Objective To investigate the efficacy and safety of unilateral biportal endoscopic transforaminal lumbar interbody fusion(UBE-TLIF),minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF),and posterior lumbar interbody fusion(PLIF)in patients with lumbar disc degenerative change.Methods The medical records of 101 patients with lumbar disc degenerative change who underwent surgical treatment in our hospital from January 2019 to December 2022 were retrospectively collected,and they were divided into UBE-TLIF group(37 cases),MIS-TLIF group(33 cases)and PLIF group(31 cases)according to types of operation.The operation related indexes,visual analogue scale(VAS),dysfunction and postoperative complications of the three groups were compared.The height of the intervertebral space and the lumbar lordosis angle were measured before and after surgery.Interbody fusion 12 months after surgery were evaluated via Bridwell criteria.Results The duration of operation of UBE-TLIF group was significantly longer than that of MIS-TLIF group and PLIF group,and MIS-TLIF group was significantly longer than that of PLIF group,the differences were statistically significant(P＜0.05);The intraoperative blood loss and postoperative drainage volume in the UBE-TLIF group were significantly less than those in the MIS-TLIF group and PLIF group,and the MIS-TLIF group was significantly less than that in the PLIF group,the postoperative hospital stay in the UBE-TLIF group was significantly shorter than that in the MIS-TLIF group and PLIF group,and the MIS-TLIF group was significantly shorter than that in the PLIF group,the differences were statistically significant(P＜0.05);The VAS of low back pain and leg pain at 1,3,and 12 months after operation in the 3 groups were significantly lower than those before operation(P＜0.05);The VAS of low back pain and leg pain at 1 and 3 months after operation in the UBE-TLIF group was significantly lower than that in the MIS-TLIF group and the PLIF group,and the VAS of low back pain and leg pain in the MIS-TLIF group was significantly lower than that in the PLIF group(P＜0.05);The Oswestry disability index(ODI)at 1,3 and 12 months after operation in the 3 groups was significantly lower than that before operation,and the ODI in UBE-TLIF group was significantly lower than that in MIS-TLIF group and PLIF group at 1 month after operation,the differences were statistically significant(P＜0.05);The intervertebral space height and lumbar lordosis angle at 1,3,and 12 months after operation were significantly bigger than those before operation in 3 groups(P＜0.05);At 12 months after operation,the intervertebral fusion rates of UBE-TLIF group,MIS-TLIF group and PLIF group were 94.59%,93.94%and 93.55%,respectively,showing no significant difference among the 3 groups(P＞0.05);The interbody fusion time in UBE-TLIF group and MIS-TLIF group was significantly shorter than that in PLIF group(P＜0.05);There was no significant difference in the incidence of complications among the three groups(P＞0.05).Conclusion UBE-TLIF,MIS-TLIF and PLIF can all achieve a higher interbody fusion rate in treating lumbar disc degenerative change,and UBE-TLIF and MIS-TLIF cause less serious surgical trauma,while UBE-TLIF outperforms MIS-TLIF in respect of surgical trauma,and sees faster postoperative recovery.

Objective To investigate the efficacy and safety of unilateral biportal endoscopic transforaminal lumbar interbody fusion(UBE-TLIF),minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF),and posterior lumbar interbody fusion(PLIF)in patients with lumbar disc degenerative change.Methods The medical records of 101 patients with lumbar disc degenerative change who underwent surgical treatment in our hospital from January 2019 to December 2022 were retrospectively collected,and they were divided into UBE-TLIF group(37 cases),MIS-TLIF group(33 cases)and PLIF group(31 cases)according to types of operation.The operation related indexes,visual analogue scale(VAS),dysfunction and postoperative complications of the three groups were compared.The height of the intervertebral space and the lumbar lordosis angle were measured before and after surgery.Interbody fusion 12 months after surgery were evaluated via Bridwell criteria.Results The duration of operation of UBE-TLIF group was significantly longer than that of MIS-TLIF group and PLIF group,and MIS-TLIF group was significantly longer than that of PLIF group,the differences were statistically significant(P＜0.05);The intraoperative blood loss and postoperative drainage volume in the UBE-TLIF group were significantly less than those in the MIS-TLIF group and PLIF group,and the MIS-TLIF group was significantly less than that in the PLIF group,the postoperative hospital stay in the UBE-TLIF group was significantly shorter than that in the MIS-TLIF group and PLIF group,and the MIS-TLIF group was significantly shorter than that in the PLIF group,the differences were statistically significant(P＜0.05);The VAS of low back pain and leg pain at 1,3,and 12 months after operation in the 3 groups were significantly lower than those before operation(P＜0.05);The VAS of low back pain and leg pain at 1 and 3 months after operation in the UBE-TLIF group was significantly lower than that in the MIS-TLIF group and the PLIF group,and the VAS of low back pain and leg pain in the MIS-TLIF group was significantly lower than that in the PLIF group(P＜0.05);The Oswestry disability index(ODI)at 1,3 and 12 months after operation in the 3 groups was significantly lower than that before operation,and the ODI in UBE-TLIF group was significantly lower than that in MIS-TLIF group and PLIF group at 1 month after operation,the differences were statistically significant(P＜0.05);The intervertebral space height and lumbar lordosis angle at 1,3,and 12 months after operation were significantly bigger than those before operation in 3 groups(P＜0.05);At 12 months after operation,the intervertebral fusion rates of UBE-TLIF group,MIS-TLIF group and PLIF group were 94.59%,93.94%and 93.55%,respectively,showing no significant difference among the 3 groups(P＞0.05);The interbody fusion time in UBE-TLIF group and MIS-TLIF group was significantly shorter than that in PLIF group(P＜0.05);There was no significant difference in the incidence of complications among the three groups(P＞0.05).Conclusion UBE-TLIF,MIS-TLIF and PLIF can all achieve a higher interbody fusion rate in treating lumbar disc degenerative change,and UBE-TLIF and MIS-TLIF cause less serious surgical trauma,while UBE-TLIF outperforms MIS-TLIF in respect of surgical trauma,and sees faster postoperative recovery.

Objective To explore the potential categories and influencing factors of the fear of progression in patients with inflammatory bowel diseases(IBD).Methods IBD patients who received inpatient treatment in a tertiary hospital in Nanjing from July 2022 to July 2023 were selected as the study subjects by convenience sampling method.The General Demographic Information Questionnaire,the Chinese version of the Fear of Progression Questionnaire-Short Form(FoP-Q-SF),the Chinese version of Inflammatory Bowel Disease Self-efficacy Scale(IBD-SES),and Social Support Rating Scale(SSRS)were administered to the participants.We applied one-way ANOVA and Logistic regression analysis to identify the factors associated with the potential categories of the fear of progression.Results A total of 303 retumed questionnaires(out of the 310)were valid,resulting an effective response rate of 97.74％.According to the results of latent profile analysis,we classified the respondents into 3 categories by the fear of progression,namely"low risk fear of disease adaptation group"(n=127,41.91％),"medium risk fear of illness distress group"(n=139,45.88％),"high risk fear of dysfunction group"(n=37,12.21％).3 groups showed statistically significant differences in permanent address,self-rated financial pressure,current disease status and self-efficacy(P＜0.05).Conclusion Patients with IBD had obvious differences in characteristics on the fear of progression.Nursing personnel should formulate personalized intervention strategies based on the classification characteristics of the fear of progression of IBD patients.Moreover,nurses should focus on improving patients'self-efficacy and promoting patients to treat medical care,stress and emotion management correctly.

Objective To compare the efficacy of arthroscopic rotator cuff repair using single row,double row,and suture bridge techniques in treating rotator cuff injuries and analyze the influencing factors of postoperative chronic pain.Methods Clinical data of 106 patients with rotator cuff injury to receive arthroscopic rotator cuff repair from January 2021 to February 2023 were retrospectively collected,were divided into single row group(n=35),double row(n=32)and suture bridge group(n=39).All patients from the three groups were evaluated using the pain visual analogue scale(VAS)and the Constant-Murley shoulder score(CMS)before surgery and 3,6,and 12 months after surgery,and their external rotation and forward flexion range of motion were measured.The incidence of postoperative retearing and chronic pain after surgery were compared among the three groups.Patients were divided into chronic pain group(n=21)and non-chronic pain group(n=85)depending whether chronic pain was seen or not after surgery and the clinical data was compared.Risk factors for postoperative chronic pain in arthroscopic rotator cuff repair patients were assessed via binary Logistic regression analysis.Results The VAS in suture bridge group was significant lower than that in single row group and double row group at 3,6 months after surgery,the VAS at 3,6,12 months after surgery in three groups were lower than that before surgery,the differences were statistically significant(P<0.05).The CMS score in suture bridge group was significant higher than that in single row group,double row group at 3,6 months after surgery,and all groups at 3,6,12 months after surgery were higher than that before surgery.The external rotation range of motion,and forward bending range of motion in suture bridge group were larger than those in single row group,double row group at 3,6 months after surgery,and all groups at 3,6,12 months after surgery were larger than those before surgery,the differences was statistically significant(P<0.05).The incidence of postoperative retearing in suture bridge group was significant lower than that in single row group and double row group,the difference was statistically significant(P<0.0167),but there was no difference between single row group and double row group(P>0.0167).The chronic pain occurrence was no statistical difference among the three groups(P>0.05).The chronic pain group had higher proportions of women,tear diameter<1.0 cm,and severe postoperative pain than those of non-chronic pain group(P<0.05).Other clinical data[age,body mass index(BMI),course of disease,location of injury,cause of injury,smoking and drinking history]were comparable between the two groups,the differences were not statistically significant(P>0.05).According to binary Logistic regression analysis,after adjusting for confounding factors(age,BMI,disease course,location and cause of injury),female gender,tear diameter<1.0 cm,and severe postoperative pain were independent risk factors for chronic pain after arthroscopic rotator cuff repair surgery(P<0.05).Conclusion In treating patients with rotator cuff injury,arthroscopic suture bridge outperforms single row and double row techniques in alleviating shoulder joint pain,promoting functional recovery and increasing range of motion,and presents lower risk of retearing.However,all three have some risk of chronic pain after surgery.Female gender,tear diameter<1.0 cm,and severe postoperative pain are independent risk factors for postoperative chronic pain.

Objective:To investigate the efficacy and mechanism of Jasminoside in dextran sodium sulfate (DSS) -induced ulcerative colitis (UC) mice.Methods:Eighteen C57BL/6 mice were randomly divided into control group, UC group and UC+Jasminoside group, with six mice in each group. The mice in UC group and UC+Jasminoside group freely drank 3%DSS solution for 7 days to induce UC mouse model. The mice in control group freely drank the water without DSS. During the modeling period, the mice in the UC+Jasminoside group were given Jasminoside at a dose of 20 mg/ (kg·d) by gavage for 7 consecutive days, meanwhile the mice in control group and UC group were given equal volumes of distilled water by gavage. The change of body weight and disease activity index (DAI) of the mice were observed daily, and the length of the colon was measured 7 days after the intervention. HE staining was used to observe the inflammatory changes of the colon, and Western blot was used to measure the expression of anti-apoptotic proteins (Bcl-2 and Bcl-xl), caveolin-1 (CAV-1), inducible nitric oxide synthase (iNOS), tight junction proteins (Occludin and Claudin-1). The differences in the above indicators among the mice in three groups were analyzed statistically.Results:All the mice survived. Compared with the control group, the body weight was lower, DAI score was higher, colon was shorter, whose differences were all statistically significant (all P<0.05), and inflammatory infiltration of colon tissue was more severe in mice of UC group. Compared with the UC group, body weight was higher, DAI score was lower, colon was longer, whose differences were all statistically significant (all P<0.05), and inflammatory infiltration of colon tissue was alleviated in mice of UC+Jasminoside group. Western blot results showed that compared with control group, the expression of Bcl-2, Bcl-xl, CAV-1, Occludin and Claudin-1 was significantly lower and the expression of iNOS was significantly higher in the colon tissues of mice in UC group, and the differences were statistically significant (all P<0.05). The expression of Bcl-2, Bcl-xl, CAV-1, Occludin and Claudin-1 in the colon tissues of mice in UC+Jasminoside group was significantly higher than those in UC group, while the expression of iNOS was lower, and the differences were statistically significant (all P<0.05) . Conclusion:Jasminoside can alleviate the symptoms of UC model mice, and its mechanism of action may be related to upregulating the expression of anti-apoptotic proteins and protecting the intestinal mucosal barrier through CAV-1/iNOS pathway.

Objective:To investigate the efficacy and mechanism of Jasminoside in dextran sodium sulfate (DSS) -induced ulcerative colitis (UC) mice.Methods:Eighteen C57BL/6 mice were randomly divided into control group, UC group and UC+Jasminoside group, with six mice in each group. The mice in UC group and UC+Jasminoside group freely drank 3%DSS solution for 7 days to induce UC mouse model. The mice in control group freely drank the water without DSS. During the modeling period, the mice in the UC+Jasminoside group were given Jasminoside at a dose of 20 mg/ (kg·d) by gavage for 7 consecutive days, meanwhile the mice in control group and UC group were given equal volumes of distilled water by gavage. The change of body weight and disease activity index (DAI) of the mice were observed daily, and the length of the colon was measured 7 days after the intervention. HE staining was used to observe the inflammatory changes of the colon, and Western blot was used to measure the expression of anti-apoptotic proteins (Bcl-2 and Bcl-xl), caveolin-1 (CAV-1), inducible nitric oxide synthase (iNOS), tight junction proteins (Occludin and Claudin-1). The differences in the above indicators among the mice in three groups were analyzed statistically.Results:All the mice survived. Compared with the control group, the body weight was lower, DAI score was higher, colon was shorter, whose differences were all statistically significant (all P<0.05), and inflammatory infiltration of colon tissue was more severe in mice of UC group. Compared with the UC group, body weight was higher, DAI score was lower, colon was longer, whose differences were all statistically significant (all P<0.05), and inflammatory infiltration of colon tissue was alleviated in mice of UC+Jasminoside group. Western blot results showed that compared with control group, the expression of Bcl-2, Bcl-xl, CAV-1, Occludin and Claudin-1 was significantly lower and the expression of iNOS was significantly higher in the colon tissues of mice in UC group, and the differences were statistically significant (all P<0.05). The expression of Bcl-2, Bcl-xl, CAV-1, Occludin and Claudin-1 in the colon tissues of mice in UC+Jasminoside group was significantly higher than those in UC group, while the expression of iNOS was lower, and the differences were statistically significant (all P<0.05) . Conclusion:Jasminoside can alleviate the symptoms of UC model mice, and its mechanism of action may be related to upregulating the expression of anti-apoptotic proteins and protecting the intestinal mucosal barrier through CAV-1/iNOS pathway.

Patients' subjective feelings, that is, patient-reported outcomes, has attracted increasing attention in patients with inflammatory bowel disease (IBD) , which plays an important role in monitoring the progress of patients' disease and guiding clinical decision-making. This article reviews the current status of assessment tools and clinical applications of patient-reported outcomes in IBD patients. This article aims to help medical and nursing staff choose assessment tools suitable for IBD patients in China, standardize the development and localization process of assessment tools, promote the application and development of patient-reported outcomes of IBD patients in China, and optimize disease management of IBD patients.

Inflammatory bowel disease (IBD) is a chronic non-specific intestinal inflammatory disease of unknown etiology, which is characterized by recurrent episodes and prolonged refractory recovery. Financial toxicity refers to the objective economic burden and subjective economic distress caused by medical expenses caused by the disease to patients. IBD patients show a certain level of financial toxicity due to frequent visits to doctors for a long time. This article reviews the concept of financial toxicity, evaluation tools and the current status of financial toxicity in IBD patients, analyzes the influencing factors of financial toxicity in IBD patients from the aspects of general demography factors, disease and treatment and psychosocial aspects, summarizes and puts forward the countermeasures of toxicity of IBD patients to reduce the economic and the direction of the future study, so as to provide reference for related research.

Objective:To observe heart rate circadian rhythm in patients with chronic kidney disease (CKD) stage 5 and to analyze the effects of parathyroidectomy (PTX) on heart rate circadian rhythm in severe secondary hyperparathyroidism (SHPT) patients.Methods:A cross-sectional observation was performed in 213 patients with CKD stage 5 and 96 controls, and the patients were divided into those with severe SHPT (PTX group, n=70) and without severe SHPT (non-PTX group, n=143). Forty-six PTX patients were followed up prospectively. The baseline data were compared among these groups. Holter electrocardiogram was performed for each participant. Non-dipping heart rate was defined as night/day heart rate ratio greater than 0.9. Multiple linear regression analysis was used to analyze the related factors of heart rate circadian rhythm in patients with CKD stage 5. Results:The 24-hour, daytime and nighttime mean heart rate in patients with CKD stage 5 were all higher than those in controls, especially in PTX group (all P<0.05). The night/day heart rate ratios of controls and CKD stage 5 patients were (0.81±0.08) and (0.91±0.08) respectively ( P<0.01). Correlation analysis showed 24-hour and daytime or nighttime mean heart rate in patients with CKD stage 5 were positively correlated with serum levels of phosphorus and ln(alkaline phosphatase), while nighttime mean heart rate and night/day heart rate ratio were positively related with serum intact parathyroid hormone level. After adjusting with postoperative follow-up period (median time: 10.9 months), 24-hour and nighttime mean heart rate, and night/day heart rate ratio in PTX patients all decreased significantly (all P<0.01). Conclusions:Heart rate is increased and circadian rhythm is abnormal in patients with CKD stage 5, which are related with mineral and bone disorder. PTX significantly decreases 24-hour and nighttime mean heart rate in severe SHPT patients, and improves the heart rate circadian rhythm.

BACKGROUND: Mesenchymal stem cell (MSC)-based cell transplantation is an effective means of treating chronic liver injury, fibrosis and end-stage liver disease. However, extensive studies have found that only a small number of transplanted cells migrate to the site of injury or lesion, and repair efficacy is very limited. METHODS: Bone marrow-derived MSCs (BM-MSCs) were generated that overexpressed the erythropoietin (EPO) gene using a lentivirus. Cell Counting Kit-8 was used to detect the viability of BM-MSCs after overexpressing EPO. Cell migration and apoptosis were verified using Boyden chamber and flow cytometry, respectively. Finally, the anti-fibrosis efficacy of EPO-MSCs was evaluated in vivo using immunohistochemical analysis. RESULTS: EPO overexpression promoted cell viability and migration of BM-MSCs without inducing apoptosis, and EPO-MSC treatment significantly alleviated liver fibrosis in a carbon tetrachloride (CCl4 ) induced mouse liver fibrosis model. CONCLUSION EPO-MSCs enhance anti-fibrotic efficacy, with higher cell viability and stronger migration ability compared with treatment with BM-MSCs only. These findings support improving the efficiency of MSCs transplantation as a potential therapeutic strategy for liver fibrosis.