Objective:To evaluate the clinical efficacy of pushing reduction with our self-designed spinal fracture reduction device in the treatment of A3N0/1 thoracolumbar fractures.Methods:A retrospective study was conducted to analyze the medical records of 53 patients who had undergone surgery for thoracolumbar vertebrae fracture at Department of Minimally Invasive Spine Surgery, Zhengzhou Orthopedic Hospital from January 2019 to January 2022. All patients were treated by internal fixation via the Wiltse approach and bone grafting through the pedicle of the injured vertebrae. Clinical data: 35 males and 18 females; age: (37.8±10.2) years; injured segments: 23 cases at the thoracic spine and 30 cases at the lumbar spine; time from injury to surgery: (3.3±1.5) days. According to whether our self-designed spinal fracture reduction device was used or not, the patients were assigned into group A (23 cases) in which the injured vertebrae were pushed and reduced using our novel spinal fracture reduction device after vertebral distraction reduction by the pedicle screw and group B (30 cases) in which the injured vertebrae were distracted and reduced using the pedicle screw alone. The operation time, intraoperative blood loss and complications were compared between the 2 groups. The anterior vertebral body height ratio (AVBHr), middle vertebral body height ratio (MVBHr), posterior vertebral body height ratio (PVBHr), Cobb angle of the injured vertebra, visual analogue scale (VAS) and Oswestry disability index (ODI) at preoperation, postoperative 3 and 6 months, and the last follow-up were compared between the 2 groups.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). All patients were followed up for (16.3±5.9) months. All incisions healed at one stage postoperatively without any related complications. The operation time in group A was significantly longer than that in group B [(115.1±16.6) min. versus (101.0±11.5) min.], the intraoperative blood loss in group A was significantly greater than that in group B [(136.5±17.0) mL versus (121.6±19.8) mL], the MVBHr at postoperative 3 months in group A (93.9%±4.0%) was significantly better than that in group B (83.3%±7.6%), and the MVBHr, AVBHr, Cobb angle, VAS, and ODI at the last follow-up in group A [86.6%±5.5%, 89.8%±4.1%, 4°(4°, 6°), 1 (0, 1) point, and 4.7%±2.0%] were significantly better than those in group B [78.0% (74.0%, 79.0%), 84.5%±4.9%, 12.2°±3.3°, 2 (1, 3) points, and 7.3%±2.7%] (all P<0.05). However, there was no statistically significant difference in PVBHr between the 2 groups at postoperative 3 months or at the last follow-up ( P>0.05). Conclusion:In the treatment of A3N0/1 thoracolumbar fractures, pushing reduction with our self-designed spinal fracture reduction device can directly and effectively reduce the fracture zone of the injured vertebra, which is conducive to maintaining postoperative vertebral reduction, reducing vertebral height loss and kyphotic deformity at a later stage, relieving lumbar pain and improving lumbar spine function.

Objective To explore the effect of long non-coding RNA(long non-coding RNA,lncRNA)small RNA host gene 15(small nucleolar RNA host gene 15,SNHG 15)regulating microRNA 95-3p(miR-95-3p)on breast cancer cell proliferation and apoptosis.Methods Breast cancer cells were divided into control group,knockdown group,interference group and co-transfection group.Human breast cancer cell line MDA-MB-231 was cultured in vitro.Measure the relative expression levels of SNHG 15 mRNA and miR-95-3p mRNA;Methylthiazolyldiphenyl-tetrazolium bromide(MTT)was used to detect the proliferation ability of breast cancer cells;The apoptosis of breast cancer cells was detected by flow cytometry;The migration ability of breast cancer cells was detected by scratch test;Transwell invasion test was used to measure the number of breast cancer cells invaded;Western blot was used to determine the relative expression levels of caspase-3,B-cell lymphoma-2(Bcl-2),and Bcl-2 associated X protein(Bax).Results Compared with control group,the relative expression level of SNHG 15 mRNA and miR-95-3p mRNA,proliferation ability,proliferation rate,migration ability,number of invasion,Bcl-2 protein expression were decreased,but the apoptosis status,apoptosis rate,caspase-3 and Bax expression were increased in knockdown group(P＜0.05).Compared with knockdown group and interference group,the relative expression level of SNHG 15 mRNA and miR-95-3p mRNA,proliferation capacity,proliferation rate,migration capacity,number of invasion,Bcl-2 protein expression were increased,but apoptosis status,apoptosis rate,caspase-3 and Bax expression were decreased in co-transfection group(P＜0.05).Compared with interference group,the relative expression level of SNHG 15 mRNA and miR-95-3p mRNA,proliferation ability,proliferation rate,migration ability,number of invasion,Bcl-2 protein expression were increased,but apoptosis status,apoptosis rate,caspase-3 and Bax expression were decreased in co-transfection group(P＜0.05).Conclusion lncRNA SNHG 15 can affect the proliferation and apoptosis of breast cancer cells by regulating miR-95-3p expression,and is positively associated with the occurrence and development of breast cancer cells.

Abstract Female stress urinary incontinence (SUI) is a major global public health problem, and its involuntary urinary leakage may seriously affect patients' quality of life. The pathophysiological changes in muscle, connective and nerve tissues induced by diabetes have been found to be strongly correlated with the development and progression of SUI. This review summarizes the association between diabetes and SUI in women and the underlying pathophysiological mechanisms, so as to provide insights into prevention of SUI among female patients with diabetes.

Ketone bodies have beneficial metabolic activities, and the induction of plasma ketone bodies is a health promotion strategy. Dietary supplementation of sodium butyrate (SB) is an effective approach in the induction of plasma ketone bodies. However, the cellular and molecular mechanisms are unknown. In this study, SB was found to enhance the catalytic activity of 3-hydroxy-3-methylglutaryl-CoA synthase 2 (HMGCS2), a rate-limiting enzyme in ketogenesis, to promote ketone body production in hepatocytes. SB administrated by gavage or intraperitoneal injection significantly induced blood ß-hydroxybutyrate (BHB) in mice. BHB production was induced in the primary hepatocytes by SB. Protein succinylation was altered by SB in the liver tissues with down-regulation in 58 proteins and up-regulation in 26 proteins in the proteomics analysis. However, the alteration was mostly observed in mitochondrial proteins with 41% down- and 65% up-regulation, respectively. Succinylation status of HMGCS2 protein was altered by a reduction at two sites (K221 and K358) without a change in the protein level. The SB effect was significantly reduced by a SIRT5 inhibitor and in Sirt5-KO mice. The data suggests that SB activated HMGCS2 through SIRT5-mediated desuccinylation for ketone body production by the liver. The effect was not associated with an elevation in NAD⁺/NADH ratio according to our metabolomics analysis. The data provide a novel molecular mechanism for SB activity in the induction of ketone body production.
Mice ; Animals ; Butyric Acid/metabolism* ; Ketone Bodies/metabolism* ; Liver/metabolism* ; Hydroxybutyrates/metabolism* ; Down-Regulation ; Sirtuins/metabolism* ; Hydroxymethylglutaryl-CoA Synthase/metabolism*

In this study, 10 aporphine alkaloids were synthesized with 1, 2-methylenedioxy substituent in ring A and 9, 10, 11-position with different substituents in ring D. Their structures were determined by ESI-MS,13C NMR and 1 H NMR.The potencial antitumor activity of these compounds against B16F10 melanoma cells were evaluated by MTT assay, and their structure-activity relationship was further analyzed.Meanwhile, zebrafish acute toxicity test was conducted to evaluate the safety of the active compounds.The results showed that some compounds had strong inhibitory activity on tumor cells, and could significantly inhibit the proliferation of B16F10 melanoma cells.Compound IVa has the best anti-melanoma activity with wide safety range, and can be used as a lead compound for further study on anti-proliferation of B16F10 melanoma cells.

Objective:To investigate the effects of PDCA method on improving the accuracy of the Autar Deep Venous Thrombosis (DVT) Scale used by nurses to assess the risk of deep venous thrombosis in surgical patients.Methods:Applied the way of PDCA, namely, raising questions, analyzing reasons, implementing measures, feeding back effects to professional explanate the difficulty in using the scale, moreover, training the nurses used level education method between August 2017 and December2018.The accuracy and consistency of the scale were compared before and after interventions.Results:A total 396 patients were evaluated in the study. There were significant differences in the consistency of evaluation among hospitalized, post-operative and discharged patients after intervention compared with before intervention ( P< 0.0167).The consistency of assessment of team members and responsible nurses increased from 68 to 120 cases, and the consistency of assessment reached 90.91%. The Kappa consistency of assessment of responsible nurses and team members increased from 0.354 before intervention to 0.879 after intervention. The effect was remarkable. Conclusions:PDCA cycle method is based on the problems found in clinical practice. It clarifies the professional terms and rules used in the scale, improves the accuracy and consistency of the Autar DVT scale used by nurses, correctly reflects the risk of thrombosis, ensures the safety of patients, and is worthy of promotion and reference.

OBJECTIVE: To establish a clinical prediction model of the mid-term fatality risk after radical resection in patients with primary hepatocellular carcinoma (HCC) based on the albumin-bilirubin (ALBI) grade and to assess its prediction value. METHODS: Clinical data of 533 patients who received HCC radical resection in Jinhua Hospital of Zhejiang University, Jinhua People's Hospital, Jinhua Hospital of Traditional Chinese Medicine and Jinhua Guangfu Hospital from January 2010 to August 2016 were retrospectively reviewed. In the training group ( =407), Cox model was used to screen the clinical risk factors of postoperative death, and a predictive model based on ALBI grade was established and then examined in the validation group ( =126). The value of the prediction model was assessed by ROC curve and calibration curve; the prediction results of the model were visualized by the nomogram for the convenience of clinical use. RESULTS: Cox model showed that ALT ≥ 80 U/L, tumor maximum diameter ≥ 5 cm, portal vein tumor thrombus and ALBI grade 2 were independent risk factors for the prognosis of patients with HCC radical resection. The prognosis index (PI) was 0.550×ALT+0.512×ALBI grade+0.872×maximum tumor diameter+1.377×portal vein tumor thrombus. The AUCs for predicting the risk of death in 12, 36 and 60 months were 0.872, 0.814 and 0.810, respectively (all < 0.01), and the goodness of fit ( ) of the established model were 0.953, 0.976 and 0.994. AUC of the established model for predicting risk of death in 36 months after resection was 0.814, which was higher than those of ALBI (AUC=0.683), BCLC (AUC=0.713), CLIP (AUC=0.689), Child-Pugh (AUC=0.645), TNM (AUC=0.612) ( < 0.05 or < 0.01). CONCLUSIONS ALT ≥ 80 U/L, maximum tumor diameter ≥ 5 cm, portal vein tumor thrombus and ALBI grade 2 are independent risk factors of patients after HCC resection, and ALBI grade-based prediction model is satisfactory in prediction of mid-term death risk of the patients.
Albumins ; Bilirubin ; Carcinoma, Hepatocellular ; Humans ; Liver Neoplasms ; Prognosis ; Retrospective Studies

Objective To analyze the influence of ligaments surrounding sacroiliac joints (SIJs) on stability of SIJs by finite element method. Methods The finite element lumbar spine-pelvis-femur model was established. Based on this normal model, all SIJ ligaments in both sides were removed in turn, to establish models without iliolumbar ligaments, sacroiliac anterior ligaments, sacroiliac posterior ligament, sacrotuberous ligaments, sacrospinous ligaments, sacroiliac interosseous ligaments, respectively. The models were used to simulate physiological motions of the spine. The range of motion (ROM) and average stress on the left and right SIJs were analyzed and compared with the normal models. Results Compared with the normal SIJ model, no significant differences in the ROM of bilateral SIJs were found in the models without sacrotuberous ligaments, sacrospinous ligaments and sacroiliac posterior ligaments; for the model without acroiliacinterosseous ligaments, there was no significant difference in the ROM of the left SIJs under spinal right rotation and ROM of the right SIJs under spinal extension, but the ROM of bilateral SIJs increased significantly under the other spinal physiological activities. Under the physiological activities of the spine, the average stress of the SIJ surface in the left and right sides of the model without acroiliacinterosseous ligaments significantly decreased. Conclusions Of all the sacroiliac ligaments, the sacroiliac interosseous ligaments showed the maximum influences on the stability of SIJs. The research findings are helpful to investigate the mechanism of SIJ subluxation and provide certain theoretical basis for clinical treatment of SIJ subluxation.

An accident of mixed acute gas poisoning accident happened in a place in GuangDong in March 2018. To investigates three poisoning workers and related clinical data were summarized., we tested the field air and analyzed the accident reasons. This event due to the staff lack of occupational protection awareness and illegal operation. The working environment must be ventilated before limited space operation, and must be sure that the limited space is safe by toxic gas monitoring. In case of occupational acute gas poisoning, rescuers should help the persons who are poisoned reasonably and meanwhile their own safety.

Retrospective analysis of 18 cases of occupational acute 1, 2-dichloroethane (1, 2-DCE) poisoning. The results showed that all patients have the main manifestations such as dizziness, headache, unresponsiveness and other symptoms of nervous system damage; Brain CT showed varying degrees of diffuse white matter lesions. Brain MRI showed extensive involvement of white matter in both cerebral hemispheres. Affected white matter area presented low intensity on T1WI, hyperintensity on T2WI and T2-Flair; Lumbar puncture examination of cerebrospinal fluid (CSF) pressure (262.5±48.39) mm H₂O; After treatment, the required time for CSF pressure to restore was (161.56±75.27) days (50-280) days. Summary, Occupational acute 1, 2-DCE poisoning caused by toxic encephalopathy can be manifested as persistent abnormalities in CSF pressure, and the CSF pressure drops slowly during treatment; Early head CT and lumbar puncture examination will be helpful for early detection of intracranial pressure in toxic encephalopathy caused by acute 1, 2-DCE poisoning. Dynamic monitoring of CSF provides guidance for acute 1, 2-DCE poisoning with a long time of treatment and various types of dehydrating agents.