BACKGROUND:With the rapid development of minimally invasive spinal surgery and enhanced recovery after surgery,endoscopic intervertebral fusion techniques have gradually emerged and been widely used in clinical practice in recent years. OBJECTIVE:To analyze the early clinical efficacy of uniaxial spinal endoscopic intervertebral fusion combined with posterior percutaneous pedicle screw fixation in the treatment of lumbar degenerative diseases. METHODS:135 patients with lumbar degenerative diseases treated by uniaxial spinal endoscopic intervertebral fusion combined with posterior percutaneous pedicle screw fixation in the Suining Central Hospital from October 2020 to December 2021 were enrolled in this study.There were 59 males and 76 females,aged 47-79 years.The lower limb and lumbar pain was evaluated by visual analog scale and lumbar function was assessed by Oswestry disability index before the operation,1 week,1,and 6 months after the operation,and at the end of follow-up.The overall pain recovery of patients was evaluated by the scoring criteria for low back pain surgery of Spine Group of Chinese Orthopedic Association and the lumbar physiological curvature and intervertebral fusion were evaluated on lumbar lateral X-ray preoperatively and at the end of follow-up. RESULTS AND CONCLUSION:(1)The 135 patients were followed up for(17.8±3.0)months after surgery.There was 1 case of endplate injury,1 case of cerebrospinal fluid leakage,1 case of nerve root injury,1 case of intervertebral cage subsidence and displacement,1 case of chronic infection,and 1 case of pedicle screw rupture.The complication rate was 5.2%.(2)The lumbar visual analog scale score and Oswestry disability index significantly decreased in the waist and lower limbs at various time points postoperatively compared with those preoperatively in 135 patients(P<0.05).The scoring criteria for low back pain surgery of the Spine Group of the Chinese Orthopedic Association were significantly better at the last follow-up than that preoperatively in 135 patients(P<0.05).(3)At the last follow-up,there was no significant difference in physiological curvature of lumbar vertebra as compared with that preoperatively in 135 patients(P>0.05),with a fusion rate of 95.8%.(4)It is concluded that uniaxial spinal endoscopic intervertebral fusion combined with posterior percutaneous pedicle screw fixation in the treatment of lumbar degenerative diseases has shown satisfactory early clinical results and is a highly safe minimally invasive spinal surgery mode.

Objective:To observe the efficacy of Long’s bone setting manipulation combined with hyperbaric oxygen（HBO）in the treatment of vertigo caused by cervical spondylosis of the vertebral artery type（CSA）.Methods:A total of 143 patients with CSA and vertigo treated in the Department of Rehabilitation Medicine of the Second Hospital of Shanxi Medical University from April 2019 to July 2020 were prospectively included as the research subjects by a random number table. The patients were divided into control group（72 cases）and observation group（71 cases）. The control group was treated with Long’s bone setting manipulation，while the observation group was treated with Long’s bone setting manipulation combined with HBO. The overall curative effect of the two groups was evaluated and compared by Traditional Chinese Medicine Syndrome Score Scale（TCMSSS）. The vertigo symptom of the two groups was evaluated by Dizziness Handicap Inventory（DHI）. The hemodynamic indexes of vertebral artery，including left vertebral artery（LVA），right vertebral artery（RVA）and basilar artery（BA），were detected and compared between the two groups by Doppler ultrasound.Results:After treatment，the overall curative effect of the observation group was better than that of the control group，with statistically significant difference（ P < 0.05）. No statistically significant difference in DHI scores or vertebral artery hemodynamic indexes between the two groups was observed before treatment（ P > 0.05）. After treatment，the observation group had lower DHI scores while higher indexes of LVA，RVA and BA compared with those in the control group（ P < 0.05）. Conclusion:Long’s bone setting manipulation combined with HBO has better efficacy than Long’s bone setting manipulation alone in the treatment of vertigo caused by CSA，which is more conducive to reducing vertigo symptoms and improving vertebral artery hemodynamics.

Objective:To observe the efficacy of Long’s bone setting manipulation combined with hyperbaric oxygen（HBO）in the treatment of vertigo caused by cervical spondylosis of the vertebral artery type（CSA）.Methods:A total of 143 patients with CSA and vertigo treated in the Department of Rehabilitation Medicine of the Second Hospital of Shanxi Medical University from April 2019 to July 2020 were prospectively included as the research subjects by a random number table. The patients were divided into control group（72 cases）and observation group（71 cases）. The control group was treated with Long’s bone setting manipulation，while the observation group was treated with Long’s bone setting manipulation combined with HBO. The overall curative effect of the two groups was evaluated and compared by Traditional Chinese Medicine Syndrome Score Scale（TCMSSS）. The vertigo symptom of the two groups was evaluated by Dizziness Handicap Inventory（DHI）. The hemodynamic indexes of vertebral artery，including left vertebral artery（LVA），right vertebral artery（RVA）and basilar artery（BA），were detected and compared between the two groups by Doppler ultrasound.Results:After treatment，the overall curative effect of the observation group was better than that of the control group，with statistically significant difference（ P < 0.05）. No statistically significant difference in DHI scores or vertebral artery hemodynamic indexes between the two groups was observed before treatment（ P > 0.05）. After treatment，the observation group had lower DHI scores while higher indexes of LVA，RVA and BA compared with those in the control group（ P < 0.05）. Conclusion:Long’s bone setting manipulation combined with HBO has better efficacy than Long’s bone setting manipulation alone in the treatment of vertigo caused by CSA，which is more conducive to reducing vertigo symptoms and improving vertebral artery hemodynamics.

Objective:To explore the clinical effect of Long′s bone setting manipulation combined with hyperbaric oxygen (HBO) on cervicogenic headache(CEH).Methods:A total of 80 patients with CEH, treated in the Department of Rehabilitation of the Second Hospital of Shanxi Medical University from January 2018 to May 2019 were selected and randomly divided into the observation group and the control group according to the random number table method, with each group consisting of 40 patients. The patients in the control group were treated with Long′s bone setting manipulation, while those in the observation group were treated with HBO combined with the same manipulation of the control group. The hemorheology indexes, headache index, range of motion (ROM) and visual analogy scoring (VAS) of the two groups before and after treatment were recorded and compared.Results:After 10 days treatment, the total effective rate of the observation group (95.0%) was significantly higher than that of the control group (85.0%); the difference was statistically significant ( P<0.05). The daily headache index, VAS and ROM scores, packed cell volume, plasma viscosity, fibrinogen, serum prostaglandin F2α, and arginine vasopressin of both two groups were all significantly lower than those before treatment; and those of the observation group after treatment were lower than those of the control group; these differences were statistically significant ( P<0.05, P<0.01). Conclusion:Long′s bone setting manipulation combined with HBO is effective in the treatment of CEH. This treatment, therefore, is worthy of popularization and application in clinic.

Objective:To explore the clinical effect of Long′s bone setting manipulation combined with hyperbaric oxygen (HBO) on cervicogenic headache(CEH).Methods:A total of 80 patients with CEH, treated in the Department of Rehabilitation of the Second Hospital of Shanxi Medical University from January 2018 to May 2019 were selected and randomly divided into the observation group and the control group according to the random number table method, with each group consisting of 40 patients. The patients in the control group were treated with Long′s bone setting manipulation, while those in the observation group were treated with HBO combined with the same manipulation of the control group. The hemorheology indexes, headache index, range of motion (ROM) and visual analogy scoring (VAS) of the two groups before and after treatment were recorded and compared.Results:After 10 days treatment, the total effective rate of the observation group (95.0%) was significantly higher than that of the control group (85.0%); the difference was statistically significant ( P<0.05). The daily headache index, VAS and ROM scores, packed cell volume, plasma viscosity, fibrinogen, serum prostaglandin F2α, and arginine vasopressin of both two groups were all significantly lower than those before treatment; and those of the observation group after treatment were lower than those of the control group; these differences were statistically significant ( P<0.05, P<0.01). Conclusion:Long′s bone setting manipulation combined with HBO is effective in the treatment of CEH. This treatment, therefore, is worthy of popularization and application in clinic.

Objective To study the effect of insulin on phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway in diabetic rats with myocardial ischemia reperfusion injury.Methods Diabetic rats were induced by high-sugar and high-fat diet plus intraperitoneal injection of streptozotocin (40 mg/kg).They were randomly divided into diabetic sham group (group A),diabetes ischemic reperfusion group (group B),diabetes ischemic reperfusion insulin treatment group (group C) and diabetic ischemia reperfusion + insulin Wortmaninn (PI3K inhibitors) group (group D),10 in each group.Myocardial ischemia reperfusion model in diabetic rats:heart was exposed between the third and fourth ribs of the left chest,2 mm from the lower edge of the left atrial ear,and 5-0 sterile suture was used to ligate the anterior descending coronary artery (LAD) and the great cardiac vein for 30 min,and then the perfusion was resumed for 120 min.Wortmannin (15 μg/kg) was given through femoral vein 20 min before ligation in group D,and the same amount of normal saline was given in the other 3 groups.Insulin (2 U/kg) was injected subcutaneously in group C and D 10 min before ligation,and the same amount of normal saline was injected subcutaneously in group A and group B.Plasma creatine kinase MB (CK-MB)and troponin Ⅰ (cTnⅠ) levels were measured in arterial blood after 120 min of reperfusion,and PI3K and Akt expression in myocardial tissue were detected by Western blot.Results Compared with the group A,the plasma levels of cTnI and CK-MB increased and the expressions of PI3K and phosphorylated protein kinase B (p-Akt) in myocardium decreased in the group B (P ＜ 0.05).After insulin treatment,the plasma cTnI [(0.89 ± 0.26) μg/L],CK-MB [(9.24 ±3.16) μg/L] in the myocardial tissue of the group C decreased,while the expression of PI3K (0.341 8 ±0.03 1) and p-Akt (0.673 1 ±0.028) in the myocardial tissue increased (P ＜0.05).After insulin + Wortmaninn administration,the plasma cTnI [(1.16 ±0.29) μg/L] and CK-MB [(12.57 ± 3.01) μg/L] in the group D increased,while the expression of PI3K (0.292 7 ± 0.036) and p-Akt (0.531 4 ± 0.030) in the myocardial tissue decreased,with statistically significant difference (P ＜ 0.05).Conclusions Insulin can reduce serum CK-MB and cTnⅠ levels in diabetic rats with myocardial ischemia reperfusion injury,possibly by activating PI3K/Akt signal transduction pathway,inhibiting myocardial enzyme release,and improving myocardial ischemia reperfusion injury in diabetic rats to play a protective role in myocardial cells.

Objective To explore the functional mechanism of a Chinese medicine compound “Qiangzhizufang”on rat model of Tourette syndrome ( TS) combined with fear.Methods The rat model of TS combined with fear was established by intraperitoneal injection of 3,3’-iminodipropionitrile (IDPN) combined with acoustic stimulation.After giving different drug lavage treatment, the changes of behavior of the rat models were assessed by field test and behavior test.The content of DA, TH and TH mRNA in the brain tissue was detected by HPLC, immunohistochemistry and RT-PCR, separately.Results Compared with the normal control group, stereotyped behavior and exercise behavior were increased, freezing time prolonged, but the content of DA, TH and TH mRNA in the brain tissue were not obviously changed in the model control group.Compared with the model control group, the stereotyped behavior and exercise behavior were decreased, content of DA, TH and TH mRNA in the brain tissue was decreased in the “Qiangzhizufang” group. Conclusions The Chinese medicine compound“Qiangzhizufang” can improve the behavior in rat models of TS combined with fear.This effect may be realized through down-regurating TH mRNA expression, reducing the content of TH, and reducing the dopamine synthesis.

Objective To explore the cell frequency , phenotypes and in vitro cytotoxic effects of circulating CD56+T cells in the patients with chronic HCV infection .Methods Peripheral blood mononu-clear cells (PBMCs) were isolated from 33 patients with HCV chronic infection and 21 healthy subjects. Multi-color flow cytometry was used to analyze cell frequency , expressions of activating receptors ( NKG2C, CD16 and NKp46) and inhibitory receptors (NKG2A and CD158a) on CD56+T cells.The functional mark-er for cytotoxic effects (CD107a) on circulating CD56+T cells and their cytokines expression (IFN-γand TNF-α) with or without stimulation of K 562 human Leukemia cell line were also analyzed .Then the correla-tions among the expressing levels of CD 107 a, IFN-γand TNF-αwere investigated .Results The frequency of CD56+T cells in periphery lymphocytes were significantly decreased in the patients with chronic HCV in -fection as compared with that in healthy controls ( P=0.018 ).The expressions of activating receptors (NKG2C, CD16 and NKp46) on CD56+T cells from HCV infected patients were decreased (P=0.015 for NKG2C, P=0.036 for CD16 and P=0.001 for NKp46), while there was no significant change in the ex-pressions of inhibitory receptors (P>0.05 for both CD158a and NKG2A).The concentrations of IFN-γand TNF-αsecreted by CD56+T cells in the patients with chronic HCV infection were significantly decreased with or without K562 stimulation (P<0.0001).However, in the presence of K562 cells CD107a expression on CD56+T cells were sharply decreased in the patients (P<0.0001).In absence of K562 cells, there was no significant change in CD107a expression on CD56+T cells from patients and healthy controls (P>0.05). The expressions of CD107a, IFN-γand TNF-αwere closely related under the stimulation of K562(r>0.80, P<0.0001).Conclusion The frequency of CD56+T cells was reduced in patients with chronic HCV infec-tion.Moreover, cytotoxic effects and cytokines production mediated by CD 56+T cells were also significantly impaired, indicating that the dysfunction of circulating CD 56+T cells might be associated with the persist-ence of chronic HCV infection .