OBJECTIVE: To investigate correlation between preoperative C ₂ slope (C2S) and effectiveness at 2 years after short-segment anterior cervical discectomy and fusion (ACDF), with the aim of providing reliable indicators for predicting effectiveness. METHODS: One hundred and eighteen patients with cervical spondylotic myelopathy, who received short-segment ACDF between January 2018 and December 2022 and met the selection criteria, were enrolled in the study. There were 46 males and 72 females, aged from 26 to 80 years, with a mean age of 53.6 years. The operative duration was (127.6±33.46) minutes and the intraoperative blood loss was (34.75±30.40) mL. All patients were followed up 2 years. The pre- and post-operative Neck Disability Index (NDI), Japanese Orthopaedic Association (JOA) score, and visual analogue scale (VAS) score for pain were recorded. Based on the anteroposterior and lateral cervical X-ray films, the sagittal parameters of the cervical spine were measured [C ₂-C ₇ Cobb angle, C ₀-C ₂ Cobb angle, T ₁ slope, C2S, sagittal segmental angle (SSA) of the surgical segment, and average surgical disc height (ASDH) of the surgical segment]. Statistical analyses were performed to assess the differences in these indicators between pre- and post-operation, as well as the correlations between the preoperative C2S and the JOA score, NDI, and VAS score at 2 years after operation. The patients were allocated into group A (C2S >11.73°) and group B (C2S≤ 11.73°) according to the median value of the preoperative C2S (11.73°). The JOA score, NDI, and VAS score before operation and at 2 years after operation, as well as the differences between pre- and post-operative values (change values), were compared between the two groups. RESULTS: The T ₁ slope, C ₂-C ₇ Cobb angle, C ₀-C ₂ Cobb angle, SSA, and ASDH at immediate after operation and JOA score, NDI, and VAS score at 2 years after operation significantly improved in 118 patients when compared with preoperative ones ( P<0.05). Pearson correlation analysis showed that preoperative C2S was not correlated with JOA score and NDI at 2 years after operation ( P>0.05), but negatively correlated with VAS score ( P<0.05). There were 59 patients with preoperative C2S>11.73° (group A) and 59 with C2S≤11.73° (group B). There was no significant difference in preoperative JOA score, NDI, and VAS score between the two groups ( P>0.05). There were significant differences in VAS score at 2 year after operation and the change value between the two groups ( P<0.05); there was no significant difference in the JOA score and NDI ( P>0.05). CONCLUSION Patients with cervical spondylotic myelopathy and a higher preoperative C2S exhibited superior long-term pain relief and effectiveness following short-segment ACDF.
Humans ; Male ; Spinal Fusion/methods* ; Female ; Middle Aged ; Cervical Vertebrae/diagnostic imaging* ; Diskectomy/methods* ; Aged ; Adult ; Treatment Outcome ; Aged, 80 and over ; Spondylosis/diagnostic imaging* ; Pain Measurement ; Preoperative Period ; Follow-Up Studies

Background As global environmental pollutants, chronic low-dose exposure to microplastics (MPs) is increasingly recognized for its potential risks to the nervous system. However, the molecular mechanisms linking MPs to major depressive disorder (MDD) remain unclear. Objective To investigate the mechanistic link between chronic environmentally relevant-dose MPs exposure and MDD using bioinformatics, machine learning, and molecular docking approaches, and to identify key targets and evaluate their diagnostic value. Methods Potential MPs-related targets were retrieved from the Comparative Toxicogenomics Database (CTD). Differentially expressed genes in MDD were identified using the GSE98793 dataset (128 patients and 64 healthy controls, aged 18-75 years) from the Gene Expression Omnibus (GEO). MDD-related targets were integrated from multiple databases and intersected with MPs-related genes to identify common targets. A protein-protein interaction network was constructed using the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING), and hub genes were identified via six algorithms in CytoHubba. Immune infiltration analysis was performed using single-sample gene set enrichment analysis (ssGSEA) with the Bindea signature to evaluate 19 immune cell types. A competitive endogenous RNA (ceRNA) network was constructed using multiple databases. Molecular docking was performed using AutoDock Vina to evaluate binding affinities between MPs monomers and hub gene-encoded proteins. A diagnostic model was developed and validated using the GSE76826 late-onset MDD cohort (94 patients and 47 controls, age ≥50 years). Least absolute shrinkage and selection operator (Lasso) regression was applied to identify core genes, followed by single-gene gene set enrichment analysis (SG-GSEA). Results A total of 52 common MPs-MDD targets were identified. Six key genes, namely interleukin-1β (IL1B), tumor necrosis factor (TNF), interleukin 6 (IL6), peroxisome proliferator-activated receptor gamma (PPARG), catenin beta 1 (CTNNB1), and chemokine ligand 2 (CCL2), were identified and found to be enriched in neuroinflammatory responses, lipid metabolism disorders, and the Wnt/β-catenin signaling pathway. Construction of the ceRNA network revealed that 32 microRNAs (miRNAs) and 27 circular RNAs (circRNAs) had regulatory relationships with these key genes. The immune infiltration analysis showed increased peripheral eosinophils and decreased Th17 cells in MDD patients (P < 0.05). The results of molecular docking demonstrated stable binding between bisphenol A (BPA) and PPARG (ΔG=–5.82 kcal·mol⁻¹), and between styrene and IL6 (ΔG=–5.61 kcal·mol⁻¹). The diagnostic model showed excellent performance for PPARG in late-onset MDD (AUC=0.942, 95%CI: 0.899, 1.000), with a combined model AUC of 0.954 (95%CI: 0.862, 1.000). The Lasso regression model further identified CCL2 and PPARG as core regulatory genes of MPs-MDD. The SG-GSEA indicated that CCL2 was associated with immune-inflammatory pathways and mitochondrial dysfunction, while PPARG was linked to neuroplasticity and proteostasis. Conclusion Chronic low-dose MPs exposure may contribute to MDD pathogenesis through a multidimensional "immune-metabolic-neural" regulatory network. CCL2 and PPARG may serve as potential biomarkers for environmentally associated MDD, providing new molecular insights into the link between environmental pollution and neuropsychiatric disorders.

OBJECTIVES: Pelvic floor sensory training is commonly used in clinical practice for the treatment of stress urinary incontinence (SUI); however, there is a lack of comparative studies evaluating pelvic floor sensation between women with SUI and healthy controls. Additionally, normative data for two-point discrimination thresholds in the female pelvic floor region remain scarce. This study aims to compare the results of 4 sensory tests in the pelvic floor region between women with mild SUI and healthy women, in order to provide reference values for two-point discrimination thresholds in this area. METHODS: From April 1 to October 30, 2023, 108 healthy women [(32.5±3.6) years] and 90 women with mild SUI [(32.9±3.3) years] were recruited from the Third Xiangya Hospital, Central South University. Participants underwent 4 sensory tests in the pelvic floor region: Two-dot discrimination, weight perception, shape recognition, and 9-grid localization. The results were compared between the 2 groups. RESULTS: Compared with healthy women, those with mild SUI had lower sensitivity and higher thresholds in 2-dot discrimination tests in the pelvic floor region (all P<0.001). No significant differences were found between groups in weight perception, shape recognition, or grid localization tests (P>0.05). CONCLUSIONS Women with mild stress urinary incontinence have impaired two-point discrimination ability in the pelvic floor region.
Humans ; Female ; Urinary Incontinence, Stress/physiopathology* ; Pelvic Floor/physiopathology* ; Adult ; Sensory Thresholds/physiology*

Objective:To investigate the effects of breast milk to total milk intake ratio during hospitalization on the duration of antibiotic therapy in preterm infants less than 34 weeks of gestation.Methods:Clinical data of preterm infants ( n=1 792) less than 34 gestational weeks were retrospectively collected in 16 hospitals of Jiangsu Province Neonatal-Perinatal Cooperation Network from January 1, 2019, to December 31, 2021. The days of therapy (DOT) were used to evaluate the duration of antibiotic administration. The median DOT was 15.0 d (7.0-27.0 d). The patients were divided into four groups based on the quartiles of DOT: Q 1 (DOT≤7.0 d), Q 2 (7.0 d27.0 d) groups. According to the breast milk intake ratio (breast milk intake to total milk intake during hospitalization×100%), they were also divided into four groups: very-low-ratio breastfeeding group (breast milk intake ratio≤25%), low-ratio breastfeeding group (25%75%). Univariate analysis ( Chi-square test and Kruskal-Wallis rank-sum test) was used to analyze the factors influencing DOT. Spearman correlation analysis and trend Chi-square test were used to explore the relationship between breast milk intake ratio and DOT. After using multiple imputations to address missing data, two models were constructed after adjusting for different factors, and multinomial logistic regression model was applied to evaluate the effects of the breast milk intake ratio on DOT. Finally, sensitivity analysis was conducted to assess the stability of the models. Results:(1) Of the 1 792 preterm infants, there were 507 (28.3%) in the Q 1 group, 422 (23.5%) in the Q 2 group, 438 (24.4%) in the Q 3 group and 425 (23.7%) in the Q 4 group. (2) The median values of DOT in the very-low-ratio, low-ratio, medium-ratio and high-ratio breastfeeding groups were 20.0 d (11.0-31.0 d), 20.0 d (11.0-32.0 d), 13.0 d (6.0-25.8 d) and 10.0 d (4.0-21.0 d), respectively. Compared with the very-low-ratio and low-ratio breastfeeding groups, the medium-ratio and high-ratio breastfeeding groups had shorter DOT (all P<0.05). (3) After adjusting for factors with P<0.1 (prenatal glucocorticoid exposure, antimicrobial use within 24 h before delivery, gestational age at delivery, birth weight, Apgar score≤7 at 1 min, neonatal respiratory distress syndrome, infectious pneumonia and early-onset neonatal sepsis) between the DOT quartile groups, it showed that medium-ratio and high-ratio breastfeeding were protective factors in contrast to very-low-ratio breastfeeding in the Q 2, Q 3 and Q 4 groups as compared with the Q 1 group [Q 2 group: OR=0.50 (95% CI: 0.30-0.85) and OR=0.36 (95% CI: 0.26-0.51); Q 3 group: OR=0.31 (95% CI: 0.18-0.55) and OR=0.20 (95% CI: 0.14-0.29); Q 4 group: OR=0.22 (95% CI: 0.12-0.42) and OR=0.17 (95% CI: 0.12-0.26)]. Conclusion:Breast milk intake accounting for over 50% of total milk intake has a positive impact on reducing DOT in premature infants requiring antibiotics, which suggests that breastfeeding should be actively encouraged.

Objective: To establish an optimized path for health management of HBV infections among pregnant and lying-in women based on a Delphi method, so as to provide the evidence for intensifying the interruption of the mother-to-child transmission of HBV. Methods: Based on literature review and previous studies, the preliminary framework and contents of the optimized path for health management of HBV infections were constructed. Experts from epidemiology, clinical medicine and maternal and children healthcare were invited to participate in two-round Delphi consultations, and the preliminarily designed indicators were screened and revised. The score for feasibility of each indicator was calculated, and the weight of each indicator was estimated using a proportional distribution method. Results: Sixteen experts participated in the consultation, including 13 women. The participants had a mean age of (45.69±5.71) years, and a mean employment duration of (23.06±7.05) years. All participants had a degree of bachelor and above, and there were 14 experts with vice senior professional titles. The mean positive coefficient was 96.88% and the mean authority coefficient was 0.790 during the two-round expert consultations. There were significant differences in the coordination coefficient of importance, necessity and feasibility of indicators at all levels (P<0.05), and the coefficient of variation of the feasibility was all less than 0.250. The final optimized path for health management of HBV infections among pregnant and lying-in women included 6 primary indicators, 17 secondary indictors and 73 tertiary indicators. Among the primary indicators, delivery management (0.173 4), screening and evaluation (0.172 8) and pregnancy management (0.172 7) had a high weight. Conclusion A scientific and reliable optimized path is created for health management of HBV infections among pregnant and lying-in women, which has a potential value for improving the interruption of mother-to-child transmission of HBV.

Objective:To analyze the evolution of predominant Norovirus strain GⅡ.4 Sydney[P31] from 2017 to 2020 in China.Methods:Universal primers and next-generation sequencing technology were applied to establish Norovirus genogroup Ⅱ genome amplification method . Phylogenetic and key sites were analyzed on GⅡ.4 Sydney[P31] strains.Results:Among the 8 GⅡ.4 Sydney[P31] strains, 6 were successfully amplified and the genome sequences were obtained using the preliminarily established GⅡ genome amplification method . Phylogenetic analysis showed that the 6 strains obtained in this study from 2017-2020 strains grouped with the 2015-2019 GⅡ.4 Sydney[P31] reference strains in one cluster, and the Chinese strain GZ20133135 in 2013 and the 2012-2014 GⅡ.4 Sydney[P31] reference strains grouped into another one. A mutation Asp372Asn was found adjacent to the HBGA binding site Ⅱ. Epitope analysis showed that strains after 2017 have developed several aa mutations in A epitopes (297, 372, and 373), B epitopes (333), E epitopes (414), and H epitopes (309, 310), wherein the 2020 strains 20HN261 and 20HN253 have new changes in the A epitope (368) and G epitope (355) compared with the previous strains.Conclusions:The key mutation sites of the Chinese predominant Norovirus strain GⅡ.4 Sydney[P31] have been determined, which provides a scientific basis for tracking the emergence of new strains, and provides basic data for the development of vaccines against epidemic strains in China.

Objective: To investigate the first family cluster of COVID-19 in Lanzhou, so as to provide basis for improving the COVID-19 outbreak prevention capacity. Methods : On January 23, the First Hospital of Lanzhou University reported two suspected cases of COVID-19.According to the COVID-19 Epidemiological Investigation Plan ( second edition ) , general information, disease diagnosis and treatment, clinical symptoms, laboratory test results, household environment, exposure history and close contacts were collected to figure out the source of infection and routes of transmission. Results: This family cluster lasted 29 days, from January 23 to February 21, reporting nine confirmed cases ( one death ) and one asymptomatic case. There were three imported cases from Wuhan, who were the source of the cluster; and seven secondary cases, who all had close contact with the imported cases during daily life or through having dinners. The secondary attack rate was 41.18% ( 7/17 ) . Among 9 confirmed cases, the incubation period ranged from four to ten days, with a median of nine days. Except for seven secondary cases, 24 close contacts were found and detected negative in the nucleic acid tests. Conclusions The first family cluster of COVID-19 in Lanzhou is caused by the imported cases from Wuhan. All the secondary cases have had dinners and/or had contact with the imported cases, thus they are infected through respiratory droplets and close contact.

Objective:To explore the relationship between the Spike and the Gamma rhythm of the local field potential (LFP) in Alzheimer's disease (AD) transgenic mice during fear memory activity.Methods:Six-month-old APP/PS1/tau three transgenic (3xTg) mice and wild-type (WT) mice were divided into 3xTg group and WT group, with 10 mice in each group. The electrodes were embedded into the hippocampus of mice under sterile conditions, and the behavioral experiment of conditioned fear box test was carried out two weeks later. The changes of Gamma rhythm, Spike and Burst firing were recorded and analyzed by the wireless telemetry device which embedded in the mouse head. Finally, the correlation between Gamma rhythm and Spike was calculated by entropy value.Results:(1) In behavioral experiments, the freezing ratio caused by conditioned stimulation (CS) in 3xTg mice was ((54.07±2.32)%), which was significantly lower than that of WT mice ((76.21±2.88)%) ( t=4.796, P<0.01). (2) Simultaneously recorded the average power of the Gamma oscillation in the Pre-CS period of the WT mice was ((11.574±1.147) dB), which increased to ((18.108±1.177) dB) after CS ( t=3.386, P<0.01). After CS administration, the average power of Gamma in 3xTg group((12.346±1.345) dB) was significantly lower than that of WT group ( t=3.423, P<0.01). (3) The frequency of Spike release in WT mice during the Pre-CS period was ((5.667±1.475)times/s), significantly increased to ((11.008±1.335) times/s) after CS ( t=3.542, P<0.01). The frequency of Spike release of 3xTg mice after CS ((5.249±1.033) times/s) was significantly lower than that of WT group ( t=4.788, P<0.01). (4) The Burst duration of WT group in pre-CS and CS period were ((0.550±0.043)s) and ((1.075±0.034)s), respectively. It suggested that the Burst firing frequency of WT group increased significantly after conditional stimulation ( t=5.188, P<0.01). However, the release interval of 3xTg group after CS ((0.619±0.033)s) was significantly lower than that of WT group ( t=3.352, P<0.01). (5) After CS, the Spike-Gamma entropy curve of WT mice was always higher than that of 3xTg mice. The maximum correlation of WT group and 3xTG group were (0.403±0.031) and (0.314±0.028), respectively. The Spike-Gamma correlation of the 3xTg group was significantly lower than WT mice ( t=3.372, P<0.01). Conclusion:The defect of fear memory in Alzheimer's disease may be caused by the disharmony of Spike-LFP (Gamma) distribution.

Objective To detect the viscoelasticity of carotid artery in healthy volunteers using ultrasonic shear wave dispersion ( SWD ) technique ,and explore the feasibility and influencing factors for SWD parameters . Methods Forty‐five healthy volunteers were recruited and divided into elder group ( ≥50 years old) and younger group ( ＜50 years old) according to the age . T he carotid arteries were examined by SWD at systole ,axial elastic modulus ( SWER ) and viscous index ( SWDR ) were obtained . T he pulse wave velocity ( PWV ) ,a carotid artery circumferential elastic parameter was obtained and considered as the reference indicator . T he difference of SWE R ,SWDR and PWV were compared between two groups ; and the correlation between them were analyzed by Pearson analysis ,respectively . Results ① Compared with the younger group ,the carotid PWV increased ,w hile SWE R and SWDR decreased in the elder group ( all P ＜0 .05) . ②In all subjects ,SWER was negatively correlated with PWV ( r ＝ －0 .256 , P ＜ 0 .05 ) . In the elder group ,SWER was negatively correlated with systolic blood pressure ( r ＝ －0 .357 , P ＜ 0 .05 ) ,and SWDR was negatively correlated with PWV ( r ＝ －0 .393 , P ＜0 .05 ) . In the younger group ,SWDR was positively correlated with systolic blood pressure ( r ＝0 .366 , P ＜0 .05) . Conclusions Compared with the elder group ,the carotid viscoelasticity was higher in young people ,and it is correlated with PWV . SWD can evaluate carotid viscoelasticity ,and contribute to better understanding of its tissue characteristics .

Objective: To express the NS6 nonstructural protein of human norovirus (NoV) in Escherichia coli, and to detect its enzymatic activity after purification. Methods: Human NoV NS6 gene was cloned into the prokaryotic expression vector pDE1 and then was transformed into E. coli BL21 for expression. NS6 protein was purified by Ni-NTA affinity chromatography and Superdex 200 pg column. The activity of NS6 protein was determined by digestion of fusion protein 15VP1-6P at 37 ℃. Results: Human NoV NS6 protein was stably and highly expressed in E. coli. After purification, the expressed product reached a purity of more than 95%, and the relative molecular weight of NS6 protein was about 23×10³ Da. NS6 protein could cleave the fusion protein containing rhinovirus 3C cleavage site. Conclusions The nonstructural protein NS6 of human NoV was successfully expressed in Escherichia coli, which laid a foundation for further study on the pathogenesis of human NoV.