Lumbar disc (LD) herniation and aging are prevalent conditions that can result in substantial morbidity. This study aimed to clarify the mechanisms connecting the LD aging and herniation, particularly focusing on cellular senescence and molecular alterations in the nucleus pulposus (NP). We performed a detailed analysis of NP samples from a diverse cohort, including individuals of varying ages and those with diagnosed LD herniation. Our methodology combined histological assessments with single-nucleus RNA sequencing to identify phenotypic and molecular changes related to NP aging and herniation. We discovered that cellular senescence and a decrease in nucleus pulposus progenitor cells (NPPCs) are central to both processes. Additionally, we found an age-related increase in NFAT1 expression that promotes NPPC senescence and contributes to both aging and herniation of LD. This research offers fresh insights into LD aging and its associated pathologies, potentially guiding the development of new therapeutic strategies to target the root causes of LD herniation and aging.
Intervertebral Disc Displacement/metabolism* ; Humans ; Aging/pathology* ; Nucleus Pulposus/pathology* ; Male ; Female ; Transcriptome ; Middle Aged ; Lumbar Vertebrae/pathology* ; Adult ; Cellular Senescence ; Stem Cells/pathology* ; Aged ; Intervertebral Disc Degeneration/metabolism*

Objective To investigate the efficacy of endoscopic Delta large channel unilateral laminotomy for bilateral decompression(ULBD)in the treatment of lumbar spinal stenosis(LSS),and the postoperative complications was analyzed.Methods A total of 100 patients with LSS in our hospital from January 2021 to February 2023 were selected and divided into the control group and the observation group according to random number table method,with 50 cases in each group.Patient in the control group were treated with bilateral or unilateral decompression through the median incision adjacent to the lateral spinous process,and patients in the observation group were treated with endoscopic Delta large channel ULBD.The visual analogue scale(VAS)scores,Japanese Orthopaedic Association(JOA)scores,Oswestry disability index(ODI)scores before surgery and 1 month,3 months,6 months after surgery,as well as clinical efficacy and incidence of postoperative complications of patients between the two groups were compared.Results Compared with preoperative results,the VAS scores of leg pain and low back pain and ODI scores of patients 1 month,3 months and 6 months after surgery in both groups were significantly lower(P<0.05),and JOA scores were significantly higher(P<0.05).Moreover,compared with the control group,the VAS scores of leg pain and low back pain and ODI scores of patients 1 month,3 months and 6 months after surgery in the observation group were lower(P<0.05),the JOA scores were higher(P<0.05).The total effective rate in the observation group was 98.00%,which was higher than 72.00%in the control group(P<0.05).The incidence of postoperative complications in the observation group was 4.00%,which was lower than 24.00%in the control group(P<0.05).Conclusion Endoscopic Delta large channel ULBD in the treatment of LSS can effectively reduce postopera-tive leg pain and low back pain,improve lumbar function,improve clinical therapeutic effect,and reduce postoperative complications.

Objective To analyze the prevalence,disease burden,and trends of diabetes in China from 1999 to 2019,providing reference for diabetes prevention and control as well as health resource allocation to alleviate the disease burden.Methods Data on the disease burden of diabetes in China from 1999 to 2019 were collected from the Global Burden of Disease(GBD)2019 database.Indicators such as incidence rate,prevalence rate,mortality rate,disability-adjusted life years(DALYs),years of life lost due to premature mortality(YLLs)and years lived with disability(YLDs)were used to analyze the diabetes burden in China by gender,age and year.The estimated annual percentage change(EAPC)was used to measure the temporal trend of standardized rates over a specified period,and the rank sum test was used to assess the gender differences in disease burden.Results In 2019,3.78×106 cases of diabetes and 1.73×105 deaths were reported in China.Compared with 1999,the standardized rates of incidence and prevalence increased by 5.80%and 17.12%,respectively,while the standardized mortality rate decreased by 2.82%.Compared with 1999,the standardized rates of DALYs and YLDs increased by 2.86%and 16.06%,respectively,while the standardized YLL rate decreased by 14.39%.The EAPC for diabetes incidence,prevalence,YLDs,and DALYs in the 20-40 age group all exceed 0,indicating an annually upward trend in disease burden of diabetes.Additionally,the disease burden in males was significantly higher than that in females(P＜0.05),and the gap is continuously widening.Conclusions The disease burden of diabetes in China is severe,particularly in term of life loss due to disability.The population with diabetes onset is becoming increasingly younger.Males constitute a high-risk population for diabetes-related morbidity and mortality.Diabetes prevention and control efforts should continue to enhance behavioral interventions,appropriately tilt health resource allocation towards high-risk population,and focus on improving the rehabilitation capabilities and promoting rehabilitation technology at grass-roots unit.

Objective To provide some evidence for early empirical treatment of infections caused by Pseudanonas aeruginosa(PA)and establish a certain foundation for further studies on its resistance mechanisms.Analyzed the resistance rate of PA and the phenotype characteristics for seven years at this hospital.Methods Using Whonet 5.6 software,the drug sensitivity data of PA isolated and reported from clinical specimens at Kunming First People's Hospital from 2016 to 2022 were analyzed annually.Imipenem,meropenem,ceftazidime,and cefepime were the main observation objects,statisticaly analyze the resistance of other antibiotics under different drug resistance combinations of the above-mentioned drugs Results A total of 1 920 strains of PA were detected in 7 years,with polymyxins exhibiting the lowest resistance rate at 1%.The average resistance rates for Amikacin,Gentamicin and Tobramycin were 6.4%,8.6%and 5.1%,respectively.The resistance rates of Quinolones,Piperacillin/Tazobactam,Ceftazidime,and Cefepime were similar,ranging from 10%～20%.Imipenem and Meropenem did not show better sensitivity,with resistance rates of 21.3%and 18.4%,respectively.The resistance rates of major antibiotics have fluctuated over the past 7 years,mostly increasing from 2017 to reaching a peak in 2018 and then falling back.And then stabilized with the domestic average level.1 393 strains were sensitive to Imipenem,and the sensitivity rate of Meropenem in this part was 96.2%.1 451 strains were sensitive to Imipenem,and 89%of them were sensitive to Meropenem at the same time.369 strains were both resistant to Imipenem and Meropenem,and 33.1%of them were sensitive to Ceftazidime.The more resistant to β-lactam,the lower the sensitivity rate to Amikacin and Ciprofloxacin.Conclusion The overall drug sensitivity of PA in this hospital is relatively good.Should adhere to strict management of antibiotic use.Aminoglycosides can be the preferred drugs for empirical treatment,followed by Quinolones,and Carbapenems and Ceftazidime are also candidates.PA has diverse resistance mechanisms to β-lactam antimicrobials,and carbapenem-resistant strains can be mediated by different mechanisms or jointly.

Objective: To explore the relationship between 24 hour movement behavior and physical fitness in college students, so as to provide a reference for physical fitness interventions for college students. Methods: A survey was conducted from September 23 to November 12, 2022, involving 342 college students selected from one comprehensive college among Shanghai City, Hubei Province and Zhejiang Province. Accelerometers were used to measure 24 hour movement behavior, and programs specified in the National Physical Fitness Standards for Students (2014 revision) were used to evaluate physical fitness. Compositional linear regression was used to analyze the association between 24 hour movement behavior and physical fitness. The effects of compositional isotemporal substitution of 24 hour movement behavior on physical fitness were also examined. Results: The geometric means for sleep, sedentary behavior, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) were 515.89, 678.88 , 196.30, 48.92 min/d, respectively, and the comprehensive physical fitness score was (73.09±8.55). The proportion of participants who passed the fitness test was 72.51%. Overall, 20.76% had excellent or good scores, whereas 6.73% failed. Compositional linear regression indicated that physical fitness was significantly positively associated with MVPA ( β =2.55) and LPA ( β = 5.88 )( P <0.05), but no significantly associated with sleep ( β =-5.18) and sedentary behavior ( β =-3.24)( P >0.05). Isotemporal substitution indicated that reallocation of 15 minutes from sleep and sedentary behavior to MVPA resulted in a 0.71 and 0.64 point increase in physical fitness, respectively. Similarly, reallocating the same duration to LPA led to a 0.50 and 0.43 point increase in physical fitness, respectively. Dose response analysis revealed that the mutual substitution of LPA with sedentary behavior and sleep had symmetry, whereas the mutual substitution of MVPA with sedentary behavior and sleep had asymmetry. The effectiveness of replacing sleep or sedentary behavior with MVPA in improving physical fitness decreased with increasing allocation time, whereas the adverse effects of replacing MVPA with sleep or sedentary behavior increased with increasing allocation time. Conclusion In the context of 24 hour movement behavior, increasing the time spent on LPA and MVPA is beneficial for physical fitness among college students. It should be recommend that college students actively transition from sedentary behavior to engaging in physical activity, with a particular emphasis on incorporating MVPA.

ObjectiveTo investigate the effect of capsaicin on cognitive dysfunction in rats with cerebral ischemia-reperfusion and its possible mechanism. MethodTwelve SD male rats were randomly selected as a sham operation group， and the remaining rats were sutured to replicate the model of middle cerebral artery occlusion （MCAO）. The successfully modeled rats were divided into a model group， a SB203580 ［p38 mitogen-activated protein kinase （p38 MAPK） inhibitor， 1 mg·kg^-1］ group， capsaicin low- and high-dose （50， 100 mg·kg^-1） groups ， and anisomycin （p38 MAPK agonist， 2 mg·kg^-1） + capsaicin （100 mg·kg^-1） group， with 12 rats in each group. After reperfusion and administration， the rats were scored for neurological deficits. Morris water maze and new object recognition experiments were used to test the learning and cognitive abilities of rats. The hematoxylin-eosin （HE） staining was used to observe the pathological changes in the hippocampus of the brain tissue. Immunofluorescence method was used to detect the activation of microglia in the hippocampus. Enzyme-linked immunosorbent assay （ELISA） was used to detect the levels of interleukin-1β （IL-1β）， tumor necrosis factor-α （TNF-α）， and prostaglandin E₂ （PGE₂） inflammatory factors in the brain tissue. Western blot was used to determine the protein expression levels of transient receptor potential vanillin subfamily 1 （TRPV1）， p38 MAPK， p-p38 MAPK， and cyclooxygenase-2 （COX-2） in the hippocampal tissue. ResultAs compared with the sham group， the neurological deficit score， escape latency， the number of Iba-1 positive microglia in the hippocampal CA1 area， the IL-1β， TNF-α， and PGE₂ levels in the brain tissue， and the p-p38 MAPK/p38 MAPK and COX-2 expression in the hippocampus tissue was significantly increased in the model group （P<0.01）. In the model group， the number of crossing the platform position， the novel object discrimination index （DI）， and the TRPV1 expression in the hippocampus tissue was significantly reduced （P<0.01）， the number of hippocampal nerve cells was reduced， and a large number of inflammatory cells infiltrated. As compared with the model group， the neurological deficit score， escape latency， the number of Iba-1 positive microglia in the hippocampal CA1 area， the IL-1β， TNF-α， and PGE₂ levels in the hippocampus tissue， and the p-p38 MAPK/p38 MAPK and COX-2 expression in the hippocampus tissue were significantly reduced in the capsaicin low-dose and high-dose groups （P<0.05，P<0.01）. In the capsaicin low-dose and high-dose groups， the number of crossing the platform position， the DI， and the TRPV1 expression in the hippocampus tissue were significantly increased （P<0.05，P<0.01）， a small amount of inflammatory cells were infiltrated， and the number of nerve cells was significantly increased. The use of anisomycin， an activator of p38 MAPK， increased the expression of COX-2， and significantly weakened the inhibitory effect of capsaicin on the activation of microglia. ConclusionCapsaicin has a protective effect on the cognitive function of rats with cerebral ischemia-reperfusion， and its mechanism may be related to the inhibition of the activation of p38 MAPK/COX-2 signaling pathway， thereby inhibiting the excessive activation of microglia.

Breast cancer is a malignant tumor with high mortality, and multidrug resistance (MDR) mediated by ABCG2 (ATP-Binding cassette G2) is an important cause of chemotherapy failure. It is an urgent problem to explore the mechanism of ABCG2-mediated drug resistance and its key molecules. Epithelial cell adhesion molecule (EpCAM) is involved in multiple tumor drug resistance and is closely related to breast cancer MDR. However, its role in ABCG2-mediated breast cancer drug resistance has not been clarified. The purpose of this study was to explore the regulation of EpCAM on ABCG2-mediated MDR in breast cancer cells and its mechanism. CCK8 cytotoxicity assays confirmed that the drug resistance of MCF-7/MX cell line to mitoxantrone (MX) was significantly increased compared with MCF-7 drug-sensitive strain of human breast cancer. Western blotting results showed that ABCG2 was highly expressed and EpCAM was up-regulated in MCF-7/MX cells compared with MCF-7. SiRNA knockdown of EpCAM in MCF-7/MX cells down-regulated ABCG2 expression and restored sensitivity to MX. Cell morphology was observed under an inverted microscope, and it was found that knocking down EpCAM reduced cell-cell connections between MCF-7/MX cells. The co-localization of EpCAM and claudin 1 in MCF-7/MX cells was observed by immunofluorescence. Furthermore, Western blotting results showed that EpCAM knockdown reduced claudin 1 expression in MCF-7/MX cells. In conclusion, EpCAM may promote ABCG2-mediated mMDR in breast cancers by enhancing intercellular tight junctions through interaction with claudin 1.

Objective:To explore clinical application value of immediate breast reconstruction with silicone prosthesis after nipple areolar sparing mastectomy for breast cancer.Methods:The clinical data of 30 breast cancer patients underwent immediate breast reconstruction with the silicone prosthesis after nipple areolar sparing mastectomy from January 2016 to January 2018 were collected. In the observation group, 15 patients underwent immediate breast reconstruction with the silicone prosthesis after nipple areolar sparing mastectomy. In the control group, 15 patients underwent conventional modified radical mastectomy only. The differences of operation indicator and postoperative complications between the two groups were compared, and the postoperative cosmetic effects were evaluated.Results:The patients successfully completed prosthetic breast reconstruction in the observation group. The surgical time and indwelling time of the drainage tube in the observation group were both increased compared with the control group, and the difference was statistically significant ( t=118.8 and t=23.9, P<0.05). There were no statistically significant differences between the two groups in the complications of postoperative flap necrosis, subcutaneous hematoma, intraoperative infection and incision dehiscence ( P>0.05). The total complications rate of the observation group was 40%, compared with the control group (20%), there were not statistically significant differences ( P>0.05). The postoperative aesthetic effect evaluation showed that the reconstructed breast was full in shape and basically symmetrical to the contralateral side, with an excellent and good rate of 83.3%. The patients were satisfied with the appearance of the breast. All patients were followed up for 12 to 36 months with the average time of 24 months, and local recurrence and distant metastasis were not observed. Conclusions:In the modified radical mastectomy for breast cancer with preserved nipple and areola, the immediate application of silicone prosthesis for breast reconstruction has the advantages of less trauma, faster postoperative recovery and better cosmetic effect, which is worthy of clinical application.

Aim: To investigate the effect of epithelial cell adhesion molecule (EpCAM) on metastasis and multidrug resistance of breast cancer and its mechanism. Methods Immunohistochemical staining was employed to detect the expression of EpCAM in adjacent non-tumor tissues (ANTTs) and breast cancer tissues. siRNA was applied to knock down EpCAM expression in MDA-MB-231 cells. Transwell assay was used to detect the invasion and migration ability of breast cancer cells. Western blot analysis was performed to determine the protein expression of EpCAM, epithelial mesenchymal transition (EMT) markers E-cadherin, N-cadherin and vimentin, breast cancer resistance protein (BCRP), and β-catenin. Results EpCAM immunoreactivity was consistently stronger in primary breast cancer tissues and even higher in metastatic lesions than that in ANTTs. The expression of EpCAM was significantly upregulated in triple negative breast cancer MDA-MB-231 cells. EpCAM knockdown using siRNA decreased the invasion and migration ability and BCRP expression, and partially reversed the EMT phenotypes of MDA-MB-231 cells, β-catenin expression was upregulated in MDA-MB-231 cells. ICG-001, a specific Wnt/β-catenin pathway inhibitor, downregulated the expression levels of EpCAM, N-cadherin, and vimentin in MDA-MB-231 cells. Conclusions EpCAM could promote metastasis and drug resistance of breast cancer through the induction of EMT, which is related to the Wnt/β-catenin signaling pathway.