Objective:To investigate the impact and clinical outcomes of intraoperative prone-position lumbar anteroposterior (AP) fluoroscopy under anesthesia on the selection of the lowest instrumented vertebra (LIV) in the patients with adolescent idiopathic scoliosis (AIS) plus structural lumbar curves.Methods:A retrospective analysis was conducted of the clinical data of 35 patients (29 females and 6 males) with AIS who had undergone surgical posterior correction and fusion at Scoliosis Center, The Third Affiliated Hospital, Sun Yat-sen University between January 2020 and October 2023. The mean age was (17.9±5.7) years. Lenke's classification: 6 cases of type 3, 12 cases of type 4, 7 cases of type 5 and 10 cases of type 6. Preoperatively, all patients underwent standing AP and lateral radiographs of the full-length spine, left and right bending radiographs of the spine, and full-spine CT. Intraoperatively, all patients underwent prone-position lumbar AP fluoroscopy under anesthesia. The criteria for LIV selection were: (1) it should be the most cephalad vertebra touched by the central sacral vertical line (CSVL); (2) its rotation should be ≤ grade Ⅱ by the Nash-Moe classification; (3) its tilt angle should be <25°. The preoperative and postoperative LIV rotation angles were compared, and the number of lumbar fusions was compared between preoperative planning and actual surgery. Comparisons were also made between preoperation, postoperation and the final follow-up, examining Cobb angle of the major curve, Cobb angle of the minor curve, LIV inclination, coronal balance distance (CBD), sagittal vertical axis (SVA), and distance between CSVL and LIV (CSVL-LIV). The correction rates of the major curve and the minor curve, and change in LIV inclination were compared between postoperation and the final follow-up.Results:The patients were followed for (18.0±3.0) months. The LIV rotation decreased from 8.34°±4.95° preoperatively to 5.03°±2.99° postoperatively. The intraoperative fluoroscopy reduced at least one segment fusion for 57.1% (20/35) of the patients so that the number of lumbar fusions decreased significantly from 4.2±0.7 in preoperative planning to 3.6±0.8 after actual surgery ( P<0.05). The Cobb angles of the major and minor curves, LIV inclination, and CSVL-LIV at postoperation and the final follow-up were significantly lower than the preoperative values ( P<0.05), but there were no significant differences between the final follow-up and postoperation in the Cobb angle of the major cure, Cobb angle of the minor curve, or LIV inclination ( P>0.05). None of the patients required surgical revision for distal junctional complications. Conclusions:In the surgical treatment of AIS patients with structural lumbar curves, compared to the preoperative X-rays using the same criteria, intraoperative prone-position lumbar AP fluoroscopy under anesthesia can not only be a safe and effective method for LIV selection but also effectively reduce the number of lumbar fusions to preserve more lumbar mobility.

Objective To investigate the potential causal relationship between autoimmune liver diseases(AILD)and type 1 diabetes(T1D)based on two-sample Mendelian randomization(TSM R)method.Methods Genome-wide association study(GWAS)data were obtained from the Open GWAS database.Forward Mendelian randomization analysis was performed with three types of AILD as exposures and T1D as the outcome,while reverse analysis was conducted with T1D as the exposure and three types of AILD as outcomes.Single nucleotide polymorphism(SNP)that was significantly associated with the exposure was selected as instrumental variable(IV).The inverse variance weighting(IVW)method was employed as the primary analytical ap-proach to explore the bidirectional causal relationships between AILD and T1D.Sensitivity analyses,including heterogeneity tests and horizontal pleiotropy tests,were conducted to ensure the robustness of the results.Results The IVW analysis indica-ted that primary biliary cholangitis(PBC)increased the risk of T1D(OR=1.14,95％CI:1.082-1.201,P=9.41 ×10-7),while no significant associations was observed for primary sclerosing cholangitis(PSC)and autoimmune hepatitis(AIH)with T1D(PSC:OR=1.058,95％CI:0.966-1.159,P=0.223;AIH:OR=0.992,95％CI:0.953-1.033,P=0.706).Conversely,T1D was associated with an increased risk of PBC(OR=1.272,95％CI:1.143-1.416,P=1.024×10-5)and PSC(OR=1.246,95％CI:1.072-1.448,P=0.004),but not AIH(OR=1.032,95％CI:0.931-1.144,P=0.551).Conclusion This study demon-strates a bidirectional causal relationship between PBC and T1D,and T1D also increases the risk of PSC.These findings provide new insights and directions for future research into the molecular mechanisms underlying these associations.

Objective To investigate the potential causal relationship between autoimmune liver diseases(AILD)and type 1 diabetes(T1D)based on two-sample Mendelian randomization(TSM R)method.Methods Genome-wide association study(GWAS)data were obtained from the Open GWAS database.Forward Mendelian randomization analysis was performed with three types of AILD as exposures and T1D as the outcome,while reverse analysis was conducted with T1D as the exposure and three types of AILD as outcomes.Single nucleotide polymorphism(SNP)that was significantly associated with the exposure was selected as instrumental variable(IV).The inverse variance weighting(IVW)method was employed as the primary analytical ap-proach to explore the bidirectional causal relationships between AILD and T1D.Sensitivity analyses,including heterogeneity tests and horizontal pleiotropy tests,were conducted to ensure the robustness of the results.Results The IVW analysis indica-ted that primary biliary cholangitis(PBC)increased the risk of T1D(OR=1.14,95％CI:1.082-1.201,P=9.41 ×10-7),while no significant associations was observed for primary sclerosing cholangitis(PSC)and autoimmune hepatitis(AIH)with T1D(PSC:OR=1.058,95％CI:0.966-1.159,P=0.223;AIH:OR=0.992,95％CI:0.953-1.033,P=0.706).Conversely,T1D was associated with an increased risk of PBC(OR=1.272,95％CI:1.143-1.416,P=1.024×10-5)and PSC(OR=1.246,95％CI:1.072-1.448,P=0.004),but not AIH(OR=1.032,95％CI:0.931-1.144,P=0.551).Conclusion This study demon-strates a bidirectional causal relationship between PBC and T1D,and T1D also increases the risk of PSC.These findings provide new insights and directions for future research into the molecular mechanisms underlying these associations.

Objective:To investigate the impact and clinical outcomes of intraoperative prone-position lumbar anteroposterior (AP) fluoroscopy under anesthesia on the selection of the lowest instrumented vertebra (LIV) in the patients with adolescent idiopathic scoliosis (AIS) plus structural lumbar curves.Methods:A retrospective analysis was conducted of the clinical data of 35 patients (29 females and 6 males) with AIS who had undergone surgical posterior correction and fusion at Scoliosis Center, The Third Affiliated Hospital, Sun Yat-sen University between January 2020 and October 2023. The mean age was (17.9±5.7) years. Lenke's classification: 6 cases of type 3, 12 cases of type 4, 7 cases of type 5 and 10 cases of type 6. Preoperatively, all patients underwent standing AP and lateral radiographs of the full-length spine, left and right bending radiographs of the spine, and full-spine CT. Intraoperatively, all patients underwent prone-position lumbar AP fluoroscopy under anesthesia. The criteria for LIV selection were: (1) it should be the most cephalad vertebra touched by the central sacral vertical line (CSVL); (2) its rotation should be ≤ grade Ⅱ by the Nash-Moe classification; (3) its tilt angle should be <25°. The preoperative and postoperative LIV rotation angles were compared, and the number of lumbar fusions was compared between preoperative planning and actual surgery. Comparisons were also made between preoperation, postoperation and the final follow-up, examining Cobb angle of the major curve, Cobb angle of the minor curve, LIV inclination, coronal balance distance (CBD), sagittal vertical axis (SVA), and distance between CSVL and LIV (CSVL-LIV). The correction rates of the major curve and the minor curve, and change in LIV inclination were compared between postoperation and the final follow-up.Results:The patients were followed for (18.0±3.0) months. The LIV rotation decreased from 8.34°±4.95° preoperatively to 5.03°±2.99° postoperatively. The intraoperative fluoroscopy reduced at least one segment fusion for 57.1% (20/35) of the patients so that the number of lumbar fusions decreased significantly from 4.2±0.7 in preoperative planning to 3.6±0.8 after actual surgery ( P<0.05). The Cobb angles of the major and minor curves, LIV inclination, and CSVL-LIV at postoperation and the final follow-up were significantly lower than the preoperative values ( P<0.05), but there were no significant differences between the final follow-up and postoperation in the Cobb angle of the major cure, Cobb angle of the minor curve, or LIV inclination ( P>0.05). None of the patients required surgical revision for distal junctional complications. Conclusions:In the surgical treatment of AIS patients with structural lumbar curves, compared to the preoperative X-rays using the same criteria, intraoperative prone-position lumbar AP fluoroscopy under anesthesia can not only be a safe and effective method for LIV selection but also effectively reduce the number of lumbar fusions to preserve more lumbar mobility.

P1B-ATPases are a group of proteins that can transport heavy metal ions across membranes by hydrolyzing ATP and they are a subclass of the P-type ATPase family. It was found that P1B-ATPases are mainly responsible for the active transport of heavy metal ions in plants and play an important role in the regulation of heavy metal homeostasis in plants. In this paper, we dissusses the mechanism of P1B-ATPases from the structure and classification of P1B-ATPases, and review the current research progress in the function of P1B-ATPases, in order to provide reference for future research and application of P1B-ATPases in improving crop quality and ecological environment management.
Adenosine Triphosphatases/metabolism* ; Biological Transport ; Metals, Heavy ; Plants/enzymology*

Objective:To detect the effects of polysaccharopeptide(PSP) on MyD88-dependent signaling pathway in EAC tumor-bearing mice,and explore the immunomodulatory mechanism of PSP.Methods: Ehrlich′s ascites carcinoma(EAC) C57BL/6 mice were used to establish the animal model for solid tumor.Mice were divided into two groups:WT group and MyD88-/-group.After 22 days of treatment,quantitative real-time PCR( Q-PCR) ,Western blot and were used to detect the related gene and protein expression of TLR4 pathway in spleens,ELISA were used to detect the terminal effect factors secretion eyeball blood from each group.Results:Related genes and proteins of TLR4 pathway in spleen were up-regulated significantly from two groups.Compared with WT group, related genes and proteins in MyD88-dependent pathway(MyD88,TRAF6,NF-κB,AP-1)was down-regulated in MyD88-/-group(P<0.05).Meanwhile,There was no significant change of the related genes and proteins of MyD88-independent pathway(TRAM,TRIF)in MyD88-/-group( P>0.05 ) .The terminal effect factors secretion of IL-2, IL-6, IL-10, TNF-αand IFN-γin MyD88-/-group were decreased significantly compared with WT group(P<0.05).Conclusion:The immunoregulatory effect of PSP on EAC tumor-bearing mice may be implement through the regulation of MyD88-dependent signaling pathway.