Objective To compare the efficacies of unilateral biportal endoscopic(UBE)technique and percutaneous transforaminal endoscopic discectomy(PTED)in the treatment of lumbar spinal stenosis.Methods Forty patients who were diagnosed with lumbar spinal stenosis in Chashan Hospital of Dongguan from January 2019 to January 2023 were enrolled in this retrospective study.They were divided into PTED group(n=20)and UBE group(n=20).Perioperative data(operation time,intraoperative bleeding,postoperative hospital stay,degree of decompression and complications)were compared between the two groups.Visual analogue scale(VAS)score and Oswestry dysfunction index(ODI)were collected before surgery and on 3 days,1 month and 6 months after surgery.Results There were no significant differences in the operation time,intraoperative bleeding,or hospitalization time between the two groups(all P>0.05).The incidence of postoperative complications in the UBE group was significantly lower than that in the PTED group(P=0.001).VAS score and ODI of the low back and leg pains in the UBE group were superior to the PTED group at each postoperative time point(all P<0.05).One month after surgery,the UBE group had a more significant increase in the dural sac cross-sectional area and intervertebral foramen area than the PTED group(t=3.842,P=0.003;t=2.469,P=0.006).Conclusion Compared with PTED,UBE has better clinical outcomes,higher degree of decompression,and lower incidence of complications.UBE is a safe and feasible surgical method for the treatment of lumbar spinal stenosis.

Hepatocellular carcinoma (HCC) has the features of high incidence rate, low survival rate, poor treatment outcome, and complex pathogenesis. In recent years, many studies have shown that long non-coding RNA (lncRNA) MALAT1 is upregulated in HCC and can promote the proliferation, invasion, and metastasis of HCC cells, and it can also guide the diagnosis, prognostic evaluation, and treatment of HCC in clinical practice. This article reviews the current status of research on lncRNA MALAT1 in HCC and discusses its expression pattern, mechanism of action, and clinical significance in predicting and monitoring the progression of HCC, so as to gain a deep understanding of the role of lncRNA MALAT1 in the progression of HCC. It is pointed out that lncRNA MALAT1 is expected to become a potential biomarker for the diagnosis and prognostic evaluation of HCC and may be used as a therapeutic target in clinical practice.

MicroRNA-223 (miR-223) is located on chromosome X, and is highly conserved in the process of evolution. In recent years, many studies have shown that miR-223 is abnormally expressed in a variety of digestive system tumors, such as esophageal cancer, gastric cancer, liver cancer, pancreatic cancer and colorectal cancer. MiR-223 can participate in the proliferation, apoptosis and invasion of tumor cells through a variety of signal pathways, which is expected to become a marker for the diagnosis and prognosis of digestive system tumors.

Severe acute pancreatitis is a common clinical acute abdominal disease, characterized by acute onset, rapid progression, high risk, poor prognosis and so on. Due to the high mortality of this disease, it has been the focus and difficulty of clinical research. The traditional treatment of severe acute pancreatitis mainly include fasting and parenteral nutrition. However, recently, international and national consensus suggest that early enteral nutrition is fit for severe acute pancreatitis, although the timing of early enteral nutrition has been controversial. The article summarizes the optimal timing of early enteral nutrition for severe acute pancreatitis.

Objective To observe the effect of enriched environment (EE) on the pain threshold and depression like behavior in mice with chronic constriction injury (CCI) and the underly ing mechanism.Methods Sixty C57/BL6 mice were equally randomized into five groups:sham operation group (group Sham),CCI+standard environment(SE) group (group CS),CCI+EE group (group CE),CCI+EE+temozolomide group (group CET),CCI+EE+lipopolysaccharide group (group CEL).The paw withdraw threshold (PWT),paw withdraw latency,forced swim test (FST)and sucrose preference test (SPT) were evaluated,after the operation,meanwhile the hippocampal bromodeoxyuridine (Brdu),ki67 and doublecortin (ICX) positive cells,tumor necrosis factor-α (TNF-α) and interleukin-1β(IL-1β) were determined.Results Compared with group Sham,the PWT,PWL,sucrose consumption and Brdu,Ki67,DCX positive cells were significantly decreased,the immobility time and levels of TNF-α and IL-1β were obviously increased in group CS (P＜0.05).Compared with group CE,the PWT,PWL,sucrose consumption and Brdu,Ki67,DCX positive cells were significantly decreased in groups CS and CEL.The immobility time was obviously increased in groups CS,CET and CEL,moreover,the levels of TNF-α and IL-1β were significantly increased in groups CS and CEL (P＜0.05).Conclusion EE can improve the neuropathic pain,depression-like behavior and neural regeneration in mice with CCI.The inhibition of neural regeneration can block EE-induced improvement of depression-like behavior,but does not affect the pain threshold in mice with CCI.The augmentation of central inflammation can attenuate EE-induced improvement of pain threshold and depression-like behavior in mice with CCI.

Objective To observe the variation of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and microglia in the comorbidity of neuropathic pain and depression and discuss the related mechanism.Methods The spared nerve injury model was used.Forty-four male adult Sprague Dawley rats were randomly divided into the following four groups (n=11 each): sham+vehicle group (group SV), sham+APO group (group SA), SNI+vehicle group (group SNV), SNI+APO group (group SNA).In groups SA and SNA, rats were intraperitoneally injected with apocynin (APO) 15 mg/kg 24 hours and 1 hour before SNI and continued once daily until the 14th day.The rats in the other two groups received the equal volume of vehicle.The mechanical withdrawal threshold (MWT) was tested 1 day before SNI and 7 days and 14 days after SNI, and the open field test, the forced swimming test and the sucrose preference test were performed 14 days after SNI.The prefrontal cortex were collected 2 hour after the behavior tests.The expression of gp91phox was detected by Western blot and the expression of Iba1 and gp91phox were detected by double-immunofluorescance staining.Results The reduced MWT, the increased immobility time, the decreased sucrose consumption and the increased content of gp91phox were observed in group SNV compared with groups SV, SA and SNA (P<0.05).The expression of Iba1 and gp91phox were increased in group SNV.The total travel distance in the open field test and the total liquid consumption in the sucrose preference test had no significant difference among the four groups.Conclusion Neuropathic pain may induce depressive behaviors and activate NADPH oxidase in the prefrontal cortex.Moreover, the inhibition of NADPH oxidase by APO can alleviate neuropathic pain and depression, which is potentially related to the activation of microglia.

Objective To study the surgical indications and effectiveness of short segment pedicle screw fixation plus pecutaneous vertebroplasty (PVP) for single thoracolumbar fracture combined with Kümmell disease.Methods Between June 2012 and June 2014,a prospective case series analysis was made on the clinical data of 15 selected cases of single thoracolumbar fracture patients who were combined with Kümmell disease.There were three males and 12 females,with an average age of 62.5 years (range,48-80 years).The iujured vertebrae were located at T11 in 3 cases,at T12in 4,at L1 in 5 and at L2 in 3.All the patients were treated by short segment fixation plus PVP.Operative time,surgery-related complications and adjacent vertebral fracture during follow-up were recorded.The effectiveness of the treatment was appraised by visual analogue scale (VAS),Oswestry Disability Index (ODI),Cobb angle of operative segment,which were recorded preoperatively,one week post-operatively and at final follow-up.One-way ANOVA (Analysis of Variance) was employed for statistical analysis.Results The operative time was 0.8-2 hours (mean,1.35 hour).There was no observation of incision infection,nerve injury,cement leakage or other related operative complications.A total of 15 patients were followed up for 16-36 months (mean,22.4 months),which showed solid fusion and bone bridges in all patients,with no fracture of adjacent vertebra observed.VAS was improved from preoperative (5.93 ± 0.62) points to (1.80±0.64) points one week postoperatively and (2.60 ± 0.53) points at final follow-up.ODI was improved from preoperative 61.53 ± 4.30 to 19.93 ±3.26 one week postoperatively and 23.07 ± 4.06 at final follow-up.Cobb angle of operative segment was improved from preoperative (17.40 ± 6.73) ° to (9.53 ± 3.12) o one week postoperatively and (11.00 ± 3.20) ° at final follow-up.There was significant difference of all the indexes namely,VAS,ODI and Cobb angle,between preoperative and one week postoperative status as well as between preoperative and final follow-up (P ＜ 0.05 or 0.01).However,there was no significant difference between ODI and Cobb angle in one week postoperatively and at last follow-up (P ＞ 0.05).Conclusion For single thoracolumbar fracture with Kümmell disease,short segment fixation plus PVP can shorten the surgery time,reduce the rate of complications,relieve pain,recover the function and avoid loss of kyphosis correction,as is worthy of clinical recommendation.

Objective To observe changes of hippocampal levels of pro-inflammatory cytokines in rats with neuropathic pain-induced depression, and to explore the relationship between hippocampal levels of pro-inflammatory cytokines and severity of depression.Methods Twenty-eight adult male rats were randomly divided into two groups: group sham (n=14) and spared nerve injury (group SNI) (n=14).Mechanical withdrawal thresholds (MWT) were measured 1 day before and 7, 14 and 21 days after operation.Sucrose preference test and forced swim test were tested 1-3 days before and 21-23 days after operation.After test, hippocampus was collected.The hippocampal levels of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α (TNF-α) were measured by ELISA.Correlational relationships between hippocampal levels of pro-inflammatory cytokines and sucrose preference were evaluated.Results Compared with group sham, MWT was decreased 7, 14, 21 days after operation (P<0.001).Group SNI displayed decreased sucrose preference 21 days after operation (P<0.01) and increased immobility time in FST 23 days after operation (P<0.05).The levels of IL-6 and TNF-α were increased in hippocampus (P<0.05 or P<0.01).No significant difference was observed in IL-1β.The hippocampal levels of IL-1β (r2=0.60,P<0.01), IL-6 (r2=0.55,P<0.01) and TNF-α(r2=0.60,P<0.01) were negatively correlated with sucrose preference.Conclusion The hippocampal levels of pro-inflammatory cytokines IL-6 and TNF-α are increased in rats with depression induced by neuropathic pain, and the levels of hippocampal pro-inflammatory cytokines are negatively correlated with the severity of depression.

Objective To observe the effects of enriched environment on cognitive function in mice with sepsis-associated encephalopathy and to study the neuron PAS domain protein 4 (NPAS4)/brain deprive neurotrophic factor (BDNF)related mechanisms.Methods Sixty adult male mice were divided randomly into three groups:sham operation with standard environment group (group SS,n =12),cecal ligation and puncture with standard environment group (group CS,n =24),cecal ligation and puncture with enriched environment group (group CE,n =24).All mice were reared in standard environment or enriched environment for 28 days.The fear condition test was conducted on day 29 af-ter operation in mice.The change of NPAS4 and BDNF,the density of dendritic spine were detected by western blot or golgi staining.Results Compared with group SS,the context freezing time, NPAS4 and BDNF expression and the density of dendritic spine in hippocampus decreased significantly in group CS (P < 0.05).Compared with group CS,the context freezing time,NPAS4 and BDNF expression and the density of dendritic spine in hippocampus increased significantly in group CE (P <0.05).No significant difference was observed in the conditional freezing time among three groups.Conclusion Enriched environment can obviously improve cognitive function impairment induced by sepsis-associated encephalopathy,which may be related with up-regulated expression of NPAS4/BDNF,and promoted synaptic plasticity.

ving CQI(P＜0.05).Conclusion CQI program effectively reduces CRBSI incidenee in cancer patients with PICC.