AIM:To investigate the preventive and therapeutic effects of sesamin(SES)on fatty liver disease in rats with hypertension combined with dyslipidemia,and to explore the potential mecha-nisms based on mRNA-seq.METHODS:Spontane-ously hypertensive rats(SHRs)were fed a high-fat,high-cholesterol diet to establish a rat model of hy-pertension combined with dyslipidemia,and then treated with SES for 16 weeks continuously.The ex-periment was divided into four groups:WKY,SHR,Model,and Model+SES(160 mg·kg-1·d-1).Blood pressure was measured using the tail-cuff method.Body weight was monitored,and body mass index was calculated.Liver morphology was detected by ultrasound,and liver thickness was measured.Liver wet weight was weighed,and liver index was calcu-lated.Liver volume was detected by the water dis-placement method.Serum triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),alanine aminotransferase(ALT),aspartate amino-transferase(AST),and total bile acids(TBA)were de-tected by ELISA.Liver sequencing analysis was per-formed using mRNA-seq.Liver histomorphological changes were observed by HE staining.The degree of hepatic steatosis was observed by Oil Red O stain-ing,and the degree of hepatic fibrosis was observed by MASSON staining.The mRNA expression of Al-dh1a7,Nnmt,Irs2,Pltp,and Scd was detected by q-PCR.The protein expression of Scd,Nnmt,AMPK,p-AMPK,PPARα,and PPARγ was detected by Western blotting.RESULTS:After 16 weeks of continuous SES administration to rats with hypertension combined with dyslipidemia,blood pressure was significantly reduced(P＜0.01),and body weight was decreased.Serum TG,TC,and LDL-C levels were decreased,while HDL-C levels were increased.Serum ALT and AST levels were decreased.Liver weight,organ in-dex,liver thickness,and liver volume were de-creased.The degree of hepatic steatosis and hepat-ic fibrosis was improved.A total of 545 differentially expressed mRNAs were identified in the livers of rats in each group,of which 278 were upregulated and 267 were downregulated.Among the 27 com-monly differentially expressed mRNAs,five mRNAs related to lipid metabolism were screened,namely Aldh1a7,Nnmt,Irs2,Pltp,and Scd.KEGG enrich-ment analysis showed that the enriched pathways were AMPK and PPAR.Further validation revealed that in the SES-treated group,the mRNA expression of Scd in the liver was decreased,while the mRNA expression of Nnmt was increased.The protein ex-pression of Scd was decreased,while the protein ex-pression of Nnmt,AMPK,p-AMPK,PPARα,and PPARγ was increased.CONCLUSION:SES has preven-tive and therapeutic effects on fatty liver disease in rats with hypertension combined with dyslipidemia,and its mechanism of action may be related to the reduction of Scd expression levels in the liver and the increase in the expression of Nnmt,AMPK,p-AMPK,PPARα,and PPARγ.

BACKGROUND:Spinal osteosarcoma is a rare and highly aggressive malignant tumor.Most existing studies are based on small sample sizes and have inconsistent results,making it difficult to provide reliable clinical guidance.Especially in China,due to the low incidence of spinal osteosarcoma and limited related research,clinicians lack effective prognostic tools during treatment.OBJECTIVE:To construct and validate a nomogram model for predicting the survival of spinal osteosarcoma patients based on the Surveillance,Epidemiology,and End Results(SEER)database,providing scientific evidence for clinical decision-making,particularly for optimizing treatment plans for Chinese patients.METHODS:This study conducted a retrospective analysis of patient data diagnosed with spinal osteosarcoma from the SEER database between 2000 and 2021.First,independent prognostic factors associated with specific mortality from spinal osteosarcoma were identified through univariate and multivariate Cox proportional hazards models.Subsequently,these independent prognostic factors were used to construct a nomogram model for predicting survival rates of spinal osteosarcoma patients using the"rms"package in RStudio.The model's discrimination was assessed using the C-index.Predictive ability was validated through receiver operating characteristic curves and area under the curve values.Calibration was evaluated by calibration plots,and clinical value was measured using decision curve analysis.Additionally,Kaplan-Meier survival analysis was performed to assess the rationality of the nomogram groupings.RESULTS AND CONCLUSION:(1)The final model included six variables:chemotherapy,tumor size,histological type,grade,race,and surgical intervention.(2)The C-indices of the model in the training and validation sets were 0.685 and 0.673,respectively,indicating good discrimination.(3)Calibration curves showed high consistency between predicted survival probabilities and actual survival probabilities.(4)Decision curve analysis indicated that the model provided significant net benefits across a wide range of mortality risks.(5)Kaplan-Meier survival analysis revealed significant differences in prognosis between high-risk and low-risk groups.(6)The constructed nomogram model accurately predicts the 1-year,2-year,and 3-year survival rates of spinal osteosarcoma patients,demonstrating high clinical applicability.This model not only provides an effective survival prediction tool for American patients but also offers important insights for optimizing treatment plans for spinal osteosarcoma patients in China.Future research should further validate the model's applicability in different populations and explore the impact of novel treatment methods on the prognosis of spinal osteosarcoma,aiming to improve the survival rates and quality of life of patients in China.

Objective To investigate the association of cerebral white matter lesions(WMLs)with systolic and diastolic blood pressure.Methods Patients admitted to our department from January 2023 to December 2023 were prospectively recruited for this study.The Fazekas method was used to grade the severity of the periventricular WMLs(P-WMLs)and deep WMLs(D-WMLs).Multivariate logistic regression analyses were performed to examine the association of systolic and diastolic blood pressure with WMLs.Results A total of 966 eligible participants were enrolled in this study.The mean age was 65.96±11.35 years and 487 participants(50.41%)were male.The results indicated that the more severe the P-WMLs and D-WMLs,the higher the systolic blood pressure was[P-WMLs:0:(134.41±19.86)mmHg,1:(136.82±20.47)mmHg,2:(144.52±21.64)mmHg,3:(147.80±20.7)mmHg;D-WMLs:0:(137.49±20.58)mmHg,1:(139.17±21.33)mmHg,2:(144.39±21.20)mmHg,3:(147.50±21.73)mmHg],but not diastolic blood pressure.Multivariate logistic regression analysis showed that an elevated systolic level(P-WMLs:OR=1.02,95%CI:0.009-0.021;D-WMLs:OR=1.01,95%CI:0.005-0.016)was associated with an increased risk of more severe of P-WMLs and deep D-WMLs.No significant association was observed between diastolic blood pressure and WMLs,whether for P-WMLs or D-WMLs.Conclusion The more severe P-WMLs and D-WMLs were,the higher the systolic blood pressure was.Elevated systolic blood pressure was an independent risk factors for more severe of P-WMLs and D-WMLs,but not diastolic blood pressure.

Objective:Medial sural artery perforator flap (MSAPF) was applied to aesthetically reconstruct wounds in foot, and clinical outcome of this surgical method was explored.Methods:A retrospective analysis was conducted on the data of 10 patients who underwent the surgery of transfer of free MSAPF in reconstruction of foot wounds in the Department of Foot and Ankle Surgery, Xuzhou Renci Hospital from January 2020 to January 2023. The patients were 6 males and 4 females, aged 21 to 52 years, with an average of 42.5 years. The soft tissue defects of the injuries were at 2.0 cm × 4.0 cm to 3.5 cm × 6.0 cm in size, with deep tissues exposure down to the base of wound. MSAPF was used for aesthetic reconstruction of the wounds. The surgical procedures were: (1) The flap was thinned under a microscope and only the subdermal vascular network was kept. (2) Vascular pedicle of the flap was taken as long as possible and had it anastomosed with the proximal dorsal foot artery and vein through a subcutaneous tunnel. (3) Allg?wer-Donati method was applied to suture the skin of flap. (4) Donor site was directly closed in surgery. All patients were entered in the scheduled postoperative follow-up at the outpatient clinic of the surgeon who performed the surgery to evaluate the postoperative effect and observe the survival of flaps. Maryland foot function score and British Medical Research Council (BMRC) sensory function score were used to assess the recovery of flap and limb function.Results:The flaps completely survived, and all the donor and recipient sites had primary healing. All of the 10 patients were included in the postoperative follow-up which lasted 8 to 15 months, with an average of 12 months. The flaps from foot featured a pleasing appearance, with good elasticity and wear-resistant. All patients were satisfied and able to walk normally and bear weight without an occurrence of flap ulceration. At the final follow-up, the therapeutic effect was evaluated according to the Maryland scoring system and achieved the scores at 91 to 98, with 95.6 in average. Nine patients were rated as excellent and 1 as good. The sensory grading by BMRC for the flaps was as follows: the flap sensation of the sutured nerve group recovered to S 3 in 3 cases and S 4 in 2 cases, while the non sutured nerve group only recovered protective sensation, S 2 in 3 cases and S 2+ in 2 cases. Conclusion:By applying MSAPF aesthetics to treat foot wounds, a good appearance has been achieved, with good functional recovery and satisfactory therapeutic effects.

BACKGROUND:Spinal osteosarcoma is a rare and highly aggressive malignant tumor.Most existing studies are based on small sample sizes and have inconsistent results,making it difficult to provide reliable clinical guidance.Especially in China,due to the low incidence of spinal osteosarcoma and limited related research,clinicians lack effective prognostic tools during treatment.OBJECTIVE:To construct and validate a nomogram model for predicting the survival of spinal osteosarcoma patients based on the Surveillance,Epidemiology,and End Results(SEER)database,providing scientific evidence for clinical decision-making,particularly for optimizing treatment plans for Chinese patients.METHODS:This study conducted a retrospective analysis of patient data diagnosed with spinal osteosarcoma from the SEER database between 2000 and 2021.First,independent prognostic factors associated with specific mortality from spinal osteosarcoma were identified through univariate and multivariate Cox proportional hazards models.Subsequently,these independent prognostic factors were used to construct a nomogram model for predicting survival rates of spinal osteosarcoma patients using the"rms"package in RStudio.The model's discrimination was assessed using the C-index.Predictive ability was validated through receiver operating characteristic curves and area under the curve values.Calibration was evaluated by calibration plots,and clinical value was measured using decision curve analysis.Additionally,Kaplan-Meier survival analysis was performed to assess the rationality of the nomogram groupings.RESULTS AND CONCLUSION:(1)The final model included six variables:chemotherapy,tumor size,histological type,grade,race,and surgical intervention.(2)The C-indices of the model in the training and validation sets were 0.685 and 0.673,respectively,indicating good discrimination.(3)Calibration curves showed high consistency between predicted survival probabilities and actual survival probabilities.(4)Decision curve analysis indicated that the model provided significant net benefits across a wide range of mortality risks.(5)Kaplan-Meier survival analysis revealed significant differences in prognosis between high-risk and low-risk groups.(6)The constructed nomogram model accurately predicts the 1-year,2-year,and 3-year survival rates of spinal osteosarcoma patients,demonstrating high clinical applicability.This model not only provides an effective survival prediction tool for American patients but also offers important insights for optimizing treatment plans for spinal osteosarcoma patients in China.Future research should further validate the model's applicability in different populations and explore the impact of novel treatment methods on the prognosis of spinal osteosarcoma,aiming to improve the survival rates and quality of life of patients in China.

Objective To investigate the association of cerebral white matter lesions(WMLs)with systolic and diastolic blood pressure.Methods Patients admitted to our department from January 2023 to December 2023 were prospectively recruited for this study.The Fazekas method was used to grade the severity of the periventricular WMLs(P-WMLs)and deep WMLs(D-WMLs).Multivariate logistic regression analyses were performed to examine the association of systolic and diastolic blood pressure with WMLs.Results A total of 966 eligible participants were enrolled in this study.The mean age was 65.96±11.35 years and 487 participants(50.41%)were male.The results indicated that the more severe the P-WMLs and D-WMLs,the higher the systolic blood pressure was[P-WMLs:0:(134.41±19.86)mmHg,1:(136.82±20.47)mmHg,2:(144.52±21.64)mmHg,3:(147.80±20.7)mmHg;D-WMLs:0:(137.49±20.58)mmHg,1:(139.17±21.33)mmHg,2:(144.39±21.20)mmHg,3:(147.50±21.73)mmHg],but not diastolic blood pressure.Multivariate logistic regression analysis showed that an elevated systolic level(P-WMLs:OR=1.02,95%CI:0.009-0.021;D-WMLs:OR=1.01,95%CI:0.005-0.016)was associated with an increased risk of more severe of P-WMLs and deep D-WMLs.No significant association was observed between diastolic blood pressure and WMLs,whether for P-WMLs or D-WMLs.Conclusion The more severe P-WMLs and D-WMLs were,the higher the systolic blood pressure was.Elevated systolic blood pressure was an independent risk factors for more severe of P-WMLs and D-WMLs,but not diastolic blood pressure.

AIM:To investigate the preventive and therapeutic effects of sesamin(SES)on fatty liver disease in rats with hypertension combined with dyslipidemia,and to explore the potential mecha-nisms based on mRNA-seq.METHODS:Spontane-ously hypertensive rats(SHRs)were fed a high-fat,high-cholesterol diet to establish a rat model of hy-pertension combined with dyslipidemia,and then treated with SES for 16 weeks continuously.The ex-periment was divided into four groups:WKY,SHR,Model,and Model+SES(160 mg·kg-1·d-1).Blood pressure was measured using the tail-cuff method.Body weight was monitored,and body mass index was calculated.Liver morphology was detected by ultrasound,and liver thickness was measured.Liver wet weight was weighed,and liver index was calcu-lated.Liver volume was detected by the water dis-placement method.Serum triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),alanine aminotransferase(ALT),aspartate amino-transferase(AST),and total bile acids(TBA)were de-tected by ELISA.Liver sequencing analysis was per-formed using mRNA-seq.Liver histomorphological changes were observed by HE staining.The degree of hepatic steatosis was observed by Oil Red O stain-ing,and the degree of hepatic fibrosis was observed by MASSON staining.The mRNA expression of Al-dh1a7,Nnmt,Irs2,Pltp,and Scd was detected by q-PCR.The protein expression of Scd,Nnmt,AMPK,p-AMPK,PPARα,and PPARγ was detected by Western blotting.RESULTS:After 16 weeks of continuous SES administration to rats with hypertension combined with dyslipidemia,blood pressure was significantly reduced(P＜0.01),and body weight was decreased.Serum TG,TC,and LDL-C levels were decreased,while HDL-C levels were increased.Serum ALT and AST levels were decreased.Liver weight,organ in-dex,liver thickness,and liver volume were de-creased.The degree of hepatic steatosis and hepat-ic fibrosis was improved.A total of 545 differentially expressed mRNAs were identified in the livers of rats in each group,of which 278 were upregulated and 267 were downregulated.Among the 27 com-monly differentially expressed mRNAs,five mRNAs related to lipid metabolism were screened,namely Aldh1a7,Nnmt,Irs2,Pltp,and Scd.KEGG enrich-ment analysis showed that the enriched pathways were AMPK and PPAR.Further validation revealed that in the SES-treated group,the mRNA expression of Scd in the liver was decreased,while the mRNA expression of Nnmt was increased.The protein ex-pression of Scd was decreased,while the protein ex-pression of Nnmt,AMPK,p-AMPK,PPARα,and PPARγ was increased.CONCLUSION:SES has preven-tive and therapeutic effects on fatty liver disease in rats with hypertension combined with dyslipidemia,and its mechanism of action may be related to the reduction of Scd expression levels in the liver and the increase in the expression of Nnmt,AMPK,p-AMPK,PPARα,and PPARγ.

Objective:Medial sural artery perforator flap (MSAPF) was applied to aesthetically reconstruct wounds in foot, and clinical outcome of this surgical method was explored.Methods:A retrospective analysis was conducted on the data of 10 patients who underwent the surgery of transfer of free MSAPF in reconstruction of foot wounds in the Department of Foot and Ankle Surgery, Xuzhou Renci Hospital from January 2020 to January 2023. The patients were 6 males and 4 females, aged 21 to 52 years, with an average of 42.5 years. The soft tissue defects of the injuries were at 2.0 cm × 4.0 cm to 3.5 cm × 6.0 cm in size, with deep tissues exposure down to the base of wound. MSAPF was used for aesthetic reconstruction of the wounds. The surgical procedures were: (1) The flap was thinned under a microscope and only the subdermal vascular network was kept. (2) Vascular pedicle of the flap was taken as long as possible and had it anastomosed with the proximal dorsal foot artery and vein through a subcutaneous tunnel. (3) Allg?wer-Donati method was applied to suture the skin of flap. (4) Donor site was directly closed in surgery. All patients were entered in the scheduled postoperative follow-up at the outpatient clinic of the surgeon who performed the surgery to evaluate the postoperative effect and observe the survival of flaps. Maryland foot function score and British Medical Research Council (BMRC) sensory function score were used to assess the recovery of flap and limb function.Results:The flaps completely survived, and all the donor and recipient sites had primary healing. All of the 10 patients were included in the postoperative follow-up which lasted 8 to 15 months, with an average of 12 months. The flaps from foot featured a pleasing appearance, with good elasticity and wear-resistant. All patients were satisfied and able to walk normally and bear weight without an occurrence of flap ulceration. At the final follow-up, the therapeutic effect was evaluated according to the Maryland scoring system and achieved the scores at 91 to 98, with 95.6 in average. Nine patients were rated as excellent and 1 as good. The sensory grading by BMRC for the flaps was as follows: the flap sensation of the sutured nerve group recovered to S 3 in 3 cases and S 4 in 2 cases, while the non sutured nerve group only recovered protective sensation, S 2 in 3 cases and S 2+ in 2 cases. Conclusion:By applying MSAPF aesthetics to treat foot wounds, a good appearance has been achieved, with good functional recovery and satisfactory therapeutic effects.

Central nervous system (CNS) injuries, including stroke, traumatic brain injury, and spinal cord injury, are leading causes of long-term disability. It is estimated that more than half of the survivors of severe unilateral injury are unable to use the denervated limb. Previous studies have focused on neuroprotective interventions in the affected hemisphere to limit brain lesions and neurorepair measures to promote recovery. However, the ability to increase plasticity in the injured brain is restricted and difficult to improve. Therefore, over several decades, researchers have been prompted to enhance the compensation by the unaffected hemisphere. Animal experiments have revealed that regrowth of ipsilateral descending fibers from the unaffected hemisphere to denervated motor neurons plays a significant role in the restoration of motor function. In addition, several clinical treatments have been designed to restore ipsilateral motor control, including brain stimulation, nerve transfer surgery, and brain-computer interface systems. Here, we comprehensively review the neural mechanisms as well as translational applications of ipsilateral motor control upon rehabilitation after CNS injuries.
Animals ; Spinal Cord Injuries/therapy* ; Motor Neurons/physiology* ; Brain ; Stroke ; Recovery of Function/physiology*

Objective To investigate the expressions of brain-derived nerve growth factor (BDNF) and growth-associated protein 43 (GAP-43) in the hypothalamus of rats inflicted with restraint stress and their relationship with behavioral changes.Methods Forty male SD rats were divided into control group,restraint stress 7-day group,restraint stress 14-day group,restraint stress 21-day group according to the random number table,with 10 rats per group.Behavior changes were observed by open-field test,serum levels of corticotrophin releasing hormone (CRH) by enzyme-linked immunosorbent assay,and expressions of BDNF and GAP-43 in the hypothalamus by western blotting.Results Restraint stress 7-day group exhibited increases in spanning lattice times (50.0 ± 7.0),standing times (11.4 ± 2.1)and modification times (11.2 ± 2.7) compared with all other groups (P ＜ 0.05).Restraint stress 14-day group and restraint stress 21-day group showed significant decreases in spanning lattice times (35.5 ±7.5,29.4 ± 6.8),standing times (7.8 ± 4.9,5.6 ± 3.9) and modification times (6.7 ± 2.9,4.4 ±2.6) compared with control group (42.6 ± 5.4,8.9 ± 4.3,and 7.9 ± 3.0) (P ＜ 0.05).Restraint 14-day and 21-day groups showed significant increases in serum CRH level [(750.73 ± 123.68) pg/ml and (793.06 ± 115.84)pg/ml] compared with that in restraint stress 7-day group [(500.48 ± 88.71)pg/ml,P ＜0.05],but all were lower than (336.72 ±45.34) pg/ml in control group (P ＜0.05).Levels of BDNF and GAP-43 in the hypothalamus were the lowest in control group (0.672 ± 0.185 and 0.694 ±0.253).However,restraint stress increased the expressions of BDNF and GAP-43 in the hypothalamus,with the highest level in restraint stress 21-day group (1.357 ± 0.524 and 1.486 ± 0.679) (P ＜ 0.05).Conclusion Restraim stress can up-regulate BDNF and GAP-43 proteins in the hypothalamus,and lead to plasticity changes that may relate to stress-related behavior.