1.Comparison study of the efficacy of spinal endoscopic decompression through 45° puncture versus traditional transforaminal endoscopic spinal system technique in the treatment of L5/S1 disc herniation
Fei CAO ; Peiheng YAO ; Jinjun MIAO ; Yaru JIAO
China Journal of Endoscopy 2025;31(4):65-73
Objective To investigate the efficacy and safety of spinal endoscopic decompression through 45° puncture foraminal approach in treatment of L5/S1 lumbar disc herniation(LDH).Methods Clinical data of 130 patients with L5/S1 level LDH from January 2021 to January 2023 were retrospectively analyzed.These patients were divided into two groups based on the spinal endoscopic surgery approach.Observation group(67 patients)underwent spinal endoscopic decompression via 45° puncture,while the control group(63 patients)underwent spinal endoscopic decompression using the traditional transforaminal endoscopic spinal system(TESSYS)technique.Perioperative indicators such as operation time,X-ray fluoroscopy time,and hospital stay were recorded for both groups.Visual analogue scale(VAS)scores for low back pain and lower limb pain,as well as the Oswestry disability index(ODI)were assessed before surgery and at 1 day,3 months,6 months,and 12 months after operation.The overall efficacy was evaluated using the modified MacNab criterion at 12 months postoperatively.Results All the patients in both groups successfully underwent spinal endoscopic decompression.The observation group had significantly shorter average operation time and intraoperative X-ray fluoroscopy time compared to the control group,the differences were statistically significant(P<0.05).There was no significant difference in hospital stay between the two groups(P=0.505).Compared to preoperative values,both groups showed a significant decreasing trend in VAS scores for low back pain,lower limb pain,and ODI at 1 day,3 months,6 months,and 12 months after operation,the differences were statistically significant(P<0.05).The observation group had significantly low back pain VAS score,lower limb pain VAS score and ODI at 1 day and 3 months after operation compared to the control group(P<0.05).There were no statistically significant differences in low back pain VAS score,lower limb pain VAS score and ODI between the two groups 6 and 12 months after operation(P>0.05).At 12 months after operation,the excellent and good rate was 95.5% in observation group and 85.7% in control group,with no significant difference between the two groups(P=0.054).No surgery-related complications occurred in either group.During postoperative follow-up,6 patients(9.5%)in control group experienced recurrence of low back pain and lower limb pain due to recompression of nerve roots by residual herniated material,while no recurrence was observed in observation group,the difference was statistically significant(P=0.035).Conclusion Both the 45° puncture technique and the traditional TESSYS technique can achieve satisfactory decompression effects in patients with LDH at the L5/S1 segment undergoing transforaminal spinal endoscopic decompression surgery.However,the 45° puncture technique can shorten the operation time and X-ray fluoroscopy time,resulting in more pronounced early postoperative improvement and a lower recurrence rate.It is worthy clinical application.
2.Comparison study of the efficacy of spinal endoscopic decompression through 45° puncture versus traditional transforaminal endoscopic spinal system technique in the treatment of L5/S1 disc herniation
Fei CAO ; Peiheng YAO ; Jinjun MIAO ; Yaru JIAO
China Journal of Endoscopy 2025;31(4):65-73
Objective To investigate the efficacy and safety of spinal endoscopic decompression through 45° puncture foraminal approach in treatment of L5/S1 lumbar disc herniation(LDH).Methods Clinical data of 130 patients with L5/S1 level LDH from January 2021 to January 2023 were retrospectively analyzed.These patients were divided into two groups based on the spinal endoscopic surgery approach.Observation group(67 patients)underwent spinal endoscopic decompression via 45° puncture,while the control group(63 patients)underwent spinal endoscopic decompression using the traditional transforaminal endoscopic spinal system(TESSYS)technique.Perioperative indicators such as operation time,X-ray fluoroscopy time,and hospital stay were recorded for both groups.Visual analogue scale(VAS)scores for low back pain and lower limb pain,as well as the Oswestry disability index(ODI)were assessed before surgery and at 1 day,3 months,6 months,and 12 months after operation.The overall efficacy was evaluated using the modified MacNab criterion at 12 months postoperatively.Results All the patients in both groups successfully underwent spinal endoscopic decompression.The observation group had significantly shorter average operation time and intraoperative X-ray fluoroscopy time compared to the control group,the differences were statistically significant(P<0.05).There was no significant difference in hospital stay between the two groups(P=0.505).Compared to preoperative values,both groups showed a significant decreasing trend in VAS scores for low back pain,lower limb pain,and ODI at 1 day,3 months,6 months,and 12 months after operation,the differences were statistically significant(P<0.05).The observation group had significantly low back pain VAS score,lower limb pain VAS score and ODI at 1 day and 3 months after operation compared to the control group(P<0.05).There were no statistically significant differences in low back pain VAS score,lower limb pain VAS score and ODI between the two groups 6 and 12 months after operation(P>0.05).At 12 months after operation,the excellent and good rate was 95.5% in observation group and 85.7% in control group,with no significant difference between the two groups(P=0.054).No surgery-related complications occurred in either group.During postoperative follow-up,6 patients(9.5%)in control group experienced recurrence of low back pain and lower limb pain due to recompression of nerve roots by residual herniated material,while no recurrence was observed in observation group,the difference was statistically significant(P=0.035).Conclusion Both the 45° puncture technique and the traditional TESSYS technique can achieve satisfactory decompression effects in patients with LDH at the L5/S1 segment undergoing transforaminal spinal endoscopic decompression surgery.However,the 45° puncture technique can shorten the operation time and X-ray fluoroscopy time,resulting in more pronounced early postoperative improvement and a lower recurrence rate.It is worthy clinical application.
3. The role of methyltransferase setd2 in hematological malignancies
Tumor 2020;40(2):137-145
[ABSTRACT] SET domain-containing protein 2 (SETD 2), an epigenetic gene encoding a tri-methyltransferase of histone H3 lysine 36 (H3K36), has been found to be recurrently mutated in a variety of malignancies in the past few decades. SETD2 mutation was firstly identified in solid tumors including renal clear cell carcinoma, glioma and breast cancer, then recently found in multiple hematological malignancies. Increasing evidences have revealed that SETD2 played a pivotal role in regulating the functions of hematopoietic stem cells and the normal development of hematopoietic system. Inactivating mutations of SETD2 can promote the pathogenesis of myeloid, lymphoid leukemia and lymphoma as well as the development of therapeutic resistance. Further elucidation of the molecular mechanisms underlying SETD2-associated hematological malignancies and drug resistance is of great significance for the innovations of diagnosis and treatment methods. In this review, the progress of SETD2 in hematological malignancies are elaborated.
4.Protective effect of polypyrimidine bundle-binding protein-related splicing factor on retinal pigment epithelial cell injury induced by advanced glycation end products
Chen QI ; Hui ZHANG ; Tingting LIN ; Yifeng KE ; Xinjun REN ; Shaochong BU ; Liangyu HUANG ; Yong WANG ; Mingfei JIAO ; Liying HU ; Qiong WANG ; Yaru HONG ; Xiaorong LI ; Lijie DONG
Chinese Journal of Ocular Fundus Diseases 2020;36(1):46-52
Objective To observe the protective effect of polypyrimidine bundle-binding proteinrelated splicing factor (PSF) over-expression on RPE cell injury induced by advanced glycation end products (AGEs).Methods The human RPE cells cultured in vitro were divided into three groups:normal control group (N group),blank control group (N + AGEs group),empty vector control group (Vec + AGEs group),and PSF high expression group (PSF + AGEs).group).RPE cells in N group were routinely cultured;RPE cells in N + AGEs group were only transfected but did not introduce any exogenous genes combined with AGEs induction;Vec +AGEs group and PSF + AGEs group were transfected with pcDNA The empty vector or pcDNA-PSF eukaryotic expression plasmid was introduced into RPE cells and induced by AGEs.Except the N group,the other 3 groups of cells were transfected accordingly,and were stimulated with 150 μg/ml AGEs for 72 h after 24 h.HE staining and Hoechst 33258 staining were used to observe the effect of high PSF expression on the morphological changes of RPE cells;ROS level detection was used to analyze the effect of PSF high expression on the ROS expression of RPE cells induced by AGEs;MTT colorimetric method was used to detect the high PSF expression Effects on the viability of RPE cells;Western blot was used to detect the effects of different time and dose of PSF on the expression of heme oxygenase 1 (HO-1).Results HE staining and Hoechst 33258 staining observation showed that the cells in group N were full in shape,the nucleus was round,the cytoplasm was rich,and the staining was uniform;the cells in N + AGEs group and Vec + AGEs group were reduced in size,the eosinophilic staining was enhanced,and the nucleus was densely densely stained.Pyrolysis and even fragmentation;the morphology of cells in the PSF + AGEs group was still full,the cytoplasm staining was more uniform,and the nucleus staining was uniform.The results of MTT colorimetry showed that high expression of PSF can effectively improve the viability of RPE cells,but this effect can be effectively antagonized by ZnPP,and the difference is statistically significant (F=33.26,P<0.05).DCFH-DA test results showed that compared with the N + AGEs group and Vec + AGEs group,the ROS production in PSF + AGEs group decreased,the difference was statistically significant (F=1 1.94,P<0.05).Western blot analysis showed that PSF protein upregulated HO-1 expression in a time-and dose-dependent manner.The relative expression level of HO-1 at 24,48,and 72 h after PSF protein was significantly higher than that at 0 h,and the difference was statistically significant (F=164.91,P<0.05).The relative expression level of HO-1 under the action of 0.1,0.5,1.0,1.5,and 2.0 μg PSF protein was significantly higher than 0.0 μg,and the difference was statistically significant (F=104.82,P<0.05).Conclusion PSF may inhibit the production of ROS by up-regulating the expression of HO-1,thus protecting the RPE cells induced by AGEs.
5.Lentivirus-mediated polypyrimidine bundle binding protein-associated splicing factor inhibits retinal neovascularization in mice of oxygen-induced retinopathy
Liangyu HUANG ; Yifeng KE ; Tingting LIN ; Shaochong BU ; Xinjun REN ; Mingfei JIAO ; Yong WANG ; Liying HU ; Qiong WANG ; Yaru HONG ; Xiaorong LI ; Lijie DONG
Chinese Journal of Ocular Fundus Diseases 2020;36(1):53-59
Objective To investigate the inhibitory effect oflentivirus-mediated polypyrimidine bundle binding protein-associated splicing factor (PSF) on retinal neovascularization (RNV) in mice model of oxygeninduced retinopathy (OIR).Methods One hundred and twelve 5-day-old C57BL/6J mice were randomly divided into normal control group,simple OIR model group,OIR model + lentivirus empty vector treatment group (Vec group) and OIR model + PSF lentivirus treatment group (PSF group),with 16,32,32 and 32 mice,respectively.When the mice were 7 days old,the mice in the normal control group were fed in a routine environment,and the mice in the OIR model group,Vec group and PSF group were established OIR model.The mice in the Vec group and PSF group were given an intravitreal injection of 1 μl of lentiviral vector and PSF lentivirus (titer 1 × 10~ TU/ml) at the age of 12 days.No injection was performed in the normal control group and simple OIR group.RNV was evaluated by counting the number of pre-retinal neovascular cells and analysis of non-perfusion area by immunofluorescent staining of the mouse retina.Real-time quantitative PCR was applied to detect the mRNA expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and hemeoxygenase1 (HO-1).Western blot analysis was applied to detect the protein expression ofNrf2,HO-1 and PSF.Results Of the normal control group,simple OIR model group,Vec group and PSF group,the number of pre-retinal neovascular cell nuclei were 0.00,14.36 ± 5.50,15.67 ± 4.96,8.13 ± 2.09,the non-perfusion area were 0.00%,(35.71 ± 2.81)%,(36.57 ± 4.53)%,(15.33 ± 4.75)%,respectively.The differences of the number of pre-retinal neovascular cell nuclei and non-perfusion area among 4 groups were significant (F=24.87,165.70;P<0.05).Compared with the normal control group,there were more pre-retinal neovascular cell nucleis and larger nonperfusion area in the simple OIR model group and Vec group (P<0.05).Compared with the simple OIR model group and Vec group,there were lower pre-retinal neovascular cell nucleis and smaller non-perfusion area in the PSF group (P<0.05).Real-time quantitative PCR and Western blot showed that the mRNA expression of Nrf2,HO-1 (F=53.66,83.54) and protein expression ofNrf2,HO-1 and PSF (F=58.38,52.69,24.79) among 4 groups were significant (P<0.05).The rnRNA expression ofNrf2,HO-1 and protein expression of Nrf2,HO-1 and PSF in the simple OIR model group and Vec group decreased significantly than those in the normal control group (P<0.05).The mRNA expression ofNrf2,HO-1 and protein expression ofNrf2,HO-1 and PSF in the PSF group were increased significantly than those in the simple OIR model group and Vec group (P<0.05).model group and Vec group (P<0.05).Conclusion Intravitreal injection of lentivirus-mediated PSF inhibits RNV in mice model of OIR possibly through up-regulating the expression of Nrf2 and HO-1.
6.Effects of pyrimidine bundle-binding protein-associated splicing factors on the function of hypoxia-induced human retinal microvascular endothelial cells
Manhong XU ; Linni WANG ; Tingting LIN ; Xinjun REN ; Yifeng KE ; Liying HU ; Mingfei JIAO ; Yong WANG ; Qiong WANG ; Yaru HONG ; Xiaorong LI ; Lijie DONG
Chinese Journal of Ocular Fundus Diseases 2020;36(2):135-142
Objective:To observe the effect of pyrimidine bundle-binding protein-associated splicing factors (PSF) on the function of hypoxia-induced human retinal microvascular endothelial cells (hRMECs).Methods:A three-plasmid system was used to construct lentivirus (LV)-PSF. After LV-PSF infected hRMECs in vitro, the infection efficiency was measured by flow cytometry. Real-time quantitative PCR (RT-PCR) was used to detect the expression of PSF mRNA in hRMECs infected with LV-PSF. The experiment was divided into two parts, in vivo and in vitro. In vivo experiments: 20 healthy C57B/L6 mice at the age of postnatal 7 were randomly divided into normal group, oxygen-induced retinopathy (OIR) group, OIR+LV-Vec group, and OIR+LV-PSF group, each group has five mice. Mice in 3 groups were constructed with OIR models except the normal group and the mice in OIR group were not treated. The mice in the OIR + LV-Vec group and the OIR+LV-PSF group were injected with an empty vector (LV-Vec) or LV-PSF in the vitreous cavity, respectively. The effect of LV-PSF on the formation of retinal neovascularization (RNV) was observed then. In vitro experiments: hRMECs were divided into normal group, hypoxia group, vector group, and PSF high expression group. HRMECs in the normal group were cultured in vitro; hRMECs in the hypoxic group were restored to normal culture conditions for 3 h after 3 h of hypoxia stimulation; hRMECs in the vector group and PSF high expression group were infected with LV-Vec and LV-PSF for 48 h, and hRMECs were returned to normal culture conditions for 24 h with hypoxia stimulation for 3 h. The effect of PSF on cell proliferation was observed by MTT colorimetry. Cell scratch test and Transwell migration experiment were used to observe the effect of PSF on cell migration ability under hypoxia stimulation. RT-PCR was used to observe the mRNA expression of HIF-1α, VEGF and PSF in each group of cells.Results:The LV-PSF of stably expressing PSF was successfully constructed. The infection efficiency was 97% determined by flow cytometry. The level of PSF mRNA in hRMECs infected with LV-PSF was significantly increased and detected by RT-PCR. In vivo experiments: The RNV area of the mice in the OIR group and the OIR + LV-Vec group was significantly increased compared to the normal group ( t=18.31, 43.71), and the RNV area of the mice in the OIR + LV-PSF group was smaller than that in the OIR group ( t=11.30) and OIR + The LV-Vec group ( t=15.47), and the differences were statistically significant ( P<0.05). In vitro experiments: MTT colorimetry results showed that the proliferative capacity of hRMECs in the hypoxic group was significantly enhanced compared with the normal group ( t=2.57), and the proliferative capacity of hRMECs in the PSF high expression group was significantly lower than that of the normal, hypoxic, and vector groups ( t=5.26, 5.46, 3.73), the differences were statistically significant ( P<0.05). The results of cell scratch test showed that the hRMECs could be stimulated by the hypoxia stimulation for 3 hours to restore the normal condition for 24 hours or 48 hours ( t=8.35, 13.84; P<0.05). Compared with the vector group, cell migration rate in the PSF-high expression group was not significant ( t=10.99, 18.27, 9.75, 8.93, 26.94, 7.01; P<0.05). Transwell experiments showed that the number of cells stained on the microporous membrane was higher in the normal group and the vector groups, while the number of cells stained in the PSF high expression group was significantly reduced ( t=9.33, 6.15; P<0.05). The results of RT-PCR showed that the mRNA expression of HIF-1α and VEGF in hRMECs in the hypoxic and vector groups increased significantly compared with the normal group ( t=15.23, 21.09; P<0.05), but no change in the mRNA expression of PSF ( t=0.12, 2.15; P>0.05); compared with the hypoxia group and the vector group, the HIF-1α and VEGF mRNA expression in hRMECs in the PSF high expression group were significantly decreased ( t=10.18, 13.10; P<0.05), but the PSF mRNA expression increased ( t=65.00, 85.79; P<0.05). Conclusion:PSF can reduce the RNV area in OIR model mice. PSF may inhibit hypoxia-induced proliferation and migration of hRMECs through the HIF-1α/VEGF signaling pathway.

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