OBJECTIVE: To evaluate early effectiveness of posterior 180-degree decompression via unilateral biportal endoscopy (UBE) in the treatment of lumbar spinal stenosis (LSS) combined with Michigan State University (MSU)-1 lumbar disc herniation (LDH). METHODS: A retrospective analysis was conducted on clinical data from 33 patients with LSS combined with MSU-1 LDH, who met selection criteria and were treated between March 2022 and January 2024. All patients underwent UBE-assisted 180-degree spinal canal decompression. The cohort comprised 17 males and 16 females, aged 37-82 years (mean, 67.1 years). Preoperative presentations included bilateral lower limbs intermittent claudication and radiating pain, with disease duration ranging from 5 to 13 months (mean, 8.5 months). Affected segments included L _{3, 4} in 4 cases, L _{4, 5} in 28 cases, and L ₅, S ₁ in 1 case. LSS was rated as Schizas grade A in 4 cases, grade B in 5 cases, grade C in 13 cases, and grade D in 11 cases. LDH was categorized as MSU-1A in 24 cases, MSU-1B in 2 cases, and MSU-1AB in 7 cases. Intraoperative parameters (operation time, blood loss) and postoperative hospitalization length were recorded. The visual analogue scale (VAS) score and Oswestry Disability Index (ODI) were used to assess the lower limb pain and functional outcomes after operation. Clinical efficacy was evaluated at last follow-up via modified MacNab criteria. Quantitative radiological assessments included dural sac cross-sectional area (DSCA) measurements and spinal stenosis grading on lumbar MRI. Morphological classification of lumbar canal stenosis was determined according to the Schizas grading, categorized into four grades. RESULTS: The operation time was 60.4-90.8 minutes (mean, 80.3 minutes) and intraoperative blood loss was 13-47 mL (mean, 29.9 mL). The postoperative hospitalization length was 3-5 days (mean, 3.8 days). All patients were followed up 12-16 months (mean, 13.8 months). The VAS score and ODI improved at immediate and 3, 6, and 12 months after operation compared to before operation, and the differences between different time points were significant ( P<0.05). At last follow-up, the clinical efficacy assessed by the modified MacNab criteria were graded as excellent in 23 cases, good in 9 cases, and poor in 1 case, with an excellent and good rate of 96.97%. Postoperative lumbar MRI revealed the significant decompression of the dural sac in 32 cases, with 1 case showing inadequate dural expansion. DSCA measurements confirmed progressive enlargement and stenosis reduction over time. The differences were significant ( P<0.05) before operation, immediately after operation, and at 6 months after operation. At 6 months after operation, Schizas grading of spinal stenosis improved to grade A in 27 cases and grade B in 6 cases. CONCLUSION Posterior 180-degree decompression via UBE is a safe and feasible strategy for treating LSS combined with MSU-1 LDH, achieving effective neural decompression while preserving intervertebral disc integrity.
Humans ; Spinal Stenosis/diagnostic imaging* ; Male ; Female ; Aged ; Lumbar Vertebrae/surgery* ; Middle Aged ; Intervertebral Disc Displacement/complications* ; Decompression, Surgical/methods* ; Retrospective Studies ; Endoscopy/methods* ; Adult ; Aged, 80 and over ; Treatment Outcome

Needle-free injection(NFI)has emerged as a novel vaccine delivery technology,utilizing high-pressure jet streams to deliver vaccines into intradermal or subcutaneous tissues.In recent years,the application of this technology in the fields of medicine and veterinary medicine has a-chieved significant progress.Compared with traditional needle injection,the core advantages of NFI have been highlighted in several aspects:it has significantly improved vaccination efficiency,mak-ing it particularly suitable for mass vaccination campaigns;it has reduced animal stress;it has en-hanced the comfort of vaccination;it has more effectively induced immune responses;and it has a-voided the risk of needle contamination,thereby lowering the infection rate.However,NFI has also faced challenges such as high equipment costs,complex operation,and the need to improve market acceptance.Future research directions have focused on the development of new vaccines and adju-vants as well as the design and optimization of needle-free injectors to enhance their universality and safety among different populations.In summary,NFI has provided an important solution for the innovation of vaccine delivery systems by improving vaccination comfort and immune efficacy and has offered theoretical basis and technical references for its industrial development.

Epitope vaccine is a novel strategy for vaccine development in recent years,exhibiting ad-vantages such as safety,and the ability to induce specific humoral and cellular immune responses a-gainst pathogens.Among them,the identification and delivery of epitopes are crucial in the design of multi-epitope vaccines.Compared to traditional methods of antigenic epitope identification,vari-ous new techniques such as bioinformatics,ELIspot,and intracellular cytokine staining have been developed.Since the direct immunization of multi-epitope peptides results in low protective effica-cy,efficient delivery systems are urgently needed.The antigenic epitopes commonly used delivery systems include viral vectors,and non-virus vectors such as nanoparticles,etc.Additionally,to en-hance the immunization efficacy of vaccines,antigenic epitopes are usually modified,including mul-tiple epitopes in tandem and epitope targeting modification and other strategies.This review sum-marizes the methods for accurate identification of antigenic epitopes with well immunogenicity as well as effective delivery strategies for antigenic epitopes,providing new insight into the develop-ment of novel multi-epitope vaccines.

Needle-free injection(NFI)has emerged as a novel vaccine delivery technology,utilizing high-pressure jet streams to deliver vaccines into intradermal or subcutaneous tissues.In recent years,the application of this technology in the fields of medicine and veterinary medicine has a-chieved significant progress.Compared with traditional needle injection,the core advantages of NFI have been highlighted in several aspects:it has significantly improved vaccination efficiency,mak-ing it particularly suitable for mass vaccination campaigns;it has reduced animal stress;it has en-hanced the comfort of vaccination;it has more effectively induced immune responses;and it has a-voided the risk of needle contamination,thereby lowering the infection rate.However,NFI has also faced challenges such as high equipment costs,complex operation,and the need to improve market acceptance.Future research directions have focused on the development of new vaccines and adju-vants as well as the design and optimization of needle-free injectors to enhance their universality and safety among different populations.In summary,NFI has provided an important solution for the innovation of vaccine delivery systems by improving vaccination comfort and immune efficacy and has offered theoretical basis and technical references for its industrial development.

Epitope vaccine is a novel strategy for vaccine development in recent years,exhibiting ad-vantages such as safety,and the ability to induce specific humoral and cellular immune responses a-gainst pathogens.Among them,the identification and delivery of epitopes are crucial in the design of multi-epitope vaccines.Compared to traditional methods of antigenic epitope identification,vari-ous new techniques such as bioinformatics,ELIspot,and intracellular cytokine staining have been developed.Since the direct immunization of multi-epitope peptides results in low protective effica-cy,efficient delivery systems are urgently needed.The antigenic epitopes commonly used delivery systems include viral vectors,and non-virus vectors such as nanoparticles,etc.Additionally,to en-hance the immunization efficacy of vaccines,antigenic epitopes are usually modified,including mul-tiple epitopes in tandem and epitope targeting modification and other strategies.This review sum-marizes the methods for accurate identification of antigenic epitopes with well immunogenicity as well as effective delivery strategies for antigenic epitopes,providing new insight into the develop-ment of novel multi-epitope vaccines.

African swine fever(ASF)is a virulent,hemorrhagic disease of swine caused by African swine fever virus(ASFV),which seriously affects the healthy development of Chinese pig indus-try.The genome of ASFV is large and encodes more than 165 proteins.Among them,the p54 pro-tein is encoded by the E183L gene,which has various functions such as participating in viral as-sembly,inducing apoptosis and inducing immune response.The conventional Chinese vaccine(C-strain)is a safe and effective attenuated vaccine developed by Chinese scientists.It can efficiently protect against attacks from various genotypes of classical swine fever virus(CSFV).The aim of this study was to investigate whether C-strain can express ASFV p54 protein serve as a delivery vector for ASF genetically engineered vaccines.An infectious clone of pHCLV-p54 was constructed by homologous recombination,the recombinant virus rHCLV-p54 was rescued by transfecting it into SK6 cells by blind passaging.Its genetic stability and growth curve were determined in vitro,while rabbits were immunized to evaluate its immunity effect.The results showed that the E183L gene remained genetically stable in the recombinant virus,indicating that the E183L gene could be stably inherited in recombinant viruses,but the inserted exogenous gene affected the replication of the C-strain.The results of the rabbit immunization test showed that the recombinant virus rHCLV-p54 was able to induce ASFV-specific antibodies.The above results indicated that we have successfully constructed a recombinant C-strain that stably expresses the ASFV p54 protein.In summary,the recombinant virus rHCLV-p54 has a good immunogenicity and is warranted for fur-ther evaluation as a vaccine candidate.

Quantitative analysis of UL35 and gB genes at different time points after PRV infection showed that there were significant differences between the two at 2.5,5.0 and 20.0 h after infec-tion,and the expression of UL35 gene could be observed in the early stage of PRV infection.To de-termine whether the UL 35 gene can be used as a target for the diagnosis of PRV infection,a spe-cific primer pair was designed and synthesized according to the conserved sequence of the UL35 gene of different PRV strains,and used to amplify a fragment of 54 bp in length.After optimizing the reaction conditions and system,the standard curve for the established by SYBR Green Ⅰ real-time PCR detection method showed that it had good repeatability,specificity and a good linear rela-tionship to the template concentration.No amplifications for porcine reproductive and respiratory syndrome virus(PRRSV),classical swine fever virus(CSFV),and African swine fever virus(AS-FV)were detected.Compared with the existing similar methods,the established method showed no difference in sensitivity.The coefficient of variation of inter-and intra-group repeatability for the method was less than 2％.Detection of the samples in mice challenged with PRV revealed a certain amount of viral load in tissue.The results showed that UL35 gene can be used as a target for the diagnosis of PRV infection.

Objective To analyze the prevalence of common chronic diseases and comorbidities in the elderly ≥65 years old in Xinzhou District, Wuhan. Methods A questionnaire survey, physical examination and a retrospective analysis of 12 common chronic diseases comorbidities were conducted in 2016 and 2018 in the resident elderly ≥65 years old. Results In 2016, the medical examination rate of the elderly aged ≥65 years old, the prevalence rate of ≥1 chronic disease, and the comorbidity rate of ≥2 chronic diseases in Xinzhou District were 57.37%, 82.53%, and 48.13%, respectively; in 2018, the medical examination rate, The prevalence of ≥1chronic diseases and the prevalence of ≥2 comorbidities were 47.57%, 83.13%, and 50.02%, respectively. The comparison of the three rates in two years was statistically significant (P＜0.006).The comorbidity of chronic diseases in the elderly accounted for more than 58.32%. The physical examination rate of the elderly is higher in women than in men, and higher in rural areas than in urban areas. The prevalence of chronic diseases is higher in women than in men, and the prevalence of chronic diseases is gradually increasing as the elderly ages. The prevalence of chronic diseases in people with normal BMI is lower than those with abnormal BMI, and the prevalence tend increased gradually with the increase of BMI in abnormal people. Hypertension (70.75%), hyperlipidemia (24.97%), diabetes (16.61%), osteoarthropathy (12.65%), hyperuricemia (9.35%), stroke (8.32%), eyes and appendages (5.88%)ranked the same in 2016 and 2018. Except for hyperuricemia, the prevalence of the other six diseases decreased in 2018 compared with 2016. Conclusion The prevalence of chronic diseases in the elderly ≥65 years old in Xinzhou District is relatively high, showing a slow upward trend. About 50.00% of the elderly suffer from comorbidities. The situation of chronic disease prevention and control is still severe. It is recommended to develop comprehensive prevention and control interventions among this population.

Objective:To investigate the safety and effectiveness of Willis covered stent in patients having carotid artery rupture during transnasal endoscopic pituitary tumor resection.Methods:A retrospective analysis was performed. Six patients having carotid artery rupture during transnasal endoscopic pituitary tumor resection admitted to the 3 hospitals from May 2016 to December 2019 were chosen; their clinical data were collected. The surgical processes and complications were concluded, and the prognoses were evaluated by modified Rankin scale (mRS).Results:One patient was treated with intraoperative simple tamponade compression for hemostasis, and died for massive intracranial hemorrhage 2 weeks after surgery. Five patients were occluded by Willis covered stents; the occluded success rate was 100% but ophthalmic arteries were blocked in all. During the perioperative period, diabetes insipidus occurred in one patient and incomplete oculomotor paralysis occurred in one patient; 5 patients were followed up for 3-12 months: MRI indicated subtotal resection of tumor in 4 patients and total resection in one patient, no new bleeding or ischemic stroke events occurred in these 5 patients, and the prognosis was good.Conclusion:Willis covered stent is safe and effective in patients having carotid artery rupture during transnasal endoscopic pituitary tumor resection.

Objective:To investigate the clinical outcome of transposition of the medial gastrocnemius muscle flap in repairing the middle and upper tibial soft tissue defects.Methods:The clinical data of patients with mid-upper tibial tissue defects admitted to the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from September 2016 to June 2020 were retrospectively analyzed. Doppler ultrasound was used to detect and mark the blood vessels and branches of the lower limbs before surgery, the medial gastrocnemius muscle flap was designed according to the wound condition of the patient, the soft tissue defects in the middle and upper part of the tibia were repaired by transposition, and the appearance, color, feel, texture, gait and plantar flexion strength of the affected foot, as well as the recovery of the donor site were followed up after surgery. For patients with chronic osteomyelitis, the efficacy is evaluated with reference to McKee and other osteomyelitis treatment standards, including three levels: cure, improvement and recurrence.Results:A total of 11 patients were enrolled, including 9 males and 2 females, aged 48 to 69 years. The area of soft tissue defect ranged 3.8 cm×5.7 cm-14.2 cm×7.6 cm, and the flap size ranged 13.0 cm×6.0 cm-21.0 cm×13.0 cm. After surgery, one case had blisters at the distal end, which were cured after conservative measures. Other flaps and donor wounds presented good blood circulation, the shape and function recovered satisfactorily, and the incision healed uneventfully. 11 cases were followed up for 7-18 months after surgery, with an average of 13.2 months, and the appearance, color and texture of the flap were basically satisfactory. The two-point distance perception of the flap was 13-20 mm 9 months after surgery, with an average of 15 mm. At the last follow-up visit, the plantar flexion strength of the affected side was weaker than that of the healthy side, but the gait was basically normal. All 4 patients with chronic osteomyelitis met the clinical cure criteria, and there was no rash, swelling, overheat and pain, rupture, exudation and sinus tract formation at the primary lesion during the follow-up period (average 14 months), and no osteosclerosis and dead bone formation were found on X-ray examination. There was no deformity and dysfunction at the donor site. There was one case presented pigmentation at the donor site of the thigh. Some cases presented superficial scarring.Conclusions:The transposition of the medial gastrocnemius muscle flap repairs the middle and upper tibial tissue defects without sacrificing the major blood vessels, and the flap survival rate is high, the complications are minimal, and the function and morphological recovery of the receiving area are good.