ischemic model was used by occlusion of left middle cerebral artery in rats.Two hours later,the middle cerebral artery segments were isolated from both ischemia and control groups for measurement of changes in vessel diameter induced by increasing pressure and vasoactive compounds.And then,distensibility,myogenic tone,reactivity to 5-HT and ACh were calculated and compared between groups.Results In lower pressure range,ischemic vessels showed an increased myogenic tone(at 40 mm Hg,1 mm Hg=0.133 kPa,19.3%±0.4% vs 10.0%±0.2%,t=20.568,P=0.000)and decreased diameter.In higher pressure range,ischemic vessels showed an increased diameter.distensibility and decreased myogenic tone(at 120 mm Hg,12.0%±0.2% vs 21.8%±0.4%,t=-23.575,P=0.000).In normal pressure range,myogenic tone was not altered after ischemia. Both groups constricted to 5-HT and dilated to ACh,however,the response was significantly diminished after ischemla.Conclusion These findings demonstrate that contractile and diastolic function of affected artery was impaired after ischemia,a result that may contribute to ischemia-reperfusion injury by losing upstream cerebrovascular resistance and increasing perfusion on the microcirculation.